St Andrews House

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

At our last inspection the provider had failed to fully assess the risks relating to the safety and wellbeing of people and the environment. At this inspection, improvements had been made and the service was no longer in breach of regulation 12. People told us they felt safe. There were sufficient staff available to meet people’s needs. Staff were recruited safely. The home was clean and staff followed good infection control and prevention practices. People received their medicines as prescribed and were supported by trained staff in the safe handling of medicine. Individual and environmental risks were well managed.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us they were involved in any risk assessments relating to their care and support. One person said, “I fell some time ago, the staff were brilliant. One of the seniors spoke to me and encouraged me to use my walking aid, which I hadn’t been doing.”

Staff knew how to report accidents and incidents. One staff member said, “All incidents are investigated, and the outcome is shared with the team, including any actions we need to take.” Minutes of staff meetings confirmed this. Monthly analysis of accidents and incidents were shared with the board of trustees.

Processes were in place to record and analyse accidents and incidents. Where needed, action was taken to prevent reoccurrence. For example, staff observations had increased for one person following a fall, whilst waiting for a mobility aid.

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 told us they felt safe living at St Andrews House and knew how to raise any concerns if they needed to.

Staff had received safeguarding training and understood their responsibilities to report any concerns to the manager. One staff member told us, “I would reassure the person and report to the manager so they could take the appropriate action.” Staff spoken with could identify the different types of abuse and actions to take to safeguard people and demonstrated a clear understanding of the provider’s policies. The management team understood their responsibilities to report any concerns to the local authority and to CQC to ensure any allegations or suspected abuse were investigated.

Throughout our visit, we saw many positive interactions between people and the staff supporting them.

Policies and procedures were in place to guide staff about how to protect people from the risks of abuse or harm. Information was available to people, staff, and relatives on how to report any concerns within the service and externally to the police, local authority and CQC. The provider made the appropriate alerts to local authorities when concerns were suspected or known. People’s capacity to make decisions were assessed and where necessary decisions made in the person’s best interests were recorded. The management team had oversight of Deprivation of Liberty Safeguards (DoL’s). Where needed legal authorisations were in place to restrict people and care records informed staff of these restrictions. Authorisations were monitored to ensure they remained up to date and proportionate for each person.

People told us and records demonstrated they were involved in discussions around their care and reducing identified risks.

Staff demonstrated a clear understanding of risks associated with people’s care and the actions to take to mitigate these.

During our visit we saw staff supporting people safely whilst using a range of equipment for example, hoists and mobility aids. Staff asked for people’s consent, engaging with them throughout to ensure they knew what was happening.

Risks associated with people’s care and support were managed safely. Up to date care plans and risk assessments were in place to provide staff with detailed guidance on how to support people safely. These included risks relating to people’s skin integrity, mobility, and dietary needs. One staff member told us, “We discuss any changes or concerns in our daily flash meeting to ensure we monitor people’s health closely.” Staff worked in partnership with a range of health and social care professionals to ensure people achieved good outcomes. For example, district nurses, GP’s, and chiropodists.

People told us there had been significant improvements in the safety and decor within the environment since our last inspection. One person said, “My toilet seat became loose, and it was fixed within the hour.”

Staff told us they felt safe at work and were confident any concerns they raised about the environment would be addressed quickly. One staff member told us, “We discuss any maintenance issues during the daily flash meeting." The staff member also shared these meetings were used to confirm scheduled checks, for example hot water temperatures, had been completed. Any outstanding checks were delegated for completion. This demonstrated lessons had been learned.

During our visit, we found the service was in a good state of repair and we had no concerns regarding the safety of the environment, this showed improvements had been made.

Since our last inspection the provider had employed a full time maintenance person who worked alongside the management team and was responsible for completing and actioning regular safety checks of the environment and equipment in use. The provider had implemented a range of effective environmental risk management processes.

People told us there were enough staff to support them safely and to respond to their requests for help without any unreasonable delays.

Staff told us there were enough staff to meet people’s needs. The deputy manager told us they monitored the staffing levels using a dependency tool to ensure people’s needs were met. Rotas viewed confirmed safe staffing levels were maintained. Staff spoken with told us they felt supported by the management team. One staff member told us, “The managers have an open-door policy, if we need any help or support, we get it.”

Staff were available when people needed them during our visit and people’s requests for assistance were responded to promptly. The atmosphere in the service was calm and friendly, staff knew people well and spent time chatting with people, ensuring they had everything they needed.

Staff were recruited safely. The provider sought references and completed DBS checks. Disclosure and Barring Service (DBS) checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. New staff received an induction and worked with an experienced staff member to get to know people and understand their care needs. One staff member told us, “I found the induction very helpful.” The management team carried out checks on staff competencies to ensure they were providing care, in line with their training.

People told us they thought the environment at St Andrews House was clean and well-maintained.

Staff had received training in infection prevention and control and demonstrated a clear understanding of how to minimise the risks of cross infection.

During our visit staff practiced good infection prevention and control. For example, staff wore and safely disposed of single use gloves and aprons. The service was clean and well maintained.

The provider completed regular IPC audits and took remedial action when required. These audits were fed back to the board of trustees who analysed the results and directed any further action if this was required.

People received their medicines as prescribed, including ‘when required’ medicines. Staff told us they had received medicines training and their competency to safely administer medicines was regularly re-assessed. Processes and systems were in place to ensure people’s medicines were ordered, stored, and disposed of safely in line with best practice guidance. Staff worked in line with the provider's medicines management procedure. Medicines record were up to date and regularly reviewed.