Elliscombe 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 changed to good. This meant people were safe and protected from avoidable harm.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The management team 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.

Managers and staff told us they enjoyed working with each other. There was a good sense of teamwork and communication had improved. Managers and staff listened to concerns about safety and investigated and reported safety events or ‘near misses’.

The management team had a clear vision for the service to deliver high quality and safe care to people. They focused on learning, and improving the service wherever possible.

The management team 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.

Staff contacted professionals such as GPs or district nurses if people were unwell or needed extra support. If professionals gave advice, this was recorded and staff followed this. One GP visited the home every week to review people’s health care and support. One person said, “Yes, the GP comes one day, every week.”

Care plans and risk assessments were detailed meaning accurate information was available to staff and other health care professionals if people needed to move between services. This helped to ensure people received continuity in their care.

The management team 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. Concerns were shared quickly and appropriately.

People told us they felt safe living at the home. One person said, “I am quite happy and satisfied. Everything is quite acceptable. I am not bullied.” Another person told us the best thing about Elliscombe House was “The feeling of safety.”

One relative said people’s safety had significantly improved over the last year. They told us, “People here were not always safe [in the past]. There was a lack of permanent staff, the manager had left and there were lots of agency staff used. That is all over now and it has really improved here. All the staff here now are brilliant, lovely people.”

Staff were trained in safeguarding and knew what signs may indicate potential abuse and how to report concerns to external partners such as the local authority or the CQC. Safeguarding concerns were reported, and any actions were taken seriously by the management team and staff team.

At the last assessment we found the provider had failed to assess and do all that was reasonably practicable to mitigate risks to people who received care. This placed people at risk of harm. At this assessment we found significant improvements had been made.

The management team had worked with people to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. People and relatives told us risks were well managed when care was provided.

People’s care records included information about individual risks and how staff should work to minimise risks to people. For example, risks around mobility, equipment use, skin integrity, falls and eating and drinking were assessed and regularly reviewed.

The management team detected and controlled potential risks in the care environment. They made sure equipment and facilities supported the delivery of safe care.

People told us the home was well maintained. The maintenance person had systems to ensure all equipment, such as fire detecting equipment and hot water temperatures, were regularly tested. External contractors were also used to ensure servicing of equipment took place to promote the safety of people and staff. There was no certificate available to confirm if legionella testing on the water system had been carried out. However, the owner told us this test had been done and was up to date.

A recent fire drill had taken place and staff responded well. The fire alarm system was linked to the local fire station. If the home needed to be evacuated in an emergency, there was a designated safe place for people to go to locally.

At the last assessment we found the provider had failed to ensure staff were suitably qualified, competent, skilled and experienced. Staff had not been provided with supervision or appraisals. At this assessment we found significant improvements had been made.

The management team 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.

People said they liked and trusted the staff who cared for them. One person said, “I feel safe being looked after by properly qualified staff and trained nurses.”

Staff told us their training and support had improved. When staff needed to complete training or required a refresher, this was organised for them. Staff told us a lot of training was online, but they felt it was good quality. Staff had also undertaken some nutritional training with the chef. This meant staff had a better understanding of the importance of good nutrition in maintaining good health. One member of staff said, “It really made me think about things.”

Staff told us they would like additional training in areas such as Parkinson’s disease, caring for people living with dementia and in team leadership skills. This was fed back to the registered manager who said they would include this in their training plan for staff.

Formal supervision meetings with staff and regular staff meetings were held. Records of staff meetings showed these were well attended, covered a range of topics and staff were encouraged to raise any issue they wished to discuss.

The management team had been successful in recruiting new staff; the use of agency staff had reduced significantly. People living at the home were involved in selecting new staff. Staffing levels were determined by people’s needs and kept under review. People were supported by staff who had been recruited safely. Appropriate checks were carried out on all new staff to ensure they were able to work in the UK, of good character and safe to support vulnerable people. This helped to ensure people’s safety.

The management team assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. One person said, “It [the home] is spotlessly clean. I have no complaints.”

The head housekeeper took the lead on infection prevention and control. They had cleaning schedules in place which ensured all areas of the home were maintained to a high standard.

There were ample supplies of personal protective equipment (PPE), such as disposable gloves and aprons. Staff had easy access to PPE. We observed a thoroughly clean environment and staff using PPE during our site visits. This meant people were protected from the risk of infection.

At the last assessment we found the provider had failed to ensure medicines and treatments were safe and met people’s needs, capacities and preferences by enabling them to be involved in planning, including when changes happen. At this assessment we found many improvements had been made but further improvements were necessary.

The service had systems and processes in place to manage medicines safely, however these were not always effective. Medicines which required administration at specific times were well managed. Creams people used had not been dated when they had been opened so it was not possible to confirm if they were still in date. Instructions for giving ‘as and when required medicines’ needed to be improved as these sometimes gave vague or incorrect instructions to staff. Pain relief was poorly recorded, with no indication of the level or area of pain or if any relief had been obtained from the medicines provided. Medicine competencies for some staff who currently give medicines to people were out of date.

All of these issues were discussed with the home’s clinical lead nurse who will ensure these areas were improved upon. An improvement plan had been put in place before our third visit to the home. This showed these issues would be resolved promptly.

People who received support with medicines told us it was administered appropriately and at the right time. One person said, “Regarding my medication, they [staff] stay and ensure that you take them. I take vitamin D which is good because I don’t get out and about very much.”

Medicines were stored safely and securely in line with legal requirements.