Stanley House

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 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 did not have a proactive and positive culture of safety based on openness and honesty. Staff did not always listen to concerns about safety and did not always investigate and report safety events. Lessons were not always learnt to continually identify and embed good practice.

Whilst aspects of the service demonstrated a learning culture, such as work to analyse falls and sharing information with visiting healthcare professionals and staff, this was not yet fully embedded or consistent.Staff had not always identified and reported when people had bruises. Written records had not always demonstrated these types of events had been fully investigated. Records showed the circumstances of how a person fell had reoccurred despite measures being identified to help prevent this on the first occasion. Therefore, actions to reduce the risks of incidents reoccurring had not always been effective.

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 and their relatives told us staff supported their move to Stanley House well and they were asked relevant information to help the admissions process. People told us they received the care they needed from other healthcare professionals when needed. One person said, “They called the GP in to play safe as I wasn’t feeling well and I have a catheter, but it wasn’t anything serious. I’ve got a hearing test in August, and I am on the chiropodist’s list.”

The provider looked to work with people and healthcare partners to understand what being safe meant to them and how to achieve that. They looked to concentrate on improving people’s lives or protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. However, the provider did not always share concerns quickly and appropriately.

People told us they felt safe living at Stanley House. For example, one person said, “I’m very safe, the staff are very good and check on you all the time.” Staff had been trained and understood some of the signs of potential abuse and what actions they should take to report these. The registered manager had investigated any safeguarding enquiries requested by the local authority safeguarding team however, they had not always notified the Care Quality Commission (CQC) about these as they are required to do so. This meant not all information regarding safeguarding investigations had been shared as required with the CQC for their oversight.

The provider did not always work well with people to understand and manage risks. Staff did not provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People’s care plans had not always been updated to show how risks to their health should be managed. For example, records showed staff had provided one person with food and drink modified to a variety of different thicknesses and their care plan stated they could make an informed choice as to the choking risks this presented. However, this was not the case. Whilst the registered manager told us staff had only offered the person the modified diet recommended, and the records were inaccurate, their care plan had not been updated, and this placed the person at risk of inconsistent care. The registered manager told us they would review and update this person’s care plan.

The provider had detected risks in the environment and improvement works were underway or planned, to help further control these risks. They made sure equipment, facilities and technology supported the delivery of safe care.

Some areas of the premises contained potential risks to people, for example, access to staircases. The provider had a risk assessment in place whilst they were arranging for these areas to be physically secured by key coded entry points. Other improvements were in the process of being made. For example, to the storage of medicines. We found some fire doors did not close properly and maintenance records did not show these had always been effectively monitored. Following our feedback the registered manager sent through confirmation all fire doors had been re-checked and any adjustments made.

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 ensured there were enough staff to meet people’s needs and had checked to ensure they were suitable to work in a care environment. We observed there were sufficient staff on the day of our inspection to help people in a timely manner and most people we spoke with told us staff helped them promptly. People and relatives were of the view that there were generally enough staff available. One relative told us, “From what I see, they manage okay with so many people, and it’s no different at weekends either.” Overall people told us staff attended them quickly if they used their call-bell. However, 1 person said they had sometimes had a longer wait. We made the registered manager aware of this, and they completed further checks on call bell response times, these were all within acceptable timeframes.

Staff had been trained in areas relating to people’s care however, this had not included training in health and safety. The registered manager told us aspects of health and safety training were also covered in other areas of training however, they would review staff training to ensure health and safety was appropriately covered. Whilst staff had had supervision meetings, some staff told us they would appreciate if these were held more frequently.

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.

People were happy with the cleanliness of their home and how staff supported them with their personal care. One person told us, “I love a shower and just have to ask. The staff wear all their kit while they do their washes. The whole place is kept nice too.” A relative added, “I know [my family member] gets a regular shower and they always look clean and tidy. I’ve no problem with the cleanliness of their room or the whole place really. Their clothes get nicely washed too.”

There were systems in place to ensure laundry areas were operated effectively and kept clean clothes separate to clothes needing washing. Housekeeping staff told us they had enough cleaning products and enough time to ensure they completed all planned cleaning. We observed one occasion when cleaning materials had not been locked away and this was actioned in response to our feedback. There was secure storage for cleaning materials to help ensure risks from them were reduced.

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 felt reassured with how they received their medicines. One person told us, “I have water tablets and a blood pressure one and the nurse stays and waits while I take them.” Our observations showed staff understood the correct processes to follow to safely administer and record people’s medicines. At the time of our assessment changes were being made to the storage of medicines to ensure they remained within the recommended safe temperature range.