Dewar Close

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 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 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 understood the process for recording and reporting accidents and incidents. Care plans and risk assessments were reviewed following accidents and incidents to ensure they remained relevant and escalating risks had been addressed. Where needed, people were referred to other healthcare professionals for advice and support.

The provider had systems to review accidents and incidents to identify any patterns and trends and ensure learning was identified and shared. Staff told us learning was shared in staff meetings and handovers between shifts.

The registered manager understood their responsibility under duty of candour to be open and transparent with people and their relatives. They told us, "It is about being open and transparent. Everyone makes mistakes but it is about learning from them and acknowledging it." Where accidents and incidents had occurred, people and relatives were informed.

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.

The provider ensured continuity of care for people when they were discharged from hospital or moved into the home from their local community. Pre-admission assessments were carried out face to face and included talking to the person and others involved in their care. This ensured the service could meet people’s needs and continuity as they moved between services. The provider’s director of quality and compliance told us, “We assess every individual. We have 2 trusted assessors, and they will have a look at initial enquiries. The manager will then go out and assess people’s needs to check whether we can meet them.”

Information was shared with other healthcare professionals when people needed prompt support owing to health emergencies. This included information about any risks to people’s health, their medication and their wishes for future care. The provider maintained a diary system to ensure people had support and the transport they needed to attend medical appointments outside the home. Relatives or a staff member supported people at these appointments to ensure information was shared and advice was known. Staff contacted external healthcare professionals when a need was identified.

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.

People told us they felt safe and secure living at Dewar Close. Comments included: “I am safe, absolutely, because I know they check on me regularly. If I had a problem, there is always somebody to talk to”, “I do feel safe. It is the staff; they are really nice” and “I feel safe, the environment I am in helps.” Relatives could visit when they wished to, and a facial recognition entry system meant they could enter the home freely without compromising the security of the home. During ‘residents meetings’, people and their relatives were reminded of the provider’s safeguarding procedures and how they could report any issues or concerns.

Staff and managers understood their responsibilities to report anything that might put people at risk of harm. One staff member told us, “I would report it straightaway to my manager and if they were not available, I would go to whichever manager was on duty. I would have to do it for their (people’s) safety and to make sure they are looked after properly." Safeguarding concerns were investigated and referred to the local authority safeguarding team in accordance with local policies and procedures. The provider had a safeguarding committee who reviewed concerns to ensure all actions had been taken to safeguard people from the risk of discrimination or abuse.

When people were identified as potentially being deprived of their liberty, applications were made to the authorising body as required. Nobody had any conditions on their authorised Deprivation of Liberty Safeguards (DoLS) at the time of our inspection visit.

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.

The provider carried out assessments to identify the level of risk in different areas of people’s lives. This included in relation to their mobility, nutritional intake, skin integrity and continence care. Care plans provided staff with information about how they needed to support people to mitigate identified risks. For example, when people required support with moving and transferring, the number of staff required to achieve the task safely was recorded, as well as the equipment they needed to use. Risk assessments and care plans were regularly reviewed to ensure any changes in people’s risks were identified and planned for.

Some people could become distressed and anxious due to their health conditions. There was guidance for staff about how to distract people from their anxiety and how to respond to alleviate their distress. During our inspection, we saw a person calling for help. A staff member immediately supported the person to prevent their distress. The person responded positively to the staff member’s reassurance.

The provider was fully aware of all potential risks in the care environment and controlled them well. They made sure equipment, facilities and technology supported the delivery of safe care.

The provider carried out regular health and safety checks to ensure the environment and equipment was safe. There were processes for any issues identified during the checks to be addressed. Where maintenance work was outstanding, this had been followed up by staff and reported to an external company.

The provider had an emergency evacuation plan and staff had been trained in how to respond. The plan included the equipment required in the event of a fire to facilitate an emergency evacuation. Fire equipment had been regularly tested, and the evacuation procedure had been practiced. One staff member told us, “We did a fire drill not so long ago. We used the Ski Pad so we would know how to use it in the event of an emergency.” A Ski Pad is an evacuation sledge designed for people who may be less able.

The provider had a refurbishment plan to improve the environment within the home. Some parts of the home had already been refurbished including the entrance to the home and a communal café.

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.

People told us staff were available and that they received the care they needed. Comments included: “You don’t have to run around looking for staff, they are always around” and “There seems to be plenty of staff.”

The provider had assessed the staffing levels needed to meet the needs of all people using the service. Staff rotas were planned to ensure there was a good skill mix throughout the home. Staff raised no concerns about staffing levels and their ability to provide the care outlined in people’s care plans.

New staff received an induction when they joined the service which included working alongside more experienced staff and completing the Care Certificate. The Care Certificate is a national framework of standards for the health and social care workforce in the UK. The provider required staff to regularly refresh their training to ensure they had the skills required for their role and were working in accordance with best practice. One staff member told us, “The training is exceptional. They train you hands on here and they are always telling us to keep it up to date. If you feel you need more, you only have to ask." The provider had clear records to show the training staff had completed and offered additional training to support staff in meeting the specific needs of people who used the service. The provider did not use agency staff but had their own mobile bank team of staff who supported across all the provider’s homes. This meant people received consistency of care from staff who had received the same training as permanent staff and understood the provider’s policies and procedures. Staff were offered support from the registered manager including regular supervision meetings to discuss their work and personal development. However, there were some staff who were overdue a supervision. The registered manager assured us plans were in place to address this and said, “There are some night staff who are due to be done in the next couple of months.”

The provider undertook checks to ensure staff were suitable for their role before they started working at the service.

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.

The provider had processes to manage infection prevention and control in the service. Staff told us they had received training in infection control and shared examples of practices they followed to prevent the risk of cross-contamination. Managers and staff understood the process for responding to infections and the local procedure for reporting any outbreaks. Staff had access to and were observed wearing and correctly disposing of personal protective clothing.

Care plans identified any specific infection control risks associated with people’s care. For example, in relation to catheter care or wound management.

People and their relatives raised no concerns about infection control practices or the cleanliness of the home. One relative commented, “It is always clean and tidy.” Processes had been agreed with relatives to inform them of any infection outbreaks in the home.

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 told us they received their medicines as prescribed and pain relief was available when they needed it. Comments included: “I have medicine 3 times a day and paracetamol when I am in pain”, “They monitor my medication” and “Last month the doctor lowered my dose, I feel much better since.”

Medicines were managed, stored and administered safely, in accordance with best practice guidance. There were processes to promote consistency in the administration of ‘as and when required’ medicines. Time critical medicines were given at the correct time and patch medicines were managed in accordance with manufacturer’s guidance. This ensured medicines were effective and any side effects were limited.

Staff who administered people’s medicines had received training in medicines management. Regular medication checks helped to identify any discrepancies and ensure people received their medicines as prescribed.