St Giles

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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

We reviewed 5 quality statements under this key question; safeguarding, involving people to manage risk, safe and effective staffing, infection prevention and control and medicines optimisation. During the onsite site assessment people told us they felt safe living at St Giles. Concerns about safety were listened to, investigated and reported to the relevant local authority where required, however the provider failed to notify CQC in some instances. After the onsite assessment visit, the registered manager sent through the relevant statutory notifications retrospectively. Staff had been recruited safely. There were enough, suitably trained, staff to meet people’s needs. People received their medicines by staff who were trained to do so. Care plans contained risk information relating to individual people’s needs. Effective infection prevention and control measures were in place.

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 felt safe and had confidence in the staff at St. Giles. One person said, “I like it here, I feel safe.”

Staff had received training in how to keep people safe from harm and knew how to raise concerns with the management and with external organisations if required. One member of staff said, “I would report all concerns. I would rather report than not. We report internally and externally. Internal goes to our head office and they will check it. External goes to the local authority.”

People lived in their own self-contained flats. We saw prompts for a person on their front door reminding them to lock their door.

Safeguarding policies were in place. The provider had systems in place to ensure all safety concerns investigated and action taken to ensure people’s safety, Records showed the service had made appropriate safeguarding alerts to the local authority when necessary. However, CQC had not always been notified of incidents occurring at St Giles. We discussed this with the registered manager the need to notify the CQC when safeguard alerts have been raised with the local authority. Since the assessment visit retrospective concerns have been submitted.

Support plans and risks assessments included information on how to support people safely. One person said, “In an emergency I can press my alarm, I also have a watch so if I fall staff will know.”

Staff knew people well. They were able to tell us about people’s current needs, how they wished to be supported and where information relating to risk was recorded in people’s care plans. A member of staff said, “We have access to people’s support plans it tells us everything or the team leader would update us. I was concerned about a person’s health, so we made an appointment with their GP. They adjusted their medicines, and they are fine now.”

We observed people being safely supported in line with their care plan and risk assessments.

During the onsite assessment visit, we reviewed people’s support plans and risk assessments. We found where a person had a pre-existing health condition, such as diabetes or epilepsy, more detailed guidance was required regarding potential signs and symptoms for staff to look out for should the persons condition deteriorate. After the onsite assessment visit the registered manager provided updated risk assessments and more detailed support plans. Systems and processes were in place to cascade information regarding changes to people’s care. These were regularly reviewed by the senior team.

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

There were robust and safe recruitment practices in place to make sure all staff, including agency staff were suitably experienced, competent and able to carry out their role. People told us there were appropriate staffing levels to ensure they received their required support hours per day. One person said, “I get my hours and it is mainly the same staff supporting me.”

The registered manager told us people using the service received a weekly rota informing them which staff members would be supporting them that week. Staff told us there were enough staff to meet people’s core support hours. Comments included, “We have got contracted staff and agency staff. I think they have got everybody covered. You can cancel and there is someone else. We do shifts in block of hours, all different shifts to cover people’s individual care and support needs.” And “We do have enough staff; we have had 3 agency staff come on board. We use the same staff, so they know people well here.”

Staff knew people well. They were confident when talking about their role, safeguarding and potential risks to people. During our visit, we saw there were enough staff to provide people with the support they needed. Support was person centred and provided in line with people’s agreed core support hours.

Systems were in place to ensure there were suitably qualified, skilled and experienced staff and safe recruitment practices were followed. We checked the recruitment records for 3 members of staff and all the required pre-employment checks had been completed. This included disclosure and barring service (DBS) checks and obtaining up to date references. The service used regular agency staff for continuity of care. Agency staff had received an induction and had their medicine competency checked for safe administration of medicines.

People consented to us entering their homes on the day of our assessment visit. People’s wishes around infection prevention and control in their homes were respected. For example, where a person did not wish for their carpet to get dirty, foot protectors were provided for people entering their home.

Staff told us they had access to personal protective equipment (PPE) and had received training around infection prevention and control.

The communal areas in the main building where people came to eat if they wished or come together for social activities appeared clean and tidy throughout.

The provider had infection prevention and control policies and procedures in place. Monthly audits were undertaken, and any shortfalls were addressed.

People told us they were supported with their medicines when needed. Comments included, “The staff support me with my medicines, I do get my medicines at the time I want them.” And, “Staff help me with my medicines, I get them when I want.”

Staff received training and had their medicines competency checked to ensure the safe administration of medicines to people. A member of staff said, “I have had the training, for the past 3 months I go into the office and am asked questions. We read the policies and procedures. I also have my competency checked. I also have a book I can refer to.”

The provider had systems and processes in place for the safe management of medicines. The provider had systems and processes in place for the safe management of medicines. Regular audits were completed, and actions taken in the event of any errors or discrepancies being identified.