Patcham Nursing Home

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 requires improvement. At this assessment the rating has changed to 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. The registered manager had robust processes in place to ensure any learning points following incidents were shared with staff. Staff told us that they were encouraged to reflect when incidents had occurred to improve their practice. There was an open and transparent environment at the home and regular ‘flash’ meetings were held to ensure staff were kept up to date with any changes.

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. People’s needs were assessed thoroughly before they moved into the home to ensure their needs could be safely met. One relative told us, “[Person] has dementia and was struggling at home. The transition from home to the care home went very smoothly, and I was kept informed throughout. I was also involved in the development of her care plan.” Referrals to external professionals were timely and appropriate to ensure people received safe, collaborative care.

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 living at Patcham Nursing Home. One person told us, “They look after me really well here.”

Staff completed safeguarding training and demonstrated a good knowledge of this, including what to do should they be concerned about someone. One staff member told us, “We have a saying here, ‘see it, say it, document it’. If I was concerned about anyone, I wouldn’t hesitate in telling management. I’m confident they would take action, but I know I can speak to you [CQC] or the local authority if need be.”

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. Risks were assessed and any identified risk was documented in people’s care plans. These then contained guidance for staff to follow to keep people safe. For example, where people were at risk of skin breakdown, clear guidance was in place regarding supporting the person to turn or move regularly. We saw staff adhering to this guidance to minimise risks to people. People were supported to take positive risks to aid their independence. One person told us, “I love it here. [Staff] treat us well and keep us safe.” Relatives told us that they were regularly informed and involved in decision making about risks when appropriate.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The service had a dedicated maintenance person who ensured a safe environment. Equipment was regularly checked, and any action required was completed in a timely manner. This included regular testing of the fire alarm system. The home was clean and tidy in all areas. There was a housekeeping team who ensured all cleaning tasks were undertaken robustly. The registered manager told us, “They are amazing, I can just let them get on with it and know they will do a good job.”

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 registered manager used a dependency tool to ensure the staffing level was correct to safely meet people’s needs. We saw there were enough staff on shift to respond to people in a timely way. One staff member told us, “The staff ratio here is really good, you get to spend meaningful time with people.” A person told us, “They are always there when I need them, I just press this [call bell].”

Staff had received appropriate training to fulfil their role safely. The registered manager had taken a proactive approach to ensure all training was completed. A relative said, “Staff are well trained in managing risks, particularly with [person’s] history of falls.”

There was a robust recruitment process in place which included appropriate checks such as references from previous employers.

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. Staff had received training in infection prevention and control, and we observed them using personal protective equipment (PPE) as appropriate. Staff told us that PPE was always readily available, and the deputy manager often completed spot checks to ensure they were putting this on and off correctly. There were visual displays in the home guiding people how to use PPE if necessary.

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. Those who administered medicines were appropriately trained and received regular competency checks to ensure they remained safe to do so. Regular audits were undertaken to ensure any issues were identified and addressed immediately, and learning opportunities could be taken forward. The medicines were stored safely, and medicine administration records (MAR) were completely accurately. We observed gentle interactions between staff and people who were being supported with their medicines, and this was in line with any preferences they had expressed. Some people were prescribed ‘as and when’ medicines (PRN), there were clear protocols in place to guide staff how to establish whether these were required. We saw staff following this guidance appropriately.