The Stables Residential Care 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 good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 72 (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.

Staff reported safety concerns to ensure these were investigated and actions taken to reduce risk. The provider regularly reviewed accidents and incidents and shared learning. Staff told us, “We get together to discuss and share issues,” and “There are regular team meetings where we talk about everything” Records of team meetings confirmed this.

The provider understood their responsibility to be open with people and their relatives when errors or omissions had occurred.

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.

The provider ensured people’s relatives were involved in planning and reviewing their loved one’s care. One relative told us “From day 1, actually even before [Name] moved in, I have been fully involved. The staff know what to look out for and what they need to do to keep [Name] safe.”

The provider understood the importance of continuity of care. They described how they had worked closely with family, people and health care professionals to ensure a smooth move to another home for a person whose needs could no longer be met.

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 felt safe and relatives were confident their family were safe living at The Stables. One relative told us “I am absolutely 100% confident [Name] is 100% safe here”

Staff had received safeguarding training and understood their responsibilities to keep people safe. One staff member said “I would report anything and everything to our manager. I know I can contact the local authority safeguarding team and CQC if I think my concerns haven’t been actioned.”

The provider understood their responsibility to report any safeguarding concerns to the local authority and to us, CQC and had sought appropriate legal authorisations in relation to any restrictions imposed on people.

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.

People and their relatives were confident staff provided care and support that kept people safe. One relative told us, “The staff know how to keep [Name] safe, not just [Name], all the residents. They are always about observing what is happening and making sure the residents are ok.”

Risks associated with people’s care had been identified and assessed. Risk assessments informed staff of the action they needed to take to reduce risks. A staff member told us “The management do the risk assessments. They tell us all the information we need, and it is all in the care plans.”

The provider understood the importance of promoting positive risk taking. They told us “I give them [people] all the information I can, telling them the risk involved. If someone chooses to take a risk, we make sure we can take all measures possible to keep them safe.” Records confirmed this.

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

The home was clean and well maintained. Equipment in use was in good working order. Regular maintenance and safety checks had been completed by external contractors and the management team to ensure compliance with safety standards and to minimise risks to people, visitors and staff. Where shortfalls had been identified action had been taken to address these.

Staff had completed fire safety training and took part in regular drills and staged evacuations. Staff understood the action they needed to take to keep people safe in the event of a fire or other emergency. However, we found 1 person’s personal emergency evacuation plan (PEEP) was not easily accessible. A PEEP is a bespoke plan created to give guidance to staff around people who require additional support in case of an evacuation who may require additional support, to keep them safe, in the event of an emergency such as a fire. This was immediately addressed during the inspection.

People and relatives were very satisfied with the environment and did not have any concerns. Comments included, “As soon as you walk in it feels welcoming, homely and friendly,” and “They (management and staff) consider every little thing to make sure The Stables really is a home from home. A safe place filled with love.”

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.

People and relatives were very satisfied with the availability of, and support provided by staff. One person told us, “Nothing is too much trouble. They are always here when I need them. They are lovely and have been wonderful to me.” A relative commented, “The staff here are excellent. I can’t praise them enough.”

Staff had been recruited safely in line with the providers policy and best practice guidance. Our observations confirmed staffing levels were well maintained.

Staff had completed training including training provided by district nurses specific to people’s individual needs.

The provider operated an on-call system which ensured staff had access to advice and support at all times.

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 relatives told us the home was always clean and well maintained. One relative commented, “I was shocked to learn every resident on admission has brand new bedding and towels just for their use.”

Staff had completed infection prevention and control training and wore appropriate personal protective equipment (PPE) when providing care and support. One staff member said, “We have plenty of PPE. That’s really important, it’s how we keep infections at bay.”

Cleaning records were up to date and included all areas within the home. Infection control audits had been completed. However, audits did not clearly show what had been reviewed as part of the audit. For example, the audit did not detail if staff ‘s practice in relation to the safe disposal of PPE had been checked.

The provider’s infection prevention and control policy was up to date and reflected current good practice guidance.

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.

People received their medicines as prescribed, including medicines prescribed on an ‘as required’ basis. We observed people had ample time to take their medicine without being rushed. One relative commented, “I have absolute faith in the staff and how they manage [Names] medications.

Staff had completed training in safe medicines practices and told us they had their competency assessed to ensure they could administer medicines safely. One staff member said, “[Provider] worked with me to make sure I was doing everything in the right way. I found that reassuring.” However, records of competency checks needed to be further improved to show, for example, areas of good practice, areas for improvement, any actions required, and evidence of actions taken. The provider acknowledged our feedback and gave assurance this would be addressed.

Medicines audits were completed by the management team. However, auditing frequency was inconsistent, and audits reviewed did not cover all aspects of medicines management for example, topical creams. We did not find this had any impact on people. The provider acknowledged our feedback and began to take action to address these shortfalls.