St Georges

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• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People received safe care and were protected from the risk of abuse and harm. People's care was delivered by enough suitably skilled and trained staff who were safely recruited. People's support needs and risks were assessed with detailed care plans which provided staff with the information they needed to manage any identified risk safely. Systems in place ensured people's changing needs were met. The environment was safe with appropriate arrangements in place to ensure equipment was regularly checked. People received their medicines safely and effective infection prevention and control (IPC) practice ensured people were protected from the risk and spread of infectious diseases.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People and their relatives told us they received safe care. One person told us, "I feel safe here and I get looked after well." A relative told us, "We are very happy with the care, my [family member] is settled and cared for well."

Staff understood the requirement to keep people safe and protected from harm and abuse. Staff we spoke with told us they had no concerns with care practices or safety in the home. They were all confident in raising concerns with the management team if they did. In turn, the registered manager told us they regularly offered opportunity to staff and encouraged them to share any concerns. They were satisfied their staff cared for people safely and protected them from avoidable risk of harm.

We observed throughout the assessment a relaxed and friendly atmosphere across the service. People and visitors were relaxed with staff who were and were responsive to their requests for support.

Systems were in place to record and investigate any safeguarding matters concerns to the local authority and other stakeholders. We reviewed incidents that had occurred in the service and found where required the registered manger had reported these when needed. Where people were at risk of being deprived of their liberty to protect them from harm, the registered manager had applied for Deprivation of Liberty Safeguards (DoLS) authorisations. These were kept under review and submitted as required.

People were supported in line with their assessed needs to ensure they were safe. A relative told us, "My [family member] needs a frame to be able to move around the home safely. Every time I visit they always have it with them and when they go to sit or stand up staff are on hand to help them. They always encourage them to walk themselves as much as they can and I see carers follow them with a wheelchair just in case." People and relatives commented that because the staff were consistent in the service they felt they all knew them and their needs well. This supported people to receive safe and consistent care.

Staff knew people well. Our discussions with them about the people they were caring for matched the content contained within their records. A staff member told us, "I know [Name]'s specific dietary requirements. When I support them at mealtimes, whilst I have confidence that the kitchen staff know how to prepare their meal, I also know how they should be prepared, it's like a second layer of checking."

Staff were appropriately deployed and able to respond well to support people to manage risks associated with their health and well-being. Staff supported people in a safe way and assisted people in line with their assessed needs. They responded in a timely way and the deployment and numbers of staff on duty facilitated this.

Risks to people's care were assessed and managed to support their safety. Risk assessments were detailed and gave clear instructions about how people’s needs could be met safely. For example, where people required the use of equipment to support them transferring between their beds and chairs were clearly recorded.

People told us the service was well maintained and they were free to decorate their rooms to their own taste and preferences. They also commented when communal area decor was planned to be refreshed they were offered the opportunity to give their personal ideas on how they would like it to be updated. People’s rooms were tidy and had been personalised in accordance with the people’s wishes. One person told us, "My room is really nice and it's cleaned every day." Another person said, "The home is nice and clean, it's lovely."

Staff said the environment was safe for them to work within. No accidents or incidents in relation to environmental safety had been reported.

Our observations of the environment matched the positive feedback we received from people, relatives and staff. The service was well maintained and records demonstrated that maintenance checks were completed in a timely manner. Fire safety, legionella and equipment checks were regularly undertaken in line with the recommended timeframes.

An emergency contingency plan with comprehensive and detailed information to guide staff in case of an emergency was in place. This included the use and direction to temporary accommodation if a serious incident such as a fire or flood occurred.

People and relatives told us there were enough staff deployed daily to meet their needs. They all commented when they requested support staff responded promptly and the care that they expected was delivered. One person told us,"Staff are good and around when i need them." A relative said, "There are sufficient staff here, [family member] never has to wait long."

Staff told us they had no concerns with the number of them deployed on each shift. One staff member told us, "With the number of people we have here currently the staffing level is about right. We are able to support people and not rush." The registered manager said they confident the numbers of staff they had assessed needed to be deployed was accurate and, had received no concerns from staff regarding these calculations. They added they had no care vacancies and were operating with a core group of consistent staff.

We observed throughout the inspection people being responded to promptly when they summoned staff for support. Examples included our monitoring of call bell response times by staff, and observing people in communal areas when they asked staff for support. Staff were also aware and responded to people who communicated a need for support in different ways. For example, when a person became distressed in a corridor, staff attended to the person promptly and guided them to the communal lounge which is where they indicated they wished to be.

Staff were recruited safely following the provider's recruitment policy. Prospective staff were required to evidence their performance in previous roles, a full employment history, evidence of their right to work in the UK and also evidence that they were fit to undertake the role. All staff had Disclosure and Barring Service check undertaken prior to commencing roles. This ensured the provider employed only staff suitable to work in this type of service.

People told us they felt the service was clean, tidy and well maintained. One person told us, “Staff are always tidying my room, change bedding and wash and iron my clothes." A relative said, "Things, quite a while ago, weren't that good but it is much cleaner now and the place never smells."

We discussed the concerns we received with the registered manager regarding IPC measures and their compliance with them. They offered, and went to great lengths, to demonstrate and evidence the concerns raised were unfounded and supported the inspection team to validate this. Care staff told us they had sufficient equipment and PPE to continually provide safe care. Domestic staff were deployed throughout the day and they told us they had all the equipment and materials available to them to ensure the risk of infection and cross contamination was minimised as far as practicably possible.

Our assessment was partly prompted by concerns raised to us in relation to infection prevention and control (IPC) measures in place. However, from our observations supported by records we reviewed, we found no concerns in relation IPC matters at the service. We visually inspected the majority of people's bedrooms, all communal areas, kitchens and bathrooms and found them clean, odourless and in a good state of repair. Care and ancillary staff washed their hands effectively, wore appropriate personal protective equipment (PPE) prior to delivering care and preparing and handling food, and PPE used was disposed of safely.

The registered manager had systems and processes in place to assess and manage the risk of infection. Up to date cleaning schedules were in place in place. Infection control audits were regularly completed, and action was taken where issues were found.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.