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 assessment we rated this key question requires improvement. At this assessment the rating has remained the same due to our assessment 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.

Not enough improvement was made during this assessment and the provider remained in breach of legal regulation in relation to the ways people’s medicines were managed and safe environments.
 

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.
During our visit we found that not all windows were fitted with tamper-proof restrictors. This increased the risk of people accessing windows in an unsafe manner and did not fully mitigate the risk of falls. Not all wardrobes had been securely fixed to the wall. This meant there was a risk of furniture tipping over, which could cause injury to people living in the home, visitors or staff. Some areas of the home had not been cleaned effectively, and we identified damaged surfaces throughout the service which meant it may be difficult to clean thoroughly and may impact the provider's ability to maintain appropriate standards of cleanliness and infection prevention and control. We also found not all staff had participated in regular fire drills in line with the provider's policy. This meant the provider could not be assured that all staff had the knowledge, confidence and practical experience required to respond effectively in the event of a fire or other emergency.
 

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 assessment, we were not assured that people always received their topical medicines as prescribed. During this assessment, we found sufficient improvements had not been made in this area. Staff failed to accurately record the application of topical creams and maintain complete and accurate medicines records. This meant the provider could not be assured that people had consistently received their prescribed topical medicines or that there was a clear audit trail to demonstrate medicines had been administered as intended.We also found the provider's medicines policy did not provide sufficient guidance on the management of topical medicines. This increased the risk of inconsistent practice and did not support staff to manage, administer and record topical medicines safely and effectively. In addition, staff competency assessments relating to medicines management were not sufficiently detailed and were not in line with best practice. This meant the provider could not be assured that staff had the necessary knowledge, skills and competence to administer and record medicines safely and consistently.

The provider told us they were reviewing their medicines practices and policies to strengthen oversight and support safer medicines management. However, at the time of our assessment, the improvements required had not yet been fully implemented. These issues meant people were not always protected from the risks associated with the unsafe management of medicines.