Trewan House 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 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 66 (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. There was an effective system in place for recording and monitoring accidents and incidents that occurred in the home. Accidents were analysed for any trends, and action was taken to reduce further incidents. For example, when a person experienced a skin injury, this led to an in-depth review and whole service improvements being adopted, such as improved incident records and improved records to detail communication with people’s relatives.

The provider worked with people and healthcare partners to establish and maintain safe systems of care. An electronic system was in place which recorded information about each person’s care needs, health conditions and information from healthcare professionals about current treatments, medicines prescribed and any ongoing health appointments. This enabled the provider to easily share information with other healthcare professionals when required, such as if a person was admitted to hospital. The system promoted a smooth transition between services and ensured continuity of care.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Effective safeguarding systems were in place. Safeguarding concerns were shared with the local authority when required. Staff received safeguarding training and were aware of their safeguarding responsibilities. Restrictive practice being used were legally justified, proportionate, necessary and as a last resort. People told us they felt safe living at Trewan House Care Home.

Individual risks were thoroughly considered, and risk management plans were in place to guide staff and reduce the risk of harm. Through our observations of care, we were assured staff understood people’s assessed needs and provided care in a way that kept them safe. However, some further improvement was needed to ensure all records contained consistent information relating to risk. For example, a person’s mobility care plan did not reflect they were a high risk of falls, despite their falls risk assessment stating they were. A person’s nutrition and hydration care plan contained inconsistencies about how their diet should be modified. We shared our findings with the home manager who took immediate steps to remove the inconsistencies from the care plans.

The provider mostly detected and controlled potential risks in the care environment. However, they did not always make sure equipment supported the delivery of safe care. We identified warning lights were flashing on 2 pieces of equipment required to reduce the risk of skin injuries. These concerns had not been picked up by the provider’s monitoring systems. The provider was responsive to our findings and took immediate action to reduce the risk. We were assured all equipment was functioning correctly before the end of the inspection process.

The provider held monthly health and safety meetings with the home manager and other members of the leadership team to discuss the environment and to maintain good oversight of actions required to ensure environmental safety. We found servicing and maintenance by external professionals was up to date.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. While we were assured staff were up to date with training which the provider deemed mandatory, we identified they were not always applying safe moving and handling principles in practice. For example, we observed staff supporting a person to move which did not fully promote their safety. No harm occurred as a result. We shared our findings with the home manager who took immediate action to reduce the risk through additional training and increased observations of staff.

Staff were safely recruited and we saw the necessary background checks were undertaken before they commenced employment. We saw staff undertook a range of training courses specific to people's needs, such as diabetes awareness and Parkinson's disease awareness.

The provider assessed and managed the risk of infection. Domestic staff worked hard to maintain a clean environment and our observations found the home clean and hygienic throughout. Staff followed good infection control practices, and we observed them wearing PPE when necessary. People provided positive feedback about the cleanliness of their home. One person told us, “My room is kept nice and clean” and another told us, “Oh yes, it’s spotless.”

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. There was an effective medicines management system in place. Medicines records provided sufficient information to guide staff in safe administration. At our previous assessment we highlighted concerns about unsafe medicines practice relating to the timing of paracetamol administration and a lack of records showing the placement of medicines patches. We were assured lessons had been learnt and found improvements in these areas at this assessment.