Polebank Hall 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 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 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.

The provider had policies and procedures in place to support organisational learning and continuous improvement. There was evidence that lessons were considered when things went wrong and leaders of the service demonstrated strong commitment to learning and improvement.

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 staff knew how to raise and communicate concerns, and they felt these would be resolved promptly. One person told us, “The manager comes to see me, and I can always talk to them.”

People were consistently supported through safe systems, processes, and transitions between services. Individual risk assessments were in place and were comprehensive, detailed, and regularly reviewed. These provided clear guidance for staff on how to support people safely while promoting their rights, choices, and independence. Staff worked effectively with people to identify and manage risks in a person-centred way, enabling them to lead as independent a life as possible while ensuring their safety and wellbeing.

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 policies and procedures in place designed to protect people from avoidable harm and to promote their safety and wellbeing. People and their relatives consistently told us they felt safe receiving support from the service and spoke positively about the care provided by staff.

Feedback from people and their relatives was positive. One person told us, “Yes, I do feel safe in here. It is the staff that makes you safe.” One relative told us, “I do think my loved one feels safe in here.”

Staff had good understanding of how to keep people safe and protected them from avoidable harm. There was evidence that staff completed safeguarding training.

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 whetherthe service was working within the principles of the MCA and how they managed DoLS within the service. We found that provider demonstrated a clear understanding of their responsibilities under the MCA. There was evidence that capacity assessments were completed when required and best interest decision-making processes being followed when people lacked the capacity to make decision about their care.

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.

People's risk assessments were completed and reviewed when required. These were detailed, person-centred, and clearly identified potential risks, together with the measures needed to reduce the likelihood of harm. Risk assessments provided staff with clear guidance on how to support people safely while promoting their independence, choice, and wellbeing. People and their relatives told us they were involved in discussions about their care and support needs. One relative said, “My loved one's care plan is available. I nip to the office, and they update me on anything that I need to know. My loved one has recently been re-assessed."

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

During our visit, we identified a number of environmental and fire safety concerns within the service. These included issues relating to fire doors, fire compartmentation, and aspects of the premises that could impact people's safety, such as some window restrictors not being sufficiently robust and furniture not always being securely anchored to walls.

The provider had an action plan in place to address the identified concerns and demonstrated they were actively working through the required improvements. Following feedback provided during the inspection, some issues were addressed immediately, including securing furniture to walls.

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.

Staff were recruited safely. Records demonstrated that the necessary pre-employment checks had been completed before staff commenced their roles. This included Disclosure and Barring Service (DBS) checks and the obtaining of appropriate references to help ensure staff were suitable to work within the service.

Staff competency assessments were undertaken to help ensure staff had the skills and knowledge required to perform their roles effectively. Staff were provided with training relevant to their responsibilities. However, during the inspection, we identified some gaps in staff knowledge and practice, as not all staff consistently followed safe moving and handling principles. This was fed back to the registered manager, who took prompt action to address the issue with staff. We also saw evidence that this was discussed with staff in the past.

Records showed staff received regular supervision and annual appraisals, providing opportunities to discuss their performance, development needs, and any concerns about their work.

Staff were supported and encouraged by the provider to speak up and share feedback about the service. One staff member told us, “I have no concerns at present but would feel confident to raise concerns with the management.”

There were sufficient numbers of staff deployed to meet people's needs safely and effectively. People received support from a consistent team of staff who knew them well and understood their individual needs, preferences, and routines. One person told us, “There seems to be enough staff. When I press my buzzer, they come.” A relative said, “There seem to be staff always available. You don't have to go searching for anyone.”

People and their relatives spoke positively about staff and the quality of care they received. Feedback consistently highlighted staff's caring and compassionate approach. One relative told us, “My loved one is very happy here. Staff are amazing and very caring.” Another relative said, “They are extremely caring. It comes from the top (senior management).”

The provider did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading or share concerns with appropriate agencies promptly.

Existing quality assurance measures were not always effective in identifying and addressing concerns in a timely manner. During our visit, we identified areas of the home that required further attention. For example, some people's bedrooms and bathrooms required a deeper standard of cleaning. In addition, parts of the home environment, including fixtures, fittings, and furnishings, were worn and showed signs of deterioration, which could impact the effectiveness of infection prevention and control measures. There was an ongoing action plan in place to address and improve these areas within the home, and we saw evidence that some actions had already been completed. For example, flooring and furniture in some of people’s bedroom was replaced.

There were appropriate policies and procedures in place to support the prevention and control of infection. Staff had access to personal protective equipment (PPE), and we observed this being used appropriately when required. Records demonstrated that infection prevention and control audits and monitoring checks were undertaken.

However, these quality assurance measures were not always effective in identifying and addressing concerns in a timely manner. During our visit, we identified areas of the home that required further attention. For example, some people's bedrooms and bathrooms required a

deeper standard of cleaning. In addition, parts of the home environment, including fixtures, fittings, and furnishings, were worn and showed signs of deterioration, which could impact the effectiveness of infection prevention and control measures. There was an ongoing action plan in place to address and improve these areas within the home, and we saw evidence that some actions had already been completed. For example, flooring and furniture in some of people’s bedroom was replaced.

We also discussed the appropriate storage of PPE with the registered manager during the inspection. Following our feedback, immediate action was taken to address these concerns.

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.

There were policies and procedures in place to support the safe management and administration of medicines. Overall, medicines were administered safely, and people did not raise any concerns about the support they received with their medicines. One relative told us, “Staff always make sure my loved one takes their medicines.” Another relative said, “In the past, staff had to take time to help my loved one swallow their tablets, but now they cannot swallow tablets, staff have arranged for them to receive their medicines in liquid form.”

Staff demonstrated a good understanding of the principles of safe medicines administration. Medicines errors and incidents were appropriately investigated, and lessons learned were identified and shared to reduce the risk of recurrence. Staff responsible for administering medicines received relevant training, and their competencies were assessed regularly to help ensure safe practice.

People’s medicines needs were periodically reviewed. One relative told us, “The care plan is reviewed annually. This includes medicines. My loved one had a period when they become agitated in the evening, but they adjusted their medicines and now it is better.”

The registered manager maintained oversight of medicines management within the service. Records showed that medicines audits and monitoring checks were completed, and appropriate action was taken when issues were identified. This helped to promote safe medicines practices and ensure people received their medicines as prescribed.