Ghyll Royd 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 72 (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, investigated and reviewed accidents, incidents and safeguarding concerns. Records showed learning and reflective practice unintended incidents. Additional skin integrity checks, oversight and wound care training had been introduced to support good practice. Whilst some repositioning records were not always completed within the assessed timescales, we saw no evidence people had experienced harm as a result, and the provider had taken steps to strengthen monitoring and recording processes.

Following the inspection, the provider gave assurances that this seemed to be a recording issue rather than people not being repositioned and they planned to strengthen the recording oversight of positional turns.

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.

Staff made appropriate referrals to and involved relevant professionals such as the GP, tissue viability nurses and social workers. When people’s needs changed, staff reviewed care plans and introduced additional monitoring, equipment or support. A relative said, “Yes, staff all responded to [their] changing needs.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve it. 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.

Staff recorded safeguarding concerns, made referrals and notified the Care Quality Commission where required. Staff demonstrated a good understanding of what safeguarding was and their role to escalate concerns. The registered manager kept a detailed record of safeguarding incidents to monitor for patterns or trends. The provider worked in line with the principles of the Mental Capacity Act 2005 (MCA) and ensured people were supported to make their own decisions wherever possible. Where people lacked capacity, appropriate processes were followed to ensure decisions were made in their best interests and in the least restrictive way. Following the recent Supreme Court ruling, staff were reviewing people's DoLS arrangements to determine whether existing authorisations remained appropriate and compliant with current legal requirements.

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.

Care plans and risk assessments were detailed, regularly reviewed and addressed risks including falls, choking, mobility, nutrition, medicines, distress and the use of equipment. Records showed people or their representatives were involved in care planning wherever possible, and relatives could access care updates. Staff responded to changing risks by seeking professional advice, reviewing care plans and introducing additional monitoring or equipment.

The provider detected and controlled most risks within the care environment. The home was clean, well maintained and appropriately decorated. Fire safety, electrical, gas, water, lifting equipment and other environmental records were in place, and equipment was serviced. Staff completed monthly fire drills and routine environmental checks. However, some emergency pull cords were tied up or did not reach the floor which could prevent people from summoning assistance if they had fallen. An unlocked shower room was being used for storage and one radiator required repair. The provider addressed the pull cords and storage concern promptly by the second day of the assessment. The provider needed to ensure environmental monitoring consistently identified and resolved these risks before they could affect people.

The provider completed checks to ensure there were enough staff available to meet people’s needs promptly and consistently but this was not always the experience felt by people and their relatives. Rotas showed consistent staffing, and the dependency assessment indicated planned staffing levels were met. Training compliance was recorded as 96%, and staff generally described their induction, training and support positively. However, feedback on staffing levels was mixed. The provider had systems in place to assess and monitor staffing levels. Records showed planned staffing levels were maintained. However, feedback from staff, people and relatives indicated staffing levels did not always feel sufficient to meet people's needs in a timely way. People and relatives described staff as busy and rushed at times, and some felt additional staff were needed. Whilst we observed people's needs being met during our visits, the mixed feedback and concerns raised demonstrated the provider's staffing arrangements were not always effective in ensuring people always experienced care and support in the way they expected. The provider had recognised some of these concerns and had recently increased staffing levels on 1 unit and taken steps to review staffing arrangements.

The provider assessed and managed the risk of infection. The home was clean, with no significant malodours, and bedrooms and communal areas were well maintained. Bathrooms had appropriate hand-cleaning supplies, and staff were observed wearing personal protective equipment (PPE) and infection control practice during care and medicines administration. Staff had completed relevant training, and governance arrangements included checks of staff infection prevention and control practice.

The provider made sure medicines and treatments were safe and met people’s needs and preferences. Staff administered medicines safely and demonstrated knowledge, competence and organisation during the observed medicines round. Interactions were positive and person-centred. Systems included daily medicines reports, monthly monitoring and audits. Care records contained medicines care plans, risk assessments and protocols for medicines prescribed when required (PRN), covert medicines and time-sensitive medicines. The provider acted following medicines incidents through reflective accounts, healthcare advice, competency checks and changes to guidance and monitoring.