The Minster

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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

Care plans were in place, and where people were at risk of harm some assessments were carried out. We identified areas where improvements to records were required to ensure safe consistent care was provided. There were enough staff available to meet people’s needs. There were systems in place to ensure staff were safely recruited. Induction and training processes promoted safety, including those for agency staff. People were involved in the support they received.

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.

The provider had a safeguarding procedure in place. Details regarding this were visible on posters throughout the service. Records showed that safeguarding was discussed regularly at team meetings.

People were comfortable in the presence of staff. It was evident that staff knew people well. There was a relaxed, happy, and homely atmosphere at the service.

Staff knew how to recognise and report abuse. They said if they reported any concerns, they were confident action would be taken. The registered manager was clear about their responsibilities to report and investigate any safeguarding issues.

People told us they felt safe. When asked if they felt safe, 1 person told us, “I would say so, I would go to the manager and she would listen, one thing I like about her is she is a good listener.” Relatives told us they were happy with the care their loved ones received and they felt they were safe. Comments included, “[Relative] is well looked after in the home”, “Very happy and not sure what to improve. They treat her like her family’’, “I am quite happy. I know who to go if I need to have a word’’, “[Relative] has to be watched when eating and drinking because of choking- they have adhered to the SALT plan” and “I do feel she’s very safe- I’ve often asked her if she’s worried about anything, but she says no." People told us they made their own choices and decisions. For example, people confirmed they were able to go to bed and get up when they wanted.

Staff and the management team knew people well and were aware of people's risks and the support they needed to remain safe.

Staff supported people to be involved in the support they received. People had been involved in telling staff how they wanted to be supported when they became anxious or upset. Relatives told us they felt involved. Comments included, “They always let me know what’s going on’’ and “They keep me up to date, they phone me to let me know if she’s under the weather.’’

Care plans were in place. We found risk assessments were not always in place when risk was identified. For example, 1 person’s care plan stated they had a history of falling downstairs but did not have a risk assessment in place regarding the stairs although they regularly accessed them. The registered manager addressed this during the assessment. Care plans contained contradictory information. For example, 1 person’s care plan stated they required thickened fluids, although guidelines from a speech and language therapist stated they required normal fluids. The registered manager addressed this during the assessment. Risk assessments required reviewing to ensure they reflected the persons current needs. For example, 1 person had a choking risk assessment in place that had not been reviewed following a choking incident. Others had been reviewed, although staff did not always have access to the up to date documents. The registered manager told us about their plan to address this during the assessment. Other records viewed also required additional information to ensure they provided sufficient guidance for staff. For example, 1 person’s health records stated a physiotherapist had requested a person was supported with exercises 3 times a day. There were no details regarding this within the persons care plan. The registered manager started to address this during the assessment.

During the assessment site visit we observed people being supported in line with dysphagia assessments completed by Speech and Language Therapists in relation to difficulties with swallowing.

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 systems in place to ensure staff were safely recruited. We found 1 reference was not sought and was not within a staff members file, the registered manager addressed this during the assessment. Induction and training processes promoted safety, including those for agency staff. People’s records contained a one-page profile with essential information and dos and don’ts to ensure that new or temporary staff could see quickly how best to support them. Staff rotas were based on people’s needs and preferences. Agency staff were currently being used within the service. There were a range of checks in place to ensure agency staff had the right skills to undertake their role.

People and relatives told us there were enough staff available most of the time, and they thought staff had the right skills and knowledge. One person confirmed there was “enough staff that know me well." Relatives told us, “The staff are friendly polite and professional and caring”, “Like all homes, perhaps they might be short of staff but there seems to be plenty about when I visit’’, “When I’m there, they always seem to have a good number of staff on’’, “[staff are] familiar and regular and know them to be trained” and “Personally I think she is lucky. She has a good team looking after her. We are just so grateful that she is where she is."

We observed there were enough staff available to respond to people’s needs and wishes. Staff knew people well. Our observations of staff supporting people were positive. For example, we observed positive banter between people and staff.

Staff told us there were enough staff available to meet people’s needs, although this consisted of regular use of agency staff. Staff were happy in their roles and felt well supported. They told us they received supervision and the training they required to carry out their roles. They told us if they required any additional training, they could ask for this, and it would be provided.

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.

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