Archived: Smithy Bridge Court

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 good. At this assessment the rating has remained 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 were confident in the process for reporting accidents and incidents. They felt comfortable speaking to senior staff and nurses and felt safety events were suitably investigated. A senior staff member told us how lessons learned were shared by the provider via emails and discussed in regular meetings.

The manager explained how information from the person-centred software was analysed each morning to identify trends and any areas requiring improvement or changes in practice. We reviewed information from monthly provider meetings; these identified areas where a focus might be needed, for example people repeatedly declining oral hygiene or following a high number of falls and we saw the provider had detailed what actions were to be taken. This information was reflected in care plans which were updated accordingly.

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.

Staff reported they had a good relationship with the local GP practice, and we observed a psychologist and physiotherapist on site during the inspection. The psychologist worked with both residents and staff to help understand and better manage people's behaviours; this included observations of practice to see how staff recognised and responded to any triggers which might lead to escalated behaviours.

Where referrals were required these were mainly completed by nursing staff. They were documented appropriately, and information was also shared in staff huddles and flash meetings to ensure all staff were aware. The provider had a safe move-in protocol and accompanying form for new admissions to the home. This ensured all relevant information was captured to fully support the health and wellbeing of the person.

The provider worked with people and partners to understand what being safe meant to them and the best way to achieve that. The manager demonstrated the effective systems in place to ensure people were safeguarded from neglect and abuse.

Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, abuse, and neglect. We saw concerns were shared with relevant parties quickly and appropriately, for example the local authority and CQC. People told us they felt safe at the service and people’s relatives felt their loved ones were safe.

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 which mattered to them. Risks associated with people's care were identified and, predominantly, managed effectively.

Staff assessed and managed risks to people’s health, safety and wellbeing effectively. Appropriate mitigations were in place where people were at risk of falls and staff took appropriate action to support people. People’s care records contained detailed risk assessments; these guided staff in meeting people’s support needs, whilst minimising any identified risks. Risks were further reduced by staff who knew people’s individual care needs.

Following an increase in falls the provider had taken appropriate action. A physiotherapist employed by the service had linked in with the falls prevention team to help reduce the number of falls in the home.

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

The home had systems in place to check the home environment was safe including a daily walk around by the manager and regular audits of equipment. Staff were consistent in their approach to using and maintaining equipment with elements such as brakes and batteries being checked each time they used them.

The corridors were free from clutter and where issues with wheelchairs had been identified these were stored in a separate room to ensure they were not used. The home was divided into separate units, providing the opportunity for people to be in a male or female only unit if this was deemed most suitable for their needs.

Safety certificates including gas, electric, profile beds and lifts were up to date and a recent visit from the Greater Manchester Fire Service confirmed that the necessary fire provisions were in place.

The manager 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. The manager used a dependency tool to ensure there were enough staff to support people and on the days of inspection we observed there to be enough staff.

We received feedback from people and relatives in relation to staffing numbers; on the whole people thought there were enough staff and staff teams on units were mainly consistent. Comments included, “I like it here; the staff are alright,” and, “It’s a fine place. Basically, the staff are a regular team. They are helpful. The night staff are also good,” and, “It isn’t too bad here; the staff are kind, but they could probably do with a few more.” A relative we spoke with said, “It does seem a settled staff team; we have got to know them all.”

Staff we observed using equipment appeared competent and trained in the manoeuvres and chatted with people whilst providing assistance.There were good interactions between staff and people throughout the inspection on each floor of the home.

Staff had completed training relevant to their role so they could support people safely. For example, records indicated staff had completed manual handling training to ensure they could support people safely with their mobility.

Staff were recruited using safe recruitment checks, this included a Disclosure and Barring Service (DBS) check. A DBS provides background checks to help employers make safer recruitment decisions for roles that involve working with children and vulnerable adults. Where warranted, risk assessments were in place to support recruitment decisions.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies.

Staff had completed infection prevention and control (IPC) training and had access to guidance informing them about safe IPC practices. Staff understood their responsibilities for ensuring safe IPC practices. The environment had no mal-odours and was clean and hygienic. An issue we raised regarding one communal toilet was dealt with immediately.

There was a good stock of personal protective equipment located across the home and staff were observed using and disposing of it safely. Audits were completed for all areas; any shortfalls identified were addressed quickly to minimise the risk of the spread of infection. Staff involved in barrier nursing were aware of the steps they should take to help minimise the potential spread of infection.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Systems were in place to ensure regular medicines were given safely and at the right time.

Information about people’s medicines was recorded in electronic care plans. People were given their medicines in a safe way, and people we spoke with were happy with the way they received them. When medicines were given, they were recorded within electronic Medicines Administration Record charts (MARs). These showed people generally received their medicines in the way prescribed for them.

Managers told us staff had completed medicines training and regular competency checks ensured they gave medicines safely. Staff we spoke with and training records we saw confirmed this. There were mechanisms in place to identify, report and investigate any incidents, such as missed or late medications, to try to reduce the risk of recurrence.

There were no GP ward rounds at the home, but staff explained people were under a variety of GPs in the area. Staff had no issues and were able to seek support and advice from GPs or the Rapid Response team as and when needed.

People who had thickening powder added to drinks because of swallowing difficulties were administered these safely and records were completed accurately, however we did find a tub of thickener inappropriately stored in a kitchen drawer and not locked away. We brought this to the manager’s attention. This had been resolved by our second day of assessment and mechanisms put in place by the manager to incorporate storage checks of thickener into daily walk rounds of the home.

When medicines were prescribed to be taken ‘when required’ there was information in place to guide staff when these might be needed. Staff were knowledgeable about people’s needs and requirements. When medicines were given covertly people’s mental capacity was assessed, best interest decisions taken, and the situation discussed with prescribers.

There were suitable arrangements for medicines needing cold storage and those requiring extra security. Suitable temperature monitoring was carried out to make sure medicines were safe and effective. We identified one fridge with a temperature issue; this had already been flagged by the provider and raised with the pharmacy.