Grey Gables

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

Systems were in place to manage safeguarding incidents and staff were trained in safeguarding people from the risk of abuse. There was a learning culture in place that identified themes, trends and lessons learned from incidents. There were sufficient numbers of suitably trained staff to meet people’s needs. The environment people lived in was safe and medicines were managed, stored and administered safely.

This service scored 78 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s feedback raised no concerns about learning culture. However, relatives felt their loved ones were safe living at Grey Gables.

Staff feedback demonstrated a good learning culture was in place. Staff felt confident in reporting any concerns to the registered manager and told us what steps they would take to ensure people were safe following on from an accident or incident.

Processes demonstrated a positive learning culture. Accidents and incidents were recorded, and a detailed analysis was completed. People using this service and staff were involved in these person-centred reviews. Records included the type of incident that had occurred, who was involved and looked for trends and themes such as the time of day and location of where the incident occurred. Evidence of lessons learnt was shared through regular staff meetings. In addition to the registered manager undertaking audits of accidents and incidents, the director alongside a positive behaviour support (PBS) practitioner also reviewed this to further strengthen the governance process and help reduce future risks. This improved the wellbeing of people living at Grey Gables.

People’s feedback raised no concerns about this quality statement. Relatives said that they were not always told when referrals had been made to other services, however this was in line with people’s wishes.

Staff told us they were informed of changes or new admissions to the home by handovers, messaging groups and communication logs. Staff knew where people’s risk assessments were located and told us they had time to read them. The registered manager told us that not all residents wanted their information shared with relatives and people’s wishes were taken into consideration.

Feedback from partners was positive in this area. One partner praised the transition process. They said, “They have done a good job, the transition process was excellent.” Another partner spoke highly of the service and the environment people lived in. They said, “The environment is excellent and that makes a difference to people’s lives.”

Processes supported the service working well with partners to maintain safe care. We saw evidence of referrals to other healthcare professionals being made in a timely manner. Care plans held detailed accounts of healthcare needs such as opticians and dental. Oral care plans were detailed and evidenced what the person could do for themselves and what support they needed. Pictures were displayed in people’s bathrooms with prompts on good oral hygiene. People’s needs were assessed prior to them coming into the service, these assessments were used to formulate person centred support plans. Hospital passports were in place and detailed enough to ensure the smooth transfer of information should anyone be admitted to hospitals.

People told us they felt happy living at Grey Gables and relatives felt their loved ones were safe. When asked whether they feel safe, one person said, “Yes, the staff keep me safe.”

Staff were knowledgeable about safeguarding procedures, knew where the policy was kept and felt comfortable raising concerns should they need to. Staff were aware of the escalation process of raising concerns and could identify different types of abuse. Staff told us they had training in safeguarding and the mental capacity act and spoke of the importance of gaining consent. One staff member praised recent safeguarding training they had undertaken. They said, “We have recently done safeguarding training, it was really good, and I learnt a lot.”

We observed staff to be kind and people appeared to be relaxed around them and in their environment.

Safeguarding incidents were reported, recorded and investigated by a range of senior staff members to ensure robust systems were in place to keep people safe. Extensive reports were written up following on from a safeguarding concern which detailed what immediate action was taken, recommendations and the outcome for the person and staff. Detailed analysis of safeguarding concerns had been reviewed by the registered manager, director and the head of quality within the service to look for any trends and themes and help to reduce future risks. This process added a further level of protection for people living at this service. A detailed safeguarding and whistleblowing policy was in place as well as safeguarding posters around the home detailing what to do should someone have any concerns. These policies were also available in an easy read format. Staff training compliance rates for safeguarding and the mental capacity act were high. People were supported to understand their rights under The Mental Capacity Act 2005 (MCA). MCA assessments had been completed and DoLS applications had been submitted to the assessing authority.

People’s feedback raised no concerns about safety. However, people did tell us that staff keep them safe. Relatives thought staff manage risks well. However, concerns were raised about one person’s weight management plan and how this was monitored by staff and communicated to relatives. The registered manager had a robust plan in place for this.

Staff felt confident in managing risks and felt they had enough training in this area. Staff knew what to do should someone become unwell and knew how to escalate this up to senior managers. Staff told us they felt confident in managing behaviours that challenge and that they had undertaken training in this area.

We observed risks to be well managed and people’s safety was taken into account. A lot of thought had been put into providing a safe environment for people to live in including adaptations to ensure risks to people were minimal.

Processes supported good risk management. Risk assessments were tailored to meet people’s specific needs and updated regularly. Support plans held detailed accounts of how to manage risks such as behavioural risks and everyone living at the home had a PBS plan. People’s healthcare needs were taken into consideration and there were risk assessments relating to specific health conditions.

People told us the environment they lived in was clean and maintained by staff.

Staff had no concerns about the safety or the environment at Grey Gables. Staff told us they attended fire drills and knew what to do should a fire occur. The registered manager told us about the safe systems they had in place to ensure regular checks of the environment were carried out.

We observed the environment to be safe and had been adapted to suit people’s needs. People’s safety had been carefully considered throughout the design of the home. For example, taps were replaced with touch points and were controlled so they did not flood or cause burns. Everyone living at Grey Gables had their own living area, bedroom and private bathroom. This meant people had their own space as well as the communal areas to relax in and feel safe.

Processes supported a safe environment. Regular checks on the environment were carried out to ensure people’s safety. All relevant health and safety checks had been completed and audits were undertaken regularly to ensure a safe environment was maintained. The fire risk assessment had recently been reviewed and we saw evidence of fire drills taking place at different times of the day to ensure all staff could attend. Personal emergency evacuation plans (PEEPS) were up to date and comprehensive enough to guide staff should a fire occur.

People told us they were happy with the staff. One person said, “I am happy with staff, [name of staff member] is the best I have ever had.” Relatives were also positive about the staff team. One relative said, “I cannot fault the staff, they are very kind and caring.” Another relative said, “The staff I have seen seem knowledgeable. They sit back when [relative] is with family but intervene when they need to.”

Staff told us there was enough staff and spoke highly of the induction process and how this gave them confidence to do their role. Staff were knowledgeable about the training they had completed and told us if they ever felt they needed any more training, this would be organised. Staff also praised the supervision process and said they attend regular team meetings. The registered manager and director spoke of the recruitment process and promotions in house. This was a structured process to ensure the right people were in the right roles.

There were sufficient numbers of suitably trained staff to meet people’s needs and to support them to stay safe. We witnessed kind and positive interactions between staff and people throughout our site visit. Staff interacted well with people and were seen to be patient.

Staff recruitment processes were robust and the supervision process was inclusive to ensure staff could speak up when they needed to. This included undertaking appropriate checks with the Disclosure and Barring Service (DBS) and obtaining suitable references. DBS checks provider information including details about convictions and cautions held on the Police National Computer. This information helps employers make safer recruitment choices. Lengthy inductions took place to ensure the staff member was suitable for their role. Various training courses were available to staff including a new monthly course which focused on different subjects each time. Supervisions and appraisals were regularly carried out and detailed how staff were encouraged in their role. In addition to scheduled supervisions and appraisals, staff could request a responsive supervision to discuss a recent incident or anything that was on their mind to promote staff wellbeing and to identify any issues to ensure people living at this service were safe.

People told us the environment they lived in was kept clean.

Staff told us they had undertaken training on infection, prevention and control and said there were plentiful supplies of PPE. Staff had knowledge of infection prevention and control procedures.

We observed Grey Gables to be clean, tidy and odour free. The laundry room was kept clean and there were plentiful supplies of PPE.

Processes supported good infection prevention practices. There were detailed policies in place that covered all aspects of infection, prevention and control measures that needed to be in place. Staff had undertaken training in this area and cleaning schedules were evident throughout the service.

People’s feedback raised no concerns about this quality statement. People told us they received their medicines.

Staff told us they had been trained on medicines management and had their competency checked regularly. Staff knew the process should someone refuse their medication and understood the principles of STOMP (stopping over medication of people with a learning disability, autism or both with psychotropic medicines.) The registered manager told us staff have their competency checked regularly and any concerns were raised and actioned.

Medicines were being managed, stored and administered safely. Medication plans and information around specific medicines were very detailed, and person centred. PRN protocols (for as and when required medicines) were person centred and detailed enough to guide staff. Checks of medication showed stocks were in line with what was written on the medication administration record (MAR) and audits were being undertaken. A medicines policy was in place and being followed.