Devonshire Dementia Care 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

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.

The provider had developed a positive learning culture within the care home. People were encouraged and supported to raise safety concerns with managers and staff. Managers and staff understood the importance of reporting safety concerns. Systems were in place to support staff to report and record safety concerns and events when they arose. Any safety concerns or incidents that did occur were investigated and when lessons needed to be learnt this was used to continually improve staff practice.

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.

Managers gathered information about people’s individual needs and wishes, and risks to their safety, prior to moving into the care home. This information was used to develop person-centred care and risk management plans. These were shared with staff to help them provide safe and appropriate care to people from the moment they started living in the care home. Managers and staff worked closely with relevant family members and other community-based health and social care professionals to ensure care plans and risk assessments reflected people’s current needs and wishes.

The provider 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. The provider shared concerns quickly and appropriately.

People told us the care home was a safe place to live. A person said, “Yes, I like it here. The staff are nice to me, so of course I feel safe in this home.” A relative added, “The staff know what they are doing and how to keep my [family member] safe.” The managers and staff understood how to safeguard people. They knew how to recognise and report abuse and were able to articulate how they would spot signs if people were at risk of abuse or harm. A staff member told us, “I would report any abuse or neglect happening here straight away to the manager in charge of the shift.” A manager added, “I know I must report any safeguarding incidents to without delay to the local authorities safeguarding team, the CQC and police if we suspect a crime has been committed.” Managers worked proactively with the relevant agencies, when a concern was raised, and took appropriate action to safeguard people from further risk.

The service was working within the principles of the Mental Capacity Act 2005 (MCA). Appropriate legal authorisations were in place to deprive people of their liberty where this was deemed necessary to ensure their safety. Staff understood people’s capacity to make decisions about their care and support using people’s preferred method of communication. Managers and staff had received Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) training.

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 that mattered to them.

Systems were in place to ensure risks people might face were routinely assessed, monitored and reviewed. People’s care records contained sufficiently detailed information for staff to follow. This ensured risks people might face were prevented or significantly reduced. Managers and staff were fully aware of the potential risks people might face and the steps they needed to take to reduce or safely manage them. A community-based care professional told us, “Flow charts are clearly displayed through the home so staff know what action to take to reduce or safely manage every eventuality related to identified risks including, pressure wounds, infectious diseases, falls, and incidents when positive behavioural support is required.” Risk assessments and management plans were reviewed at regular intervals and updated according to reflect any changes in people’s needs.

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

People told us the care home was a safe and comfortable place to live. The environment was free from unnecessary slip or trip hazards which enabled people to move freely and safely around the care home. Safety systems and equipment people needed was in place and serviced at regular intervals to support the safe delivery of care. We saw walls in the care home had been painted contrasting colours to help a person who was visually impaired safely navigate their way around the care home. Staff had clear guidelines available to help them deal with emergencies. A community-based care professional told us, “The providers fire safety practices were adequate.”

The provider 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 provider operated safe recruitment practices, so only suitable staff were employed to work at the care home. The provider had systems to check staff suitability during recruitment and induction. They carried out a range of checks. New staff shadowed experienced workers. They completed a comprehensive induction which included training and assessments of their skills and knowledge.

Staff received the right mix of e-learning and in-person practical and theoretical training and competency-based assessments which were being routinely refreshed and updated. A community-based care professional told us, “The provider is 100 percent compliant with mandatory training for staff.” Staff also confirmed they received all the training they needed to perform their role and responsibilities well. A staff member remarked, “The training we receive here is always relevant and ongoing, whether it being in-person or an online course.” Another staff member added, “The managers place great emphasis on staff training and development within the home.”

The provider employed enough qualified, skilled and experienced staff which ensured people received their care and support from staff who were familiar with their individual needs, preferences and daily routines. Staffing levels matched the staff duty rota on the day of our site visit. Managers and staff were visibly present throughout the care home and were quick to respond to people’s questions and requests for support. People told us the care home was adequately staffed. A relative said, “There’s always plenty of staff working in the home whenever I visit my [family member].”

Staff were given regular opportunities to reflect on their practice and identify any training, learning, or support needs. They attended routine supervision meetings and team meetings with line managers and colleagues. A staff member told us, “We have regular supervision and team meetings with our line managers and co-workers, so I do feel I get all the support I need.”

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

People lived in a clean, hygienic environment. A person told us. “This is a clean home”, while a relative added, “The staff always keep the place immaculately clean.” Staff had received food hygiene and infection control training and knew how to prevent infections spreading. They had access to resources and equipment to help them reduce infection risks, which included adequate supplies of personal protective equipment [PPE].

The provider made sure medicines were safe, well-managed and met people’s needs, capacities and preferences. They always involved people in planning, including when changes happened.

Medicines systems were well-organised and safely managed. Medicines stocks, balances and records showed people consistently received their medicines as prescribed. Care records contained detailed guidance for staff about how people needed and preferred their prescribed medicines to be administered. Sufficiently detailed risk assessments and protocols for the administration of prescribed medicines were in place to guide staff.

The provider worked closely with a range of community-based health and medical care professionals to review ‘as required’ behavioural modification medicines people had been prescribed to significantly reduce their use in line with the principles of STOMP (Stop The Over-Medication of People with a learning disability). STOMP is a recognised best medicine practice programme approved by the NHS.

Staff had received medicines training and their competency to continue managing medicines safely was routinely assessed by their line managers. There were regular internal audits of the care home’s medicines practices, so any medicines errors would be identified and managed quickly. The provider had policies in place relating to the safe storage and administration of medicines. Staff were able to demonstrate how to correctly store controlled drugs as per the providers policy.