Appletrees Care Home

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• 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 inspection we rated this key question requires improvement. At this inspection the rating has remained the same due to our inspection activity only looking at specific quality statements. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed. At our previous inspection the service was in breach of legal regulation in relation to the ways people’s medicines were managed. Not enough improvement was made during this inspection and the provider remained in breach of legal regulation.

This service scored 59 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.

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. At our last inspection we found the kitchen had out of date dry food items and not all items were labelled or stored correctly and in line with Environmental Health guidelines. At this inspection, some dried food items were still unlabelled, we could not be assured the food items were within their recommended use by date. This posed a risk people may be consuming out of dated food and is a repeated concern from our last inspection We shared this with the registered manager who told us they would ask staff to carry out additional checks. We found improvements with the safety of the building, the provider had reviewed the hot water piping throughout the building and this had now been covered.

We did not look at Safe and effective staffing during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning. At our last inspection the provider failed to ensure they had effective oversight of medicines management. Whilst we saw some improvements with ensuring people had the correct covert medicines documentation, we could not be assured people always received their topical creams administered as prescribed. Staff were not recording and maintaining accurate records. We checked multiple records where we found there were no safe topical creams management procedures in place. This meant we could not be assured people had their topical creams applied as prescribed. Prescribed creams were now stored in people’s bedrooms in unlocked drawers, whilst this may not pose a risk to people, a risk assessment had not been completed to demonstrate if risks had been considered. This placed service users at increased risk of harm and is a repeated concern from our last 2 inspections. We shared our findings with leaders, who told us they have introduced additional documentation to manage topical cream administration and would review if there were any potential risks to people with the storage of prescribed creams.