Foxland Grange

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.

This is the first assessment for this service under this provider. The key question has been rated 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.

Lessons were learnt to continually identify and embed good practice.

Effective systems were in place to ensure lessons were learnt and good practice was imbedded throughout the home. The registered manager spoke positively about the learning culture of the home, the importance of this, how they identified and implemented this and how it was discussed and shared with staff. They gave us examples and we saw how learning was discussed and shared with staff through staff meeting minutes.

Staff told us they were involved with this process, and they confirmed information was shared with them when needed. They felt involved with all aspects of the home, including learning.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored.

There were processes in place to ensure people’s needs were assessed before they moved into the home. Comprehensive assessments were completed as part of this process, which were face to face and completed by a senior member of the team. We saw care plans and risk assessments were developed based on this assessment. Staff confirmed they were aware of people’s assessed needs and reviewed this information to ensure they delivered care in line with this. They felt assessments were detailed and provided them with the information they needed about people.

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

People felt safe being supported by staff. People understood how to raise concerns about their safety if needed. One person told us, “Safe yes, everything is done just for you, [you’re] made to feel that you belong here.” A relative said, “Yes, [name] is safe, they have been here 9 years, if it wasn’t safe they would not be here.”

There were systems in place to ensure safeguarding concerns were identified, reviewed and investigated when needed. Staff told us they had received training in this area and records we viewed confirmed this. Staff were aware of what action they should take if there were concerns and they were confident action would be taken by the management team to address any concerns raised.

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 whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that when needed, DoLS were in place for people and the required processes had been followed.

Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People and relatives raised no concerns with how their individual risks were managed.

There was a system in place to ensure people had care plans and risk assessments that had been developed individually, based on their assessed needs, which were reviewed regularly and/or when changes occurred. Care plans and risk assessments were developed with people and those important to them. The provider supported people to manage their risks independently when it was safe to do so, such as medicines, mobility and catheter care.

Plans considered people’s levels of support, and any known risks such as when they were at risk of developing sore skin, dietary requirements or any other health needs.

The provider detected and controlled potential risks in the care environment.

People and relatives raised no concerns with the safety of the environment.

The environment had been adapted and decorated to meet people’s individual needs. The home was currently going through refurbishment. Where needed, any risks to the environment had been considered and assessed, such as fire safety. There were processes in place to ensure any risks were identified so that appropriate action could be taken.

The provider had systems in place to ensure there were enough staff available to support people.

People were generally happy with the number of staff available, although some people felt there were less staff at weekends and some people felt there could be more staff. However, records we reviewed confirmed there were enough staff available based on people’s assessed needs and the provider ensured the number of staff did not drop below this. The registered manager told us some of the office staff or managers were not always available at weekends which meant the home looked less busy. Other people raised no concerns with the staffing levels. One person said, “[I] very rarely use the call bell, but if I do they come promptly.”

Staff had received mandatory training that gave them the skills to safely support people. Staff and nurses had also received specific training that was individual to the support people received, including ‘recognising deteriorating health in residents’ training.

Staff had received the relevant pre-employment checks before they started working with people to ensure they were safe to do so.

The provider assessed and managed the risk of infection.

Most people and relatives were happy with the cleanliness of the home. One person told us their room was cleaned regularly. A relative told us, “[Person’s] room always looks clean and tidy.” However, another person raised concerns that their room had not been recently cleaned. We shared this with the registered manager who said they would immediately look into and address this concern.

Staff told us and records confirmed they had received training in infection control and prevention (IPC). There was enough Personal Protective Equipment (PPE) available for staff and when needed this was used correctly. There were processes in place to monitor IPC to ensure concerns were identified so appropriate action could be taken.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

People raised no concerns with the management of their medicines. One person said, “Medications are given to me by the staff, never missed.”

Staff administering medicines had received training and their competency was checked to ensure they were safe to administer these to people. When people had ‘as required’ medicines there was guidance in place for staff to follow. The registered manager had recognised that some of these protocols needed more information and the staff team were working through completing these. The guidance we viewed which had been completed, contained detailed person centred information about people and the management of these medicines. We saw medicines were stored safely and administered as prescribed.