Stonebridge 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 inspection we rated this key question good. At this inspection 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 strong, proactive and positive culture of safety, based on openness and complete honesty. Staff actively listened to concerns about safety and thoroughly investigated and reported incidents and accidents. The provider had a robust system in place for monitoring incidents and completed an in-depth trends analysis. Lessons learned were shared with the staff team and appropriate guidance was reiterated. Leaders guided staff in a nurturing and positive way, where the whole team learned and were part of improving the service. We found examples of lessons learned which included an example of balancing people’s independence with keeping them safe if their mental health deteriorated. There had been an incident where 1 person had become unwell and had broken into their medicine cabinet, which was in their room, and managed to take an overdose. The staff called 999 promptly and worked with safeguarding, health professionals and the person’s psychiatrist to review lessons that could be learned. The service reviewed people at risk of similar incidents occurring and removed the medicine from their cabinets with their or their representative’s agreement. Staff told us, “It is a fine line between promoting independence and when their [people living at the service] mental health dips”. The person involved in the incident returned back to the home with an increase in staff and observations put in place to mitigate the risk of the incident reoccurring. Another example of lessons included a person’s GP changing their prescription without consulting the other specialist health professionals involved in their care. The management team shared learning regarding ensuring people’s specialist consultants were also involved in any prescription changes to ensure any it doesn’t have a negative impact on the person’s physical or mental health.

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 or were admitted to hospital. One person told us, “They made me feel welcome here, I like it so much more than [previous care home] where I was always told no, they [staff] are lovely”.

Staff contacted professionals such as GPs or psychologists, if people needed support. If professionals gave advice that needed to be followed, this was recorded and staff followed this. The management team made sure any changes to people’s support after visiting other health and social care services were clearly recorded and shared with the staff team.

People and their relatives told us they or their family member felt safe living at the service. Staff were trained in safeguarding and knew what signs may indicate potential abuse and how to report concerns to external partners such as the local authority or CQC. 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. Safeguarding concerns were reported, and any actions were taken seriously by the management and staff team. People showed us how safe they were feeling through their interactions with the staff team and by showing signs they were happy, as they went about their day.

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. Risks associated with people’s care were identified and managed to keep people safe. The registered manager told us how risk assessments were designed in collaboration with people and those important to them. The service supported people to effectively manage known risks. All areas of risks identified for people were clearly assessed and planned for. We found care plans contained best practice guidance for staff to follow, and staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. The home management team and senior leaders ensured they actively listened to feedback or concerns from people and their relatives to improve care quality.

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 upskilled their staff by supporting them to advance in their careers. For example, supporting care staff with their wish to train to become nurses. The provider also upskilled their senior team so they could provide in house training to their staff. This meant the provider kept up to date with best practice, and was able to share this with their staff in a way which was individual to the people they supported.

Staff told us they received training and support and felt the management team were very approachable. Without exception, all staff were passionate, committed, and put people at the centre of all they did, strived for excellence and enjoyed working at the service. Morale was good, all were signed up to the values and vision of the home. Staff were well supported through regular supervision, reflective practice, and appraisal.

There were sufficient staff available, with the right skills and experience to keep people safe and provide high quality care. We saw staff responded to people quickly and assisted them in line with their needs.

People and relatives told us there were enough staff to keep them safe. The provider had a safe recruitment process to ensure staff were suitable for working with vulnerable adults.

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 upskilled their staff by supporting them to advance in their careers. For example, supporting care staff with their wish to train to become nurses. The provider also upskilled their senior team so they could provide in house training to their staff. This meant the provider kept up to date with best practice, and was able to share this with their staff in a way which was individual to the people they supported.

Staff told us they received training and support and felt the management team were very approachable. Without exception, all staff were passionate, committed, and put people at the centre of all they did, strived for excellence and enjoyed working at the service. Morale was good, all were signed up to the values and vision of the home. Staff were well supported through regular supervision, reflective practice, and appraisal.

There were sufficient staff available, with the right skills and experience to keep people safe and provide high quality care. We saw staff responded to people quickly and assisted them in line with their needs.

People and relatives told us there were enough staff to keep them safe. The provider had a safe recruitment process to ensure staff were suitable for working with vulnerable adults.

The provider assessed and managed the risk of infection. Staff were trained in infection and prevention control (IPC) and told us they had the necessary equipment to keep the service clean. We observed the service to be visibly clean and odour free. As part of the renovation, consideration had been taken to ensure the materials and new equipment were easy to keep clean, for example, the new flooring was washable and non-slip.

Staff supported people to take part in cleaning some areas of the service if they chose to do so.

Audits and checks were in place to monitor the cleanliness of the service and the effectiveness of the IPC measures in place.

People told us they received medicines on time, including appropriate pain relief. Where people required covert medication, they had care plans in place to support this, linked to a mental capacity assessment and a best interest meeting with relatives, a GP, social care representative and staff at the care home. One relative told us, “I appreciate [person living at the service] medication has been really well managed by the support staff at the home and have never had any concerns.”

We found a small sample of protocols to aid staff on when to give as required medicines needed further explanation, regarding how staff were to administer the medicine. We raised this with the provider during our inspection and the protocols were immediately reviewed and updated.

Staff were trained to safely administer people’s medicines and their competency to do this was regularly checked. The management team audited and had checks in place to make sure medicines were being administered safely.