Neville House Residential 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 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 did not always have a proactive and positive culture of safety based on openness and honesty. Lessons were not always learnt to continually identify and embed good practice.

Systems were in place to record incidents and accidents, however the quality and level of detail of incident reports varied. For example, one report identified a person sustained an injury following a fall but did not explain what injury had occurred. Some incident reports did not record outcomes when medical advice had been sought, so it was not clear what action had been taken.

Staff responded appropriately to individual incidents and spoke of their confidence in doing so. The registered manager told us learning from incidents was a regular agenda item at team meetings, giving staff the opportunity to discuss and reflect. However, in addition to the recording issue, we did not see evidence of overall auditing and analysis to identify wider patterns or trends. This limited the provider's ability to learn from incidents to drive service improvements.

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.

The provider worked closely with healthcare professionals and followed guidance, supporting people to receive care that reflected their changing needs and circumstances. Staff recognised when people's needs changed and sought appropriate advice.

Staff communicated effectively with each other to help ensure continuity of care. Important information about changes to people's health, preferences and support needs was shared through regular handovers and daily communication books.

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.

The provider had effective safeguarding systems in place. Staff received safeguarding training and understood how to recognise, report and escalate concerns. They told us they felt confident raising concerns and were assured managers would respond appropriately.

People told us they felt safe at the service and would feel comfortable to raise concerns if needed. A relative said, “The staff are easy to talk to if there is an issue. We have no concerns. [Person] is looked after so well.”

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). Staff demonstrated an understanding of the importance of protecting people's rights and ensuring care was provided in the least restrictive way possible.

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.

Staff understood the risks involved with people's care and were able to describe how these were managed in practice. People and, where appropriate, their relatives were involved in discussions about their care and support, helping to ensure decisions reflected what mattered to them.

Staff were responsive to people’s changing needs and sought advice from healthcare professionals when required. Care plans were updated regularly to reflect changes which helped keep people safe while maintaining their independence.

The provider did not always detect and control potential risks in the care environment.

Environmental checks, audits and risk assessments were completed, with issues identified and addressed through management oversight processes. However, during the inspection we identified some health and safety risks not identified by the provider.

We noted 2 raised door frames in communal areas which we assessed as potential trip hazards. Many people living at the service were independently mobile using the support of mobility aids. We observed people take extra care and consideration when attempting to cross these thresholds, sometimes becoming unsteady when trying to lift their mobility aid over the frame.

Wardrobes and large fixtures were not secured to walls, which presented a potential health and safety risk. We reviewed a recent incident report in which staff responded to a person calling for help after a cabinet became unstable, causing the drawers to fall out while they were trying to prevent it from falling on top of them.

Overall, the care environment was safe and well managed. The provider took action to resolve the risks we identified during this inspection.

Equipment and technology, such as hoists and call monitoring systems, were used effectively to support people's safety and wellbeing. The provider held the required safety certificates and servicing records, and corrective action and recommendations from external professionals were acted upon promptly.

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.

Recruitment and induction processes were robust. Appropriate checks with the Disclosure and Barring Service (DBS) had been completed before staff commenced care, and staff were encouraged to sign up to the update service to ensure their DBS certificate stayed up to date.

Most staff had worked at the service for many years, with some having worked there for more than 10 years, including the registered manager and some of the senior team. It was clear staff had developed positive relationships with people and understood their individual needs and preferences. Staff worked well together and demonstrated the skills and knowledge needed to support people safely.

People and their relatives told us there were enough staff to provide the support required. Staff were confident in their roles, understood their responsibilities and told us they received regular training and supervision, which they found helpful and supportive.

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 provider followed infection prevention and control procedures in line with current guidance. Regular audits, monitoring and management oversight supported safe practice and helped ensure expected standards were maintained.

The service was clean and free from clutter during our inspection. Staff had access to personal protective equipment and understood how to use it correctly.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

People received their medicines as prescribed. Medicines were stored securely, and regular checks were carried out to ensure they were managed safely.

Medication administration records were completed correctly and showed that people received their medicines at the right time. Instructions for medicines that were given when required were in place and provided clear guidance for staff.

Staff understood how to administer medicines safely and had completed the required training and competency checks. Staff were aware of how to report and manage medication errors if they were to occur.