St Martins

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

The rating for the key question of Safe has improved to Requires Improvement. Improvements had been made to the process of reporting and managing safeguarding concerns. Staff were now confident to raise concerns with the management team and that appropriate action would be taken. People had been given the opportunity to be involved with managing risk and making changes to keep them safe. Staff had been recruited safely and their training had improved, new staff now received an induction and their skills had been assessed. There were enough staff to meet people's needs and there had been a reduction in the use of agency staff. Medicines management had improved people received their medicines as prescribed but additional staff still required training to make sure staff were always available to administer medicines.

This service scored 47 (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.

Staff were aware of their responsibility to safeguard people from discrimination and abuse, they knew of the signs of abuse and how to report concerns about abuse. Staff were confident the management would take action when they raised concerns. Staff had completed safeguarding training and knew how to whistleblow to the local authority if needed. Staff told us, the restrictions which had been in place under the previous management had been removed and this had a positive impact on people's health and well-being. Staff told us the culture within the service had improved and the atmosphere was now open and transparent. The management team understood their responsibility to report safeguarding concerns to the local authority and to work with them to reduce the risk of the incident happening again.

There were now systems in place to record concerns, the actions taken and the outcome of any investigation by the local authority. The manager maintained the log and updated the records when appropriate. The manager had informed the Care Quality Commission of any safeguarding concerns as required by regulation and the actions taken to keep people safe.

People told us they felt safe living at the service and were confident to raise concerns with the management team. People told us their experience of living at the service had improved with the new management team, one person commented, "They let me go out more”. This person had not been supported to go out previously to attend their church services. Another person told us, “I feel safe and do not worry about the staff, they are very good to me”. We observed people happy and relaxed with staff, people were comfortable to ask for anything they wanted such as drinks, this was an improvement from our last on site visit. People and relatives were now confident to raise concerns with the management team. One visitor told us concerns they had raised about their friend had not been addressed by the previous manager and this had impacted on the persons wellbeing. They said the new manager had listened and addressed all the concerns and the person “feels very at home now”. People told us, "I could tell anyone around if I had concerns. They are very easy to talk to about situations” and “I can explain to the staff if anything worries me”.

People's care plans and risk assessments had been reviewed and updated as people's needs changed. Risks to people's health and wellbeing had been assessed using appropriate tools such as Waterlow score to assess risks to people's skin integrity. Staff reviewed these assessments, referred people to health professionals when required and put strategies in place to reduce the risks to people including pressure relieving mattresses and modified diets. Accidents and incidents were recorded and analysed for any patterns or trends, action had been taken to reduce the risk of them happening again and actions reviewed to make sure they had been effective.

Staff supported people in the way they preferred and observed people discreetly to make sure they were safe. Staff followed people's care plans and risk assessments to make sure they were as safe as possible. We observed people being supported to be as independent as possible and making decisions about risks during the day.

Risks to people's health and safety were managed with people involved as much as possible. People told us, they had spoken with staff about how to reduce risks including falls. One person told us, they had moved room so they were able to mobilise to their room independently reducing the risk of falls. Staff had reviewed people's risks and identified patterns leading to incidents, suggestions to reduce risks were discussed with people and an agreement was reached. Staff had adjusted the environment to support people to mobilise safely using walking aids when they had an individual way of walking putting them at risk. Staff had observed people's non verbal expressions and how they reacted to different approaches to managing risks, staff had adapted strategies to take this into account. This included changing drinks to a decaffinated, which reduced the person's anxiety while they could drink as much as they wanted. Another person's diabetes was being managed without taking blood test, which distressed them.

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 enough staff to meet people's needs. We observed staff had the time to spend with people. Staff were observed sitting and chatting with people as well as supporting them with meals and drinks. People were not rushed and staff supported them at their own pace.

Staff had been recruited safely. Staff had completed application forms, references had been obtained and Disclosure and Barring Service check had been completed, to make sure staff were of good character. Staff had received supervision to discuss their development needs to improve their skills and knowledge. Staff had received training which included face to face training for practical topics such as fire evacuation and first aid. New staff had completed an induction and their competency had been checked to make sure they were safe to deliver care.

People told us they felt safe living at the service and were confident to raise concerns with the management team. People told us their experience of living at the service had improved with the new management team, one person commented, "They let me go out more”. This person had not been supported to go out previously to attend their church services. Another person told us, “I feel safe and do not worry about the staff, they are very good to me”. We observed people happy and relaxed with staff, people were comfortable to ask for anything they wanted such as drinks, this was an improvement from our last on site visit. People and relatives were now confident to raise concerns with the management team. One visitor told us concerns they had raised about their friend had not been addressed by the previous manager and this had impacted on the persons wellbeing. They said the new manager had listened and addressed all the concerns and the person “feels very at home now”. People told us, "I could tell anyone around if I had concerns. They are very easy to talk to about situations” and “I can explain to the staff if anything worries me”.

Staff told us the culture within the staff team had improved and they thought they now worked well as a team. Improvements had been made to the way work was allocated and the management team could now identify if staff needed further support in their role. Staff confirmed they had received training since the last on site visit, new staff told us they had received an induction, supervision and their competency had been checked to make sure they were confident to complete their role. Staff told us they were encouraged to manage their own duty rota and cover any gaps, this had worked well and had reduced the use of agency staff.

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

Staff told us they had received training to administer medicines and were aware of their responsibility to make sure people received their medicines as prescribed. Staff described how they made sure there was enough medicines available for people. There were staff who were responsible for ordering the medicines, they told us how they made sure people's monthly medicines were correct, recorded in the electronic system and disposed of in line with guidelines.

There were processes in place to order, store, dispense and dispose of medicines safely. Medicine audits were completed regularly and action taken when there were any shortfalls found. Staff who administered medicines had received training and their competency had been checked. There was not always enough staff trained to administer medicines at night. There was a risk assessment in place to make sure people received 'when required' when they asked at night.