- Care home
House of St Martin
Report from 11 July 2024 assessment
Contents
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
Safe
People received safe care which respected their rights.
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.
Learning culture
People lived in an environment where the current management team were continually looking at improvements and enhancements to the care and support people received.
A member of staff told us that there was an open culture which enabled mistakes to be talked about so that learning could take place. One member of staff said, “There is lots of reflective practice. It encourages you to come forward.”
The provider took action to make sure any shortfalls in the service led to improvements for people. For example, following out of date medication entering the home a new system of checks was put in place.
Safe systems, pathways and transitions
People who wished to move to the home had their needs assessed to make sure it was the right place for them. One person told us how staff were supporting them to move to a more independent setting and were working with other professionals to achieve this. Another person told us how staff had helped them to access healthcare support.
The registered manager told us people moving to the home were not always able to visit before moving in. They said they met with people and tried to give them as much information about the care home as possible to help them make a decision.
Professionals felt that staff at the home worked well with them to meet people’s needs.
Assessments of need were carried out in partnership with other professionals. This helped make sure people’s needs and risks were fully understood, and appropriate plans of care could be put in place.
Safeguarding
People felt safe living at the home. People told us they had keyworkers who they would be comfortable to raise concerns with. One person told us, “I feel safe here. I feel totally at home.”
Staff knew how to recognise and report concerns. All staff asked said they were confident that any concerns raised would be listened to and investigated to make sure people were kept safe. Staff spoke affectionately and respectfully about people.
People looked comfortable and relaxed with the staff who supported them. We saw people chatting and laughing with each other and staff.
The provider worked with appropriate agencies to ensure all safeguarding concerns were fully investigated. The provider worked with other professionals to ensure that any restrictions were kept under review and remained appropriate. The provider made applications for people to be legally deprived of their liberty where they needed this level of protection to keep them safe.
Involving people to manage risks
Risk assessments were written with people to make sure they were fully aware of any restrictions placed on them. People were able to tell us about measures in place to minimise risks to themselves and others.
Staff had a good understanding of the risks to, and from, people who lived at the home. Staff were able to tell us about the action they took to minimise these risks and promote quality of life and independence.
We saw people received care and support in accordance with their risk assessments. However, we also saw people were able to decline some healthcare support which may have alleviated some physical risks. People’s decisions to decline some support was respected by staff.
At the last inspection we found that risk assessments were not always up to date and reflective of people’s needs. At this assessment we found that improvements had been made. Risk assessments were robust and comprehensive in respect of people’s healthcare needs and other risks. Probation and police staff attended regular risk meetings to discuss and assess any issues and concerns. This ensured risk assessments were in accordance with restrictions and conditions relating to individuals.
Safe environments
People lived in an environment which was well maintained and appropriate to people’s needs. People we spoke with were happy with the facilities at the home. House repairs and health and safety issues were a standing agenda item for client meetings. This meant people could be kept up to date with the progress of requested repairs.
Staff did not raise any issues about the safety of the environment. One staff member told us, “The most important thing is this is people’s home. It’s safe but we've also made it a much nicer environment. Lots of the home has been redecorated, new spaces created, and we have a new garden with raised flower beds where people can do some gardening.”
Since the last inspection there had been improvements to the environment. This included soothing spaces and areas where people could work towards independence.
Weekly health and safety checks ensured that all areas of the home and equipment were maintained to a good standard. This included weekly checks on fire detecting equipment. Regular fire evacuations helped to make sure everyone knew how to respond in the event of a fire.
Safe and effective staffing
At the last inspection we found people were not always being supported by adequate numbers of staff with the appropriate skills to meet their needs. People now felt there were enough staff to support them. One person had chosen specific staff who they had built a good trusting relationship with to assist them. People told us staff were skilled at supporting them. One person said how staff had helped them to build their confidence which had led to them being able to try new things. Another person said, “Support from staff has been fantastic.”
Staff told us they felt that changes since the last inspection had meant they now had more permanent staff. Staff felt well supported by their colleagues and the current management team. One staff member said, “They've built a really good team with a much better skill set. Staff have really good knowledge and it's focused on each person. The new management team are absolutely easy to talk to. There is an open-door policy, and I feel I can go to any of the management team at any time.”
During our site visits we saw people had access to staff to support them with their physical and psychological needs.
In addition to mandatory training, staff were able to access training relevant to people’s specific needs. This had included training in end-of-life care and dementia. Safe recruitment processes were followed. There had been a focus on significantly improving the staff recruitment process. This included researching and imbedding good and innovative practice to help select, recruit and retain the right calibre of staff. Strong links had been built with universities, creating employment or placement opportunities for students with the provider. These measures had been very successful and central to the development of the current staff team.
Infection prevention and control
People lived in a clean and pleasant environment. No one raised any concerns about infection control practices.
The provider used contract cleaners to maintain cleanliness throughout the home. The registered manager told us they were looking into employing housekeeping staff as part of the staff team.
All areas of the home were clean and fresh. We saw staff used personal protective equipment, such as disposable gloves, when appropriate.
There were cleaning schedules in place to make sure all areas of the home were kept clean and hygienic. Monthly infection prevention and control audits ensured high standards were maintained.
Medicines optimisation
People received their medicines from staff who had received training and had their competency to safely administer medicines assessed. People who wished to administer their own medicines were supported to do so in a safe way. One person said, “I look after all my medication. I get a month's supply at a time. No problem with that, I'm happy doing it and know what I need to take and when.”
Staff felt confident with the system used to administer medicines. They felt the system minimised the risks of errors and was easy to audit. They told us they carried out regular stock checks which enabled them to keep track of all medicines on the premises.
The provider used an electronic system to administer medicines. All medicines which were administered were checked by two staff which minimised the risks of errors. Medicines which required additional security and recording were appropriately stored and recorded. We checked a sample of these medicines and found stocks and records were correct. Where medicine errors occurred these were fully investigated, and action was taken to minimise the risk of reoccurrence.