St Giles Hospice CQC Report 2017 St_Giles_Hospice_CQC_Report_2017 | Page 10

infection control practices.
Records showed that required servicing and maintenance of equipment used for people's care was regularly
checked and kept up to date for safe use. Where there was potential for medical emergencies to occur in
relation to people's health conditions, there were clear procedures to inform staff how to respond, which
staff understood. This included, if life preserving equipment and procedures needed to be used or followed.
This showed the provider's arrangements to manage care and service risks were comprehensive and helped
to ensure people's safety and protection.
People, relatives and staff were confident to raise any concerns they may have about people's safety in care.
All surveyed felt people were protected from harm or abuse when they received care. Procedures were in
place to enable staff, people and visitors to the service; to report any concerns they may have about people
or children's safety. The provider's written procedures showed clear lines of accountability and reporting for
safeguarding adults and children who are vulnerable, which staff understood. Staff and volunteers were
provided with guidance and training, which included multi-agency roles and arrangements for safeguarding
adults and children. The provider's safeguarding adults' staff training provision was under review to follow
new national guidance for health care staff roles and competencies. This helped to ensure that people and
children who came into contact with the service were safeguarded when required against harm or abuse.
Staff and volunteers described safe recruitment procedures were followed, which helped to make sure they
were suitable to provide people's care and support. Related records we looked at reflected this.
People, relatives and staff said that staffing arrangements were sufficient to meet people's care needs. All of
the people we spoke with confirmed they received timely care and support from the right staff at the time
needed or agreed. At the inpatient unit, we observed that staff were visible and to hand when people
needed them. Most people and relatives we surveyed in relation to people's care at home said staff arrived
on time and stayed for the agreed duration of the care call. Managers told us that staffing arrangements
were closely monitored and acted on when required to ensure people's care. For example, in the event of
staff absence from work. Contingency plans were in place in the event of staff sickness and absence and for
unexpected events and unforeseen emergencies, such as adverse weather conditions. All of the staff we
surveyed told us there was a lone worker policy in place which helped to keep them safe. This showed staff
were safely recruited and deployed.
Medicines were consistently managed by staff in a way that was safe. The provider employed a lead
pharmacist, who undertook to ensure the safe and efficient use of medicines used for people's treatment,
known as medicines optimisation. This included looking at any reported medicine incidents. A second
pharmacist provided support checking prescription charts for safety. Policies for the safe management,
optimisation and prescribing of medicines in palliative care were available and kept up to date. Nurse
competencies in medicine management were checked to ensure their understanding of the safe handling,
preparation, administration and recording of medicines.
Arrangements were in place for recording medicines prescribed for and given to people. Overall prescription
charts were clear and fully completed which showed people were getting their medicines when they needed
them. We were shown how medicines prepared in a syringe driver for one person's pain relief were checked
and recorded by two nurses. This helped to ensure the correct amount of medicine was being given to the
person. A syringe driver helps control symptoms by delivering a steady flow of liquid medication through a
continuous injection under the skin. A specific pain management chart had been developed by the service.
This was used to assess peoples' level of pain in order to determine what pain relief was required. When
people wished to self-administer their own medicines independently they were supported to do this and
10 St Giles Hospice - Whittington Inspection report 24 February 2017