Galsworthy House Nursing Home

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

People were protected from the risk of abuse or harm. Staff understood their duty to safeguard people and the action they should take to make sure people would be protected. Safety risks to people were managed well and staff understood how to reduce risks, to keep people safe from injury or harm. Staff received relevant training to meet people’s needs. They were supported through supervision and appraisal to continuously learn and improve their working practice. Recruitment processes were robust and only suitable staff were employed to work for the service. People and staff had mixed views as to whether there were enough staff on duty to support people at all times. The provider gave assurances that there were sufficient numbers of staff to meet people’s needs. However, the provider took on board the feedback we received and had started to consult with people, to gain their feedback and views as part of a review of staffing levels, with a view to making changes if these were required.

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.

People’s feedback indicated they felt safe at the service. One person told us, “I absolutely feel safe here. No worries or concerns about anything.” Another person said, “I feel quite safe. I do understand people here are different, but safety is good. I don’t feel unsafe or uneasy here.” People were comfortable raising safeguarding concerns and confident appropriate action would be taken in response. One person told us, “I am perfectly able to look after myself and not scared about anything. I would speak out if I wasn’t happy.” A relative said, “We would talk to the manager. She is very visible and very helpful.” Another relative told us how the service had dealt with concerns they had raised. They said, “I was so pleased with the managers that they took action straight away about this and we were involved and we are going to get a report about what happened. The managers are both proactive and dealt with everything so well. They didn’t ignore it and didn’t make any excuses.”

Staff understood their duty to safeguard people from abuse. Staff knew the signs to look for that might indicate abuse and how and when to report concerns to the appropriate person or agency. A staff member told us, “I have had safeguarding training. I do know that people are different and have their own personalities. I would look to see if people behave differently. This would make me worried and I would tell the manager immediately. I know people quite well now, so I know people and if something is not right, I would tell someone.” Managers encouraged people and staff to speak up if they had safeguarding concerns. A staff member said, “[Registered nurse] says if you see something, then inform us.” The home manager told us, “I think I am very approachable and staff do come and see me. I try to encourage the staff to speak to the deputy manager as well. I try to make sure I am visible and want staff to feel comfortable that they can talk to me any time.” The home manager undertook checks to seek assurances that people were safe at the service. They told us, “We have audits and daily walkarounds and we have a lot of meetings with the staff team and with the management team. When things go wrong, we act on this. I talk to staff members and find out how things are and how people are.”

People were comfortable and at ease with staff. People had no hesitation approaching staff and asking for their help and support. Staff were attentive to people and showed genuine interest in their wellbeing. Staff appeared to know people well and were alert to any changes that might indicate people needed reassurance to reduce any anxiety or discomfort they might be experiencing.

Systems were in place to support people and staff to raise safeguarding concerns, without fear, to the relevant person or agency. The home manager understood their duty to work in line with the service’s policy and procedure for safeguarding people. This included making timely referrals and working proactively with the relevant agencies in an open and transparent way. Our checks of safeguarding records confirmed this. People’s care records showed the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty. Any conditions related to DoLS authorisations were being met.

Risks to people’s safety and wellbeing were managed well which helped people to do the things that mattered to them. People were not subject to unnecessary restrictions. One person told us, “I go out in my scooter and I know how to keep myself safe. I know when I’m being stupid or not, or safe or not. They don’t restrict me in any way. When I wanted a scooter I talked about it, about how I could have one, and we got it done.” A relative said, “[Family member] only walks a little and recently fell out of bed. She now has a big mattress beside the bed so she won’t hurt herself if it happens again. Quite a few of the staff pop in and out to check on her as she spends most of her time sitting in her room or in the corridor outside her room where there is a resident cat that she loves.” Another relative told us, “[Family member] walks with a zimmer and although her sight is poor we are happy that she is safe with the staff.” People were assured that staff were trained to use equipment safely when supporting them. One person told us, “I feel safe when they use the equipment.”

Staff were well informed about risks to people and made sure people understood how these would be managed, to keep them safe. A staff member told us, “I talk to people and make sure they are ok and comfortable. I ask for people’s permission to move them using the hoist. I make sure people are comfortable to be supported with the hoist. I reassure them and comfort them and only move them when they are ready and with their permission. You can’t force people to do things they don’t want to do.” Another staff member told us about a person they were supporting, who was at high risk of falling, and how they encouraged and supported them to use their walking frame to reduce this risk and keep them safe. Staff had been trained to use a wide range of equipment and were comfortable and confident using this to keep people safe. A staff member told us they understood people could become anxious when being hoisted and said they would demonstrate to people on themselves how the equipment would be used to reassure people it was safe to use.

People were supported by staff to stay safe at the service. Staff helped people to move safely around the environment to enable people to do the things they wanted to do, for example, take part in mealtimes or activities of their choosing. Staff were patient and made sure people moved at a pace of their choosing. Staff offered positive encouragement and support to people to help them move with confidence, particularly when using equipment such as hoists.

Systems were in place to assess, monitor and review risks to people’s safety and wellbeing at regular intervals. Staff had access to information about risks to people through people’s care records, which provided guidance about the actions they should take to keep people safe. People’s records were current and up to date with information about risks to their safety and wellbeing. People and those involved in their care, had been supported to make decisions about risks to their safety and wellbeing and how these would be managed.

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 had mixed views about whether there were enough staff to meet their needs. People told us, during busy periods, staff appeared stretched and they felt more staff were needed during these times. Comments we received from people included, “Sometimes the staff are overstretched. The mornings and evenings mostly when people are going to bed or getting up and I sometimes have to wait a while for them to come and support me. It does vary. It’s hit and miss really.” “There are 20 people on this floor and they only had 2 staff on the other night to help people go to the toilet. The staff are great but they need more of them.” “There are 2 carers from 8pm to 8am. Maybe it’s enough but they seem to take an awful long time to come. There are a lot of people that need 2 staff to help them.” And, “I feel sometimes they could do with more people. This floor is busy. First thing in the morning is when you notice it more.” People spoke positively however about the staff team and the support they received from them. One person told us, “The staff are very good and very care centred and very careful.” A relative said, “The carers are excellent.”

Staff had mixed views about whether there were enough staff on duty at all times, to meet people’s needs. Some staff thought that there were and they had enough time to undertake their duties. However, others told us the service needed more staff during busy periods to meet people’s needs. A staff member told us, “Yes, we are short of staff. We have three in the afternoon and four in the morning…we have had a lot of people leaving here. Because of the shortages I pick up a lot of extra shifts. But it does affect you…we are busiest after lunch, so we need to double up to support people as a lot of people want to have a nap after lunch.” Another staff member said, “Some days it is not enough if we have 2 carers and the nurse. It happens once a week maybe. Some days we have 4 staff. Why is that? Maybe because they were checking if it can work with less staff.” Another staff member told us, “There is agency every day. We try to cover shifts also. There is not enough staff employed. It is enough on each floor, but it includes agency.” The home manager told us staffing was planned based on people’s dependency levels at the service. They were confident there were enough staff to meet people’s needs and said, “I do think there is enough staff here. That’s my honest opinion. We don’t just follow the dependency tool. We add in additional hours as well. We are going over the agreed hours.” We shared the mixed feedback we had received from people and staff with the home manager during our visit. The home manager took on board our feedback and told us they would review staffing levels again, particularly during busier periods, and would consult with people and relatives for their views about this. They also told us that use of agency staff was decreasing and people and staff should soon start seeing the positive impact of this at the service.

People did not wait long for support from staff when they needed this. Staff responded promptly to people’s requests for assistance. Staff were present and observant when people were moving around to make sure people were safe. Staff looked in on people who chose to spend time in their rooms or in quieter spaces around the service to check if people needed anything.

Safe recruitment practices were in place to ensure suitable and competent staff were employed to support people. This included reviewing staff’s identity, their eligibility to work in the UK, references from previous employers and criminal records checks. A formal tool was used to calculate people’s dependency needs and establish safe staffing levels. At the time of our assessment, staffing levels were in line with the dependency tool, however, there was a reliance on the use of agency staff. Staff received regular training and supervision to ensure they had the knowledge and skills to undertake their duties and support people safely.

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.