St Mary's House

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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

People were protected from the risk of harm and abuse by staff who understood their responsibilities for safeguarding people. People told us they felt safe, one person said, “I have always felt safe here, safer then I was at home.” People and their relatives were involved in planning care and in managing risks. Staff knew people well and were knowledgeable about their needs and risks. Safe systems supported staff to monitor any changes and review their care needs regularly. There were enough staff to care for people safely. People told us, and we observed, they did not have to wait for their care needs to be met. Staff had received the training they needed to be effective in their roles and told us they felt well supported.

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.

Risk assessments were detailed, person centred and provided clear guidance for staff. This included risk assessments and care plans to support people with health needs including diabetes, catheter care and assistance with mobility. Appropriate assessments were used to determine the level of risk including for example waterlow assessments. Systems supported staff to monitor changes for example, weight monitoring identified increase in weight for person who was pre-diabetic and appropriate actions were taken to address increased risks. People were encouraged to remain active with activities and there was a balanced and proportionate assessment of the risks associated with those. This allowed them to participate as much as possible and to go out and about when they wanted to.

People told us they felt safe and they knew who to talk to if they had any concerns. Their comments were consistently positive and included, “I think it’s lovely…it’s very, very safe,” and, “Yes very safe, I press this (buzzer) if needed, and I can always talk to the carers (if worried).” A relative said, “We visit as much as possible, we feel they (relation) are very safe when we leave and don’t worry.” We observed people appeared comfortable in the presence of staff who knew them well. One person told us, “I have been as happy here as I have ever been in my life, I have got on well with them all (staff) since I have been here.”

Staff had received training and demonstrated a good understanding of safeguarding, including how to recognise signs of possible abuse and when to report concerns. Staff were consistent in their understanding of MCA and DoLS and gave examples about how they would support people who might lack capacity to make certain decisions. Examples included seeking consent and making decisions in people’s best interests if they were not able to give informed consent. Staff described an open culture where concerns were discussed, for example in team meetings.

Risk assessments were detailed, person centred and provided clear guidance for staff. This included risk assessments and care plans to support people with health needs including diabetes, catheter care and assistance with mobility. Appropriate assessments were used to determine the level of risk including for example assessments to determine if people's skin integrity was at risk. Systems supported staff to monitor changes for example, weight monitoring identified an increase in weight for a person who was pre-diabetic and appropriate actions were taken to address increased risks. People were encouraged to remain active with activities and there was a balanced and proportionate assessment of the risks associated with those. This allowed them to participate as much as possible and to go out and about when they wanted to.

Staff were knowledgeable about risks to the people they supported. For example, some people needed support to move around and change position including with the use of a hoist and sling. Staff described having received the training they needed to support people safely. Staff spoke confidently and accurately on the support people needed to manage their medication, environmental risks etc as well as what actions to take in the event of an emergency for example, when a person fell and suffered a head injury staff knew the appropriate actions to take to ensure the person's safety. Staff described supporting people to be involved in making decisons about their care . For example, a staff member had discussed results of a blood test with a person and the options that were available to them. They were supported to make a decision about what steps they wished to take regarding their health needs and an appropriate referral was made to access a health care service.

Staff knew people well and understood their needs and how to support people to manage risks. People appeared comfortable with staff who were confident, kind and caring in their approach. We observed staff were aware of guidance in care plans in how to support people with risks. For example, at meal time a person who had risks associated with eating and drinking was supported with a modified meal in line with SaLT guidance.

People told us they were supported to take positive risks and were involved in planning their care. Their comments included, “I have fallen here, they have made changes when I have fallen. I got my wheely walker, I have been much better with it since. “ And, “My care plan has been discussed with me, I make changes, we made changes recently about my meals."One person told us they needed support with moving and had support from staff with a hoist and sling. They said they felt safe and had confidence in the staff skills. They told us, “I have 2 staff help me (hoist) always 2.”

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

People told us there were enough staff to meet their needs and spoke positively about staff. Comments included, “ There are enough for us, at night the staff come and help if there is an emergency.” "They come when I press my buzzer.” “ There have always been enough staff.” "5 stars, when they work over- time they are all still cheerful. Can’t fault them." People told us staff were well trained to support them. One person said, ” I think they are trained well, I have seen them with the others who need more help and they are doing everything right. A relative told us, "They are very well trained, all of them.”

There were enough staff on duty to provide safe and effective care. Call bells were answered promptly. People did not have to wait for care. We observed there were enough staff to support a relaxed dining experience. Staff were able to spend time with people with 1:1 and group activities. Staff had time to spend talking with relatives and discussion care with visiting professionals. Staff were observed to be confident and skilled when supporting people. At meal time we observed really nice encouragement from a carer who was assisting a person with their meal at a good, slow pace.

The registered manager had oversight of staff training and compliance. Staff we spoke to were positive about the training and support they received from the provider. One staff member said, “The training is good and there is always someone to call on for advice or support.” Staff described a thorough induction when new staff joined. One staff member said, following the induction training, new staff, “Still go through shadowing until we knew they were confident and competent.” Staff were receiving regular supervision and described this as helpful. One staff member described having received feedback about their practice and supported them to reflect and make improvements saying, “It helped me provide a better experience for the person.”

Training records were viewed. Staff complete a wide range of core training, including Safeguarding, First Aid, Equality and Diversity, Health and Safety, Manual Handling etc. More specific training, tailored to the specific needs of those at the home, was provided. For example, diabetes training. The provider had full and structured induction process in place for new staff. Systems supported safe recruitment decisions. Staffing levels were maintained and there was regular oversight of the staff rota to ensure enough staff were on duty. The staff rota showed staffing levels were maintained consistently.

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.