Summercourt

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.

The provider organised managers’ away days to create an opportunity for case studies to be discussed and reflected upon based on the people they supported. Staff learnt from each other, embracing success and reflecting on where to improve. Lessons were learnt to continually identify and embed good practice. Accidents and incidents were reviewed and recorded on the electronic system. A staff member told us, “We work hard here to get things right – so we do discuss lessons learnt.” Staff shared examples, such as improving the management of medicines.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed and monitored. They made sure there was continuity of care, including when people moved between different services.

People had assessments and care plans combining information about their physical and mental health, and day‑to‑day support. Staff worked with health and social care professionals to ensure people had access to appropriate resources. The registered manager explained how they worked with community nurses to review people’s skin care needs when they moved to the home or after a hospital admission. For example, requesting a visit when a person who had been discharged from hospital arrived with skin damage. They reported a damaged area had now healed. Health and social care professionals told us they had confidence in the home and good working relationships.

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.

People looked at ease with staff, who knew them well. Staff took time to ensure everyone felt included. Staff were alert to people’s emotional well-being and were personalised in their approach. Visitors were reassured their relatives were safe, for example, “Yes, mum is safe and well looked after. I don’t have to worry now” and “My friend has been here for about 3 years. She’s very safe, the care is excellent.”

Staff had completed safeguarding training. They understood different types of abuse, so they were clear about how to report concerns both within the organisation and to external agencies. Safeguarding policies were in place. Staff shared concerns quickly and appropriately with the local authority. Records showed appropriate referrals and follow‑up when safety concerns were identified.

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 appropriate legal authorisations were in place when a person needed restrictions to keep them safe. The management team had oversight of these applications and authorisations, which ensured people’s legal rights were respected.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care that was safe and supportive and enabled people to do the things that mattered to them.

Risks to people’s wellbeing, health and safety were identified. People’s risks were routinely monitored, with detailed records. For example, food and fluid charts were completed in a timely way to ensure staff identified any issues at the earliest opportunity. Risk assessments were regularly reviewed, and people’s care plans contained good information about how staff could support them to manage specific risks.

People were at ease with the staff supporting them. Staff were mindful of people’s safety, ensuring they did not face unnecessary risk when moving around the building. We observed attentive staff used equipment safely to assist people to move and gently reminded people to use walking aids providing reassurance. Risk assessments were detailed and person‑centred. We saw how staff worked to keep people safe and understood their needs. Records were updated as necessary to reflect people’s changing needs.People and their families could not always remember when they had last read their care plan. However, we saw the content of care plans reflected what people and their families told us was important information.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Environmental safety checks covered areas such as fire safety, gas and electrical installations, water systems and equipment maintenance. The registered manager completed daily walkarounds of the building to check on the wellbeing of people but also to ensure their environment did not pose a risk to them. For example, we completed a tour of the home with the registered manager who was observant picking up an issue in 1 room which they followed up with staff.

The management team made sure equipment and facilities supported the delivery of safe care. For example, all radiators had been covered which meant people were protected from the risk of burns. Water temperatures were checked to ensure water was delivered at a safe temperature to minimise the risk of scalds and to mitigate against the risk of legionella disease. Windows were appropriately restricted, which kept people safe from harm.

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 told us they chose to staff the home at a level above the dependency tool level. This was noticeable as there was always staff observing communal areas which meant people received attentive care and helped to reduce the risk of falls. Staff said, “No problem with staffing here” and “Our new director has a lot to do with the low turnover of staff.”

Relatives recognised the positive impact of the staffing levels at the home. They said, “I’ve never known a care home like Summercourt with so many staff. I see lots of familiar faces when I visit…” and “Yes, whenever I go everyone is catered for like clockwork. It’s very calm - no buzzers going off.”

A training matrix showed high completion rates for mandatory and specialist training, including oral health care. Ongoing competency checks covered medicines and other key tasks. People told us staff knew how to care for them. Relatives said, “I don’t know the level of training the staff have but they do have good communication skills and are empathetic” and “Yes, the staff are marvellous, they are well trained and very caring.”

Recruitment practice ensured employed staff were suitable for their role. Experienced staff told us they enjoyed supporting new staff and helping them to get to know the people they cared for. For example, they said, “I have learned from some good people and now I like to pass that on to our new starters.”

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 and their visitors commented on the cleanliness and said they were impressed with the lack of unpleasant odours in bedrooms and communal areas. They said, “Yes, it always looks clean. Her bedroom smells lovely and her ensuite is spotless” and “Yes, it’s very clean. Her room is always clean, her bed is made and her bathroom is clean. It’s an old building but they do the best they can.” However, several commented some areas of the home were “tired” in appearance. The leadership group said refurbishment was on-going and further work was planned.

Staff had infection prevention and control training and used personal protective equipment. Dedicated staff carried out cleaning duties. Staff were provided with personal protection equipment which was worn appropriately.

Records showed regular audits of infection control practice and the environment, with follow up actions, if needed. Safe infection prevention and control procedures shaped staff practice and helped maintain a safe environment. Infection control procedures and audits were in line with good practice guidance.

The provider always made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff always involved people in planning, including when changes happened.

Medicines were managed to a high standard, and lessons had been learnt from a previous medicine safeguarding concern. This included a new daily patch audit to ensure they were in place and their positioning rotated. Changes included daily medicine charts audits, we saw there were no unexplained gaps. There were also regular staff competency assessments. The provider had invested in a new medicine electronic system, and there were closer working relationships with the pharmacy and care home pharmacist. External health professional audits recorded positive outcomes.

The deputy manager was the medicines champion driving best practice in the home. They were committed to providing the best level of medicine care possible for people living at the service. They demonstrated their level of knowledge as they talked us through the new systems. They were proactive and anticipated potential risks. There were daily checks of fridge temps, controlled drugs (CDs), and expiry dates with clear audit trails.

Feedback from health professionals recognised improvements initiated by the deputy manager. They confirmed the leadership team knew people’s medical needs well and understood the reasons why people had been prescribed medicines. They confirmed the leadership team were aware of possible side effects when new medications were prescribed.

External medical staff said they had good working relationships with the leadership team. One said the deputy manager ‘is very keen to ensure all the medication is taken as prescribed and will ask (the pharmacist) to amend labels accordingly if anything changes and needs clarifying for the carers.’

Staff discussions showed they monitored the effectiveness of whether medicines were working, for example pain relief, by observing people’s reactions. An external health professional said staff monitored people carefully, quickly raising concerns if there were adverse effects. For example, they said the registered manager “recognises when she needs to contact us regarding any mental health deterioration or any potential adverse effects to medication we have prescribed. She does keep in good contact via telephone or email.”

Care plans linked directly to medicines, with person centred ‘as needed’ plans, reflecting individual triggers and needs. There was personalised medicines support, including how people preferred to take their medicines, for example in yoghurt. There were no covert medicine practices. There were individualised homely remedy lists for people, with clear instructions for staff.