GHC Nursing 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 inadequate. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 69 (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. A process and system were in place to record incidents and accidents. All incidents were reviewed by the manager to ensure action was taken where necessary and reported to all relevant stakeholders, where required. The manager had completed a lesson learnt from incidents and shared the findings with the staff team with an aim to reduce incidents from re occurring. For example, the manager had identified a high number of falls had occurred during a particular time of the day and took action by increasing staffing levels during these times.

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. A new preadmission process was in place. The manager completed face to face assessments of people’s care and support needs before they moved in. The assessments included people’s choices, preferences and wishes. The staff used this to develop electronic care and risk management plans to ensure people received safe and appropriate care and support when they moved into the care home or had to move between services.

Staff were aware of the importance of protecting people’s right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The Management team and staff understood how to safeguard people. Staff were able to explain how to recognise and report abuse or harm. One staff member told us, “Yes, I can recognise sign of abuse such as physical injuries, changes in behaviour, neglect or financial exploitation. If I suspect abuse, I would follow the safeguarding policy by reporting to line manager or safeguarding lead.” The service had systems and processes in place to record and report safeguarding concerns. The manager reviewed all incidents of safeguarding and reported these incidents to the local authority safeguarding team where required. For example, a person had multiple falls recorded and their care plan evidenced the manager had made contact with relevant external health and social care agencies for their input and discussed measures to reduce the risk of harm from falls.

The provider did not always work well with people to understand and manage risks. We received mixed feedback from people and those important to them regarding being involved with their care planning including risk management. Care Records did not always demonstrate who was involved with managing known risks. People told us, “As far as I know, I haven’t got one [care plan]. I’ve asked twice, my wife has asked and didn’t get one. She might have it now, but I don’t know.” “We had a meeting (about the care plan) a few weeks ago. They talked it through and asked my opinion.” Staff were not always provided with clear written guidance on all known risks. For example, people who had active skin damage did not always have person centred written guidance in place on how to manage the risk. Systems were in place to record information; however, staff had not always followed the process and had not recorded important information such as size or a review of the skin damage to determine its progress. This meant people were at risk of harm. After our onsite visit the manager shared the action they had taken since our visit to their electronic system to support staff to complete the required information.

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. The manager told us they use an evidence-based model. We found no evidence of what this method was and how the provided used this model to determine safe staffing levels. However, the manager could demonstrate they had increased staffing levels. They increased staffing at mealtimes to ensure people had better mealtime experiences. An activities staff member was implemented to ensure people were not at risk of boredom. They had also identified from their lessons learnt into falls, they required additional staffing during the evenings, and this was planned to start 15 September 2025. During our visit we observed sufficient staffing as people were provided with unrushed care and support and were able to choose when they wanted support, such as personal care. People told us, “They [staff] come and get me up early because they know I like to. People get up at all different times of day.” “There are a lot more staff now. [staff] are lovely.” Staff told us they felt they completed a good induction and have regular one to one supervision. One staff member told us, “Yes, I receive regular one to one supervision. I feel supported frommy managers and colleagues.”

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. The home had recently had some re decorating completed to cover chipped doors. The manager told us they had plans in place for further work to be completed. The home appeared clean, infection prevention and control measures were in place. One relative told us, “It’s fabulous here. So clean.” Staff had access to personal protective equipment such as gloves.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. People received their prescribed medicines safely. Staff completed relevant training and assessments of competency were carried out by the registered manager to ensure practice was safe. Safe arrangements were in place for the safe storage of controlled drugs. However, we observed prescribed fluid thickener left out on the breakfast trolley in the dining room, accessible to others. This placed people living with dementia at risk of harm because people could have access to these products and ingest them.