Georgian 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

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has improved to good. This meant people were safe and protected from avoidable harm.

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.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Staff told us they were listened to and there was a culture of shared learning and openness. One commented; “All our staff can go to all the managers. They all have their own roles, so we need to tell them if there are any issues and they listen always. We also have staff meetings, and we talk about all the problems we are facing when supporting the residents and they are sorting those out and it is working smoothly now.” We found learning influenced working practice. For example, staff did not wear highly patterned clothing due to the potential impact on people with dementia or visual disturbances.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. When people with a learning disability or autistic people, moved into the service managers took time to help ensure they were able to meet the person’s needs and had a good knowledge of their communication styles. This had resulted in good outcomes for people when they had needed to move from their previous home.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. A safeguarding lead had been employed since the last inspection. This had resulted in better oversight of matters relating to safeguarding. The role included oversight of safeguarding issues, auditing daily notes and incident reports so they could quickly identify any developing areas of concern. Everyone living at Georgian House had been offered easy read safeguarding information and opportunities for raising concerns had been increased. The service was holding money for some people. We checked the amounts held with receipts and records and found these tallied. We did identify some areas for improvement in how people’s personal monies and expenditures were recorded and monitored. We discussed this with managers who agreed they would look at this. People were supported in line with the requirements of the Mental Capacity Act (MCA). Systems for assessing capacity had improved since our previous inspection. Capacity assessments were decision specific, and people had been involved as much as possible. Restrictive practices were monitored to ensure they were the least restrictive and in the person’s best interest. Any changes were highlighted to the relevant Deprivation of Liberty Safeguard (DoLS) team Staff were confident any safety concerns they reported would be dealt with. One commented; “If I witnessed any abuse, I would inform the senior and the senior would inform further up. If they didn’t, I would go higher, but I think the managers would always take action.” Relatives had no concerns about the safety of the service. One commented; “I personally have never seen anything to cause concern at all."

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Risk assessments were completed which identified the level of risk and provided guidance for staff on how to support people safely. Since the previous inspection systems for oversight of incidents had been strengthened. Accidents and incidents were recorded. These were reviewed regularly so any new risks would be quickly identified.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. A new electronic system had been introduced where staff could record any defects or breakages in the service. A member of staff told us; “Since it has been in place I have felt fewer issues are being picked up on Health and Safety audits every month as these are being immediately reported and dealt with via the system.” Checks relating to utilities and fire safety were completed. Any areas for improvement were completed in a timely manner. Since the previous inspection changes had been made to how the premises were used creating more shared spaces. The registered manager told us this had resulted in one particular area being less busy and the number of incidents in this space had decreased as a result. Staff had walkie-talkies so they could call for additional support if needed. An external professional told us; “There is always a member of staff to greet you at the door, which is coded for security reasons. That member of staff will ask you to check in electronically and to check out. They never leave you unattended at any time.”

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. A relative commented; “There are always staff dotted around, on the stairs, in the corridors and communal rooms.” Since the previous inspection a new rota system had been introduced. This enabled managers to evidence how staff had been deployed and monitor where agency staff were supporting people. For example, these records showed agency staff, who did not know people well, were not allocated to work with people at risk of choking or people with more complex needs. Since the previous inspection improvements to staff training had been made. Staff received training in areas identified as necessary for the service, including training on how to support people with specific mental health conditions and behaviours such as hoarding, trauma informed practice and how to support people with a learning disability or autistic people. An in-house trainer had been employed who regularly monitored staff practice to enable them to identify if additional training was required, either for individual members of staff or for teams of staff. A member of staff told us; “[Trainer’s name] is approachable and will be around the floor and observing and updating us if we need it.” Supervision was not taking place as regularly as planned. This had been identified as an area for improvement and senior staff were reviewing how supervision was managed. Systems for safe recruitment were robust. All references seen were extremely positive indicating a good calibre of staff. Pre-employment checks were completed before new staff started work. Disclosure and Barring (DBS) checks were regularly reviewed.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. The service employed dedicated housekeeping staff. Cleaning schedules were used for specific areas of the service. Monthly infection control audits were completed. A member of staff told us; “We wear gloves and, if we have to, we wear masks and aprons, they have to be taken off as you come out the room and put in the yellow bins. And we have all the infection control and COSSH training. The blue cloths, mops and buckets are for the laundry and red for toilets and bathrooms, green for rooms and corridors and yellow is for the kitchen and that is very important.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Some people chose to self-administer their medicines and there were processes to support this. People received their medicines safely and as prescribed. Medicines were stored safely including those which required additional security checks. Staff received training and had their competency assessed. Any errors were documented and appropriate action taken to mitigate the risk of reoccurrence. Staff told us they found training was useful and supportive. People’s support needs for their medicines were recorded in their care plans. We observed a medicines round and saw people’s preferences were known and respected. Medicine Administration Records (MAR) were completed appropriately. Regular medicines audits were carried out so any errors would be quickly identified.