Good –––
Is the service safe?
support to use the toilet.” We saw this person knew how to use their call alarm which was in their reach. Staff came within one minute to support this person with their needs and this happened for other people when they used their call alarms. When we spoke with staff they told us they felt there were sufficient staff to meet people’ s individual needs and spend time with people. One staff member told us they had time to sit and comfort people when this was required or massage people’ s hands. Another staff member said it was important to be able to have the availability of staff in the day and at night. They confirmed,“ Sometimes patients are emotionally frightened to sleep at night. Nice staffing levels so we can be with the patient.” We saw people’ s needs were met in a timely way during our inspection and the registered manager assessed and reviewed staffing levels so that the services provided to people were flexible, responsive and safe.
The staff team was made up of people with a range of skills and experiences in order to meet the safety and individual needs of people who used the hospice services. For example, a doctor, nurses, health care assistants, chef and domestic staff. One staff member confirmed,“ Before I started here my suitability to work with patients was checked.” Another staff member said nurse’ s registration was checked to confirm they were safe to provide nursing care to people. We saw volunteers helped to support and complement the care people received. Staff told us suitability trained volunteers helped people in different ways, such as, taking menu’ s to people at the start of the day so that people could make their meal choices.
We saw that the arrangements for the storage of medicine were in line with good practice and national guidance. For example, medicines were stored securely and accessed by authorised staff. All medicines were checked in by staff, recorded in a personal medicine plan maintained for each person. We saw two staff members prepared a controlled medicine, which is a strong type of medicine, to be given to the person by injection. They followed safe procedures in preparing the injection. For example, staff checked and counted the medicine in the controlled medicine book and wrote out the medicine to be given and the number of containers available. They had also checked the medicine against the persons prescription chart. Staff told us, and records confirmed that only staff with the necessary training could access medicines and help people to take them at the right time. We saw this was the case as one person asked for some medicine for pain and care staff said they would tell the nurse so this person’ s request could be actioned appropriately by the staff qualified to do this. We saw and heard there were various arrangements in place to promote the safe handling and use of medicines. For example, a pharmacy technician came to the hospice daily and checked medicine stocks and prescriptions. In addition to this liquid controlled medicines were checked twice weekly by the night nursing staff and documented appropriately. If there is a discrepancy this is noted in the controlled medicine book, then checked and reviewed by the pharmacist so that the appropriate action is taken. People who used the hospice service wore medicine alerts and allergy wristbands. These practices provided additional safety precautions and checking mechanisms for staff. The registered manager confirmed to us that a learning approach was taken if staff had made a medicine error. They said this was managed positively, such as, spending time with the staff member to look at how the error could have occurred. This provided staff with learning opportunities so that they continued to administer medicines in a consistently safe way.
6 St Giles Hospice- Walsall Inspection report 21 / 12 / 2015