Stella House Residential 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 changed to requires improvement.

This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The service was in breach of the legal regulation in relation to people’s safe care and treatment.

This service scored 59 (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 reported accidents and incidents, and action was taken to mitigate the risk of events happening again. The provider had a clear overview of accidents and incidents, with regular audits to evidence themes and trends had been reviewed. Root cause analyses were carried out to identify lessons learned. There was a clear process for raising concerns and complaints. Where issues were identified through the inspection process, the provider took swift action to address these.

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.

People’s needs were assessed before they started using the service. People and relatives confirmed there was responsive action and communication if people became unwell. Comments included, “[My relative] is in a safe place. The office is good at contacting me if there are any issues and this gives me confidence” and “The staff and visiting medics pick up on conditions quickly and they inform me.” Visiting professionals said the service alerted them of people’s health needs, although one told us they felt this could be more promptly done.

The provider told us they were continually trying to make sure communication was clear between teams when a person was discharged from hospital into their care, to ensure continuity and they were working with stakeholders to this effect.

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 appropriately.

The registered manager worked collaboratively with the local authority to support people safely and there were clear processes in place to manage safeguarding events. Staff had received safeguarding training and understood how to recognise and report poor care and abuse. The service was working within the legal framework of the Mental Capacity Act (MCA). 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). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. Staff sought consent from people before they offered any support.

People and relatives told us they felt safe. Comments included, “[My relative] is as safe as [they] could be” and “The home is a safe place”.

The provider worked with people to understand and manage many of the risks associated with their care and support, although there were some shortfalls identified at inspection. Staff mostly provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risks to people’s health, safety and wellbeing were mostly well assessed and regularly reviewed. Key risks such as falls, skin integrity and nutrition and hydration were assessed and monitored, although documentation was not always consistently completed. Some care records contained conflicting or incomplete information which meant staff did not always have the right information to support people’s care safely.

Staff told us they were kept up to date about any changes in people’s needs through good communication and handovers. Staff were observant of people’s mobility and safety around the home. People had good fitting footwear and reminders about using walking aids for falls prevention. Moving and handling techniques were carried out safely. We observed care being delivered in line with people’s preferences, which promoted their independence and choice.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment supported the delivery of safe care.

The provider ensured there was regular maintenance of the building and equipment and completed a consistent programme of checks. However, some aspects of equipment and the care environment needed to be evaluated more fully to ensure people’s safety. For example, where some people were at risk of falling from bed, there were bedrails in place, but several of these did not have protective covers to mitigate the risk of entrapment. There were risks associated with some people’s pressure mattress settings, which were not set to their corresponding weight. We were not assured all window restrictors complied with the necessary health and safety requirements and there was an external door which did not close securely. The provider was responsive to our feedback and took immediate action to address the matters identified.

The provider’s recruitment processes did not always demonstrate staff were appointed safely. Staff received effective support, supervision and development and work together well to provide safe care that met people’s individual needs.

The provider did not ensure sufficiently clear recording to demonstrate the robust recruitment procedures outlined in their recruitment policy had been followed. Staff had the induction, support and training they needed to be able to carry out their role and they [told us they] enjoyed their work. Regular appraisals, supervisions and staff meetings ensured the teams were kept up to date, informed and able to work safely. Safe staffing levels were in place, and this was confirmed by staff and records. The provider used a dependency tool to assess how many staff were on duty and they regularly reviewed this. Staff were attentive and responded to people promptly when they needed care and support, although some improvements were needed to ensure there was sufficient staff support for people when served with lunch in their rooms. Some people reported that responses to buzzer calls were sometimes quite slow.

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.

Processes were in place to ensure people were protected from the risk of infection. The service was clean and tidy, and staff followed good hygiene practices to keep people safe. There were sufficient supplies of personal protective equipment located around the service. There were no malodours and people and relatives complimented the appearance of the home.

The provider did not make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning their own medicines support.

The provider did not implement robust processes for the safe management of medicines. People did not always receive their medicines in line with prescribed directions and there were improvements needed to storage and recording. Care plans and documentation contained conflicting and sometimes inaccurate information regarding people’s health and medication needs. The provider took immediate action to address all aspects of the medicines safety found on the first day of the inspection, to ensure the risks were promptly mitigated.