St Lukes Care Home

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 inspection we rated this key question requires improvement. At this inspection the rating has changed to 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.

The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learned to continually identify and embed good practice. The provider had processes in place to investigate and report safety events. Records showed staff followed processes when reporting incidents and made sure people were kept safe. Staff could confidently tell us how they would report and record incidents or accidents, such as those involving people coming to harm, using established procedures. Some people in the home were at risk of harm when they were in distress which could lead to an incident. We saw that action was taken to understand why the person had become distressed or why an incident occurred and what could be changed to prevent further occurrences.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. Care plans were in place to support people to have a good day, and strategies were in place to prevent distress. The management team worked with external professionals and partner agencies to ensure there was continuity of care for people, including when they moved between different services. When people were placed in the home, their needs were assessed and reviewed to ensure they were suited to the environment and living with other people.

People had hospital passports which included important information about them that health professionals could read if for example, they were admitted to hospital. This enabled professionals to respond to people’s immediate needs. This helped support people when transitioning to the service through their care pathway.

People were protected from the risk of abuse and their rights were upheld. The provider had a safeguarding procedure so that concerns could be reported. The registered manager ensured concerns were reported to the appropriate safeguarding authorities immediately. Staff and managers understood how to protect people from the risk of abuse and received training in safeguarding people. A staff member said, “I can identify abuse, such as physical abuse or verbal abuse, and I would report it to the manager straight away and to the safeguarding team.”

The provider had taken active steps to ensure there was an open culture. There was evidence that concerns could be raised safely, poor or unsafe practice was identified and challenged. Where restrictive practice was being used, they were legally justified, proportionate, necessary and as a last resort. There was a clear commitment to reducing them. All restrictive practices were recorded in people’s Deprivation of Liberty Safeguards. Sexual safety was considered, and people’s sexual health and sexual needs were considered and supported. People told us they felt safe. A person said, “I am safe here.” Another person smiled and nodded when we asked them if they were safe in the home.

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. At our last inspection in August 2021, we found suitable risk assessments were not in place to ensure people were safe at all times. At this inspection we saw improvements had been made and risks to people were assessed more effectively.

People were involved with assessments and reviews about the level of support they need to manage their medicines safely and to make sure their preferences were included. This was clearly documented in their care plan.

Best practice guidance was followed, and risks were identified and mitigated, ensuring people were also able to maintain their independence and dignity. This included risks relating to health conditions such as diabetes, epilepsy and brain injuries. People who had conditions such as epilepsy or choking risks, were supported effectively to protect them from the risk of avoidable harm. The service worked with people to understand and manage risks which enabled staff to deliver care that met people’s needs. People and relatives told us they were involved in the development of their risk assessments to minimise the risk of injury. A relative said, “Yes we have been involved in [family member’s] care and risks.”

The management team detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People’s individual sensory needs had been considered and there were some adaptations and reasonable adjustments made to enhance people’s quality of life. People were able to have their sensory needs met to feel relaxed when at home. The management team completed an environmental risk assessment of the home to make sure it was safe for people and for staff. This included fire safety and evacuation assessments to ensure people were kept safe and staff understood what action to take in the event of an emergency. Audits of the environment were carried out to ensure staff and people had a safe home and working environment. People and staff told us they found it comfortable and they had enough space to make it work for them.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. A staff member said, “We have enough staff and we work well together. Everyone is very supportive.” Staff completed mandatory training and an induction in key areas such as learning disabilities and autism awareness, safeguarding adults, infection control, food and nutrition and equality and diversity. Safe recruitment practices were implemented to ensure staff were appropriately and safely recruited. The registered manager ensured the process was thorough and processes were followed correctly. This included obtaining applicant’s employment history, proof of identification, work permits, references and carrying out criminal record checks with the Disclosure and Barring Service (DBS). Staff told us they were well supported and records showed they received supervision, appraisals and support with additional qualifications for their continuous development.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Infection prevention and control procedures were in place. Staff had access to sufficient supplies of personal protective equipment (PPE). Staff received training to help them maintain good standards of infection control. We observed the home to be clean and well maintained. Staff regularly sanitised and cleaned surfaces to continuously prevent the spread of infection. Staff told us they followed procedures for the use and disposal of their PPE. People and relatives also confirmed staff followed safe infection control practices.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences in line with relevant legislation, current national guidance and in line with the Mental Capacity Act 2005. They involved people in planning, including when changes happened. People’s care plans clearly stated what medicines support they needed particularly where there are difficulties in communicating so that cultural, religious, dietary and other considerations were considered.

At our last inspection, we found medicines were not always managed safely as there were no PRN protocols in place for medicines to be administered ‘as required’. Protocols should include when to administer PRN medicines and dosage instructions. At this inspection, these issues had been addressed. We saw that PRN protocols were in place for each person where applicable. Controlled drugs were managed safely in line with guidance.

Staff followed procedures for recording, auditing and administering medicines to people. Staff competency checks were carried out to assess their knowledge, skills and ability to follow safe medicine administration guidance.