Gemini Assisted Living

On this page

• 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

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 75 (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 relative’s experiences of the safety of the service was positive. All relatives stated they felt their family members were well cared for and safe. One relative said, “Superb, speak from experience….. Gemini are a saver for us and [Name of person]; they have got compassion. [Name of person] is safe, very very safe, very good.” Another relative reported the management team had taken immediate action when a safeguarding incident had occurred. People said comments such as, “I am safe, yes, staff look after me, nobody hurts me” and “I like living here, I am happy …. I like all the staff everyone is nice to me. I have never felt unhappy about anything.”

People were supported to develop skills to protect themselves. The registered manager stated they supported people to understand risk in the community such as ‘stranger danger’, hate crime and harassment. Staff also helped people to understand risks when using social media on their mobile devices. The registered manager agreed to extend this support to help people understand various forms of abuse and to understand the processes to report concerns. All staff said they had been trained in safeguarding and were aware of the provider’s process in reporting any concerns. They were confident the registered manager would listen to their concerns and would take action. Staff were aware of the provider’s safeguarding policies and external safeguarding agencies.

We observed kind and compassionate interactions between people and staff. Staff provided people with choices and asked for their views and preferences. People’s wishes and privacy were respected by staff.

Systems were in place to ensure people were safeguarded from abuse and harassment. The provider had ensured staff had received safeguarding training appropriate to their role and reinforced the importance of safeguarding people in staff meetings and supervisions. The registered manager had taken the appropriate action and reported any safeguarding concerns to the relevant safeguarding agencies.

People’s relatives reported staff were very aware of people’s health needs and associated risks. Relatives reported they were involved in people’s annual and routine health checks and attending health appointments. They were kept up dated with any changes in people’s health care needs. One relative explained they were invited to attend their relative’s health care appointments with the support of the registered manager and said “Staff are proactive in keeping the hospital informed about [Name of person] health – not slapdash, very thorough and with attention to detail.” People and their relatives contributed towards the development of people’s care plans to ensure that staff had a comprehensive understanding of their required support.

Staff knew people well. They were clear about their role and were enthusiastic and spoke positively about the people they supported. Staf were knowledgeable about people’s risks and how to assist them in reducing and managing the risks effectively. For example, staff were aware of how to support people safely and administer recovery medicines when they experienced seizures. Staff were aware of and ensured people had meals and drinks in line with their dietary recommendations. Any incidents or changes in people’s health and well-being was reported to the management team and recorded on the provider’s electronic data system by staff. Staff were aware that some people became distressed in certain situations and took time to reduce or avoid certain triggers. They were aware of strategies which could be implemented to reduce people’s anxieties such as music, drives in the car and the use of weighted blankets. Staff said they supported people to attend routine health appointments, attended specialised clinics and ensured people’s care and risk plans reflected any new recommendations.

We observed safe and effective delivery of care by staff who had been trained and knew people well.

Systems were in place to identify, assess and manage people’s individual risks and to report any trends or concerns to specialised health care professionals such as seizures. The provider ensured best practice guidance was followed to help mitigate people’s risks whilst ensuring people’s choice and levels of independence were respected. Staff accessed information about people’s risks and care needs and recorded their delivery of care on the providers electronic data system. This system supported staff and managers to record, plan and coordinate people’s care in a personalised manner and to address any new or emerging risks. Effective systems were in place for staff to report and record any incidents, accidents or near misses. The registered manager analysed the reports to identify any trends or identifiable concerns, and any actions required to prevent further incidents. There was evidence of people’s reviews and discussions with relatives and staff to identify what had gone well for people and to determine any actions needed to enhance people’s quality of life. The management team and on call systems were in place to support staff when required. Systems were in place to capture people’s views such as monthly meetings with their key workers to reflect on their achievements, concerns and wishes such as activities. The provider had considered peoples and staffs compatibility such as common hobbies and interests or preferred staff gender. This helped people to engage in fulfilling activities and helped to minimise people’s anxieties and potential risks.

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

People’s relatives reported there was a consistent and well-established staff team who knew people well. One relative said, “No agency staff. No stranger coming and showering [Name of person].” Relatives raised no concerns about the skills of staff and felt staff were well trained and recruited. We received comments such as “Staff are well trained, mainly females …. All friendly and welcoming. I know all the team; I see them all on a regular basis” and “Owner chooses staff very carefully. There is consistent staff.” Relatives stated the service was flexible and staffing levels were adjusted to meet people’s needs. One relative said, “Nothing is too much trouble.”

Staff reported they had been well inducted and trained to support people including medicines training. They had been given opportunities to shadow experienced staff and felt supported by the managers. They received regular informal support and also attended regular supervision meetings to discuss their achievements, raise any concerns and discuss any personal development needs.

We observed staff supporting and engaging with people in a personalised manner and in line with best practice. It was clear that staff knew people well and had been trained to meet people’s needs.

Safe and effective staffing levels were in place to ensure people remained safe and received their funded one to one support hours to be supported to carry out activities of their choice. The registered manager shared examples of their staffing rota and explained that they tried to remain flexible to accommodate people’s needs and wishes. People benefited from an established staff team who knew people well. Unplanned staff absences were covered by permanent or bank staff. The registered manager and nominated individual also carried out shifts as required. Safe recruitment practices were being used. There was evidence that DBS checks had been obtained and references had been sought. However, not all references for some staff members provided the registered manager with evidence of good character from their previous health and social care roles. This was discussed with the registered manager who agreed to implement and record additional measures to ensure people were supported by staff of good character. Effective systems were in place to monitor staff training and identify their training requirements.

People and their families raised no concerns about the cleanliness of people’s homes or staff’s infection control practices. We received comments such as “The house is spotlessly clean”, “It’s like home from home”, “Clean, warm, tidy, bed made – welcoming” and “Nice modern house, own place for things, how a home should be.” One person said, “The house is clean. I like to help out with hoovering. We all have little jobs.”

The registered manager and staff were aware of the provider’s policies relating to infection control and the management of infection outbreaks. They told us they had access to and used personal protective equipment when supporting people with personal needs.

We observed people were supported to live in a home which was clean and well maintained. People were encouraged to be involved in the cleaning of their home and bedroom.

Staff had been trained in good infection control practices. Contingency plans were in place if an infection outbreak occurred in people’s homes. The provider had plans in place to enhance their infection control processes such as identifying an infection control lead. The lead would be responsible for completing more detailed infection control audits, develop an ‘outbreak drill’ and flow chart and develop infection control competencies to assess staff’s infection control knowledge. Arrangements were in place to support people to maintain and clean their home depending on their abilities.

People and their relatives reported they received their medicines as prescribed and raised no concerns about the management of their medicines. They received annual or earlier reviews of their medicines with relevant doctors and were informed of any prescription changes.

Staff confirmed they had been trained in safe medicines management and their skills to administer people’s medicines were regularly assessed by the management team. Staff said they had the information they needed to support people with their medicines. Robust and reviewed protocols were in place to guide staff in managing people’s allergies, medicines needed on an ‘as-required’ basis, and emergency medicines essential for recovery, such as those needed after a seizure.

We observed people receiving their medicines in a safe and personalised manner.

The provider had ensured staff were trained and competent in the management and administration of people’s medicines in a personalised manner. Medicines were managed in line with best practice and professional guidance. Medicine audits were completed weekly for people who required support with their medicines including stock balance and the use of ‘as required’ medicines. People and their relatives were involved in decisions about their medicines. The provider worked with health care professionals to ensure people’s medicines remained effective with minimal side effects. Strategies were in place and known by staff to help people manage their emotions. Medicines to help regulate people’s behaviours were used as the last resort in line with evidence-based guidance.