Uplands House 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 requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 69 (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.

We observed staff listening to people and responding to their concerns. Staff knew what incidents to report and how to report them.

The provider investigated incidents thoroughly and shared outcomes with people and relevant stakeholders. We saw evidence of change as a result of incidents which had occurred. The provider shared learning with staff through staff communication channels and team meetings.

The provider told us they received safety alerts from the government, local authority and CQC which informed them of upcoming risks. This included themes and trends to ensure the provider could take appropriate action to mitigate those risks.

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 had a robust admissions policy in place. The registered manager provider was able to explain the process which included assessing people’s needs to establish suitability and compatibility prior to moving in, visits for the person to the home, and ensuring requests to personalise rooms with decoration and furniture could be accommodated.

People were consistently supported when they were distressed. There was a focus on planning for a good day and understanding what had caused people distress so positive changes could happen.

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 had access to easy read information, or staff who knew them well to help them raise concerns.

Staff knew how to protect people from abuse and who they would report any concerns to both internally and externally.

The service shared concerns appropriately by following the correct process and ensuring these were reported to the relevant agencies.

Where restrictive practices were in place Deprivation of Liberty Safeguards (DoLS) were in place to legally authorise, restrictions placed on people to keep them safe.

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.

Staff supported people to manage risks whilst maintaining their independence by promoting positive risk taking. For example, people were assessed for risks of falls and risk of choking. When risk had been identified staff acted to keep people safe such as using specialist equipment to monitor their health condition.

The provider shared with us an example of when a person had been supported to undertake a risky activity. They told us they worked with the person and made adaptions where needed to reduce the risk.

Improvements had been made following our previous inspection. The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. However, we reviewed fire evacuation records which evidenced 19 staff members had not taken part in an evacuation in line with the provider’s policy. We had concerns new starters had not participated in fire evacuation drills during their induction period. We spoke with the registered manager about this who told us, fire evacuation practices would be taking place involving the staff who had not yet taken part.

Health and safety and fire safety risk assessments were completed and checks made of equipment to ensure it was safe to use. Regular audits were undertaken to ensure the environment and equipment remained safe to use. Any concerns were reported to the management team or appropriate person for further action.

Improvements had been made following our previous inspection. 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.

Relatives told us there were enough staff and they felt staff knew their relatives well.

The provider had a training matrix in place which evidenced staff had completed statutory and mandatory training and competency assessments. This meant staff were able to meet people's individual needs. The provider ensured staff attended bespoke training relating to supporting people with their mental health. Where staff had not completed training, they were booked onto a session in a timely manner.

The provider had recruitment processes which were fair and ensured there was no disadvantage based on any specific protected characteristic. The provider followed safe recruitment practices.

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.

The provider had a robust up-to-date Infection Prevention and Control (IPC) policy in place and staff attended IPC training.

We reviewed cleaning schedules which were consistently completed. We observed the home was clean and staff followed good practice.

The service did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

Processes were in place for the ordering, storage and disposal of medicines. However, temperature records showed the medicines refrigerator exceeded 8°C for 5 consecutive days and this had not been escalated to management. This meant there was a risk medicines may not have been stored appropriately and remained effective.

People received their medicines as prescribed, and staff demonstrated a good understanding of individuals' preferences and support needs for their medicines. However, care plans did not always contain this person-centred information, resulting in records that were not consistently reflective of people's current needs and preferences.

Bowel monitoring arrangements required improvement. Records showed gaps in monitoring for some people, including 1 person prescribed a medicine associated with an increased risk of constipation, where bowel movement monitoring had been missed for up to 10 days. This meant changes in bowel function may not have been identified promptly, increasing the risk of avoidable harm. Since our inspection, the provider developed and shared an action plan to strengthen bowel monitoring arrangements across the service. This included measures to ensure bowel function was monitored consistently and concerns were escalated appropriately.

Risks associated with high-risk medicines and smoking were not always assessed. We found no documented risk assessment in place for people prescribed anticoagulants, and risks related to people who smoked had not been considered or recorded. As a result, staff did not have clear guidance to support the safe management of these medicines and mitigate known risks. Following the inspection, the provider implemented risk assessments for people prescribed anticoagulants.

Some people were prescribed medicines on an 'as required' basis. Appropriate protocols were in place to guide staff on the safe administration and use of these medicines.

We found care plans supporting people's mental health needs were comprehensive, detailed and person-centred. They reflected people's individual preferences, including their likes and dislikes and provided staff with clear guidance on how to support people when they became anxious, distressed or agitated. This helped to ensure people received care and support in a way that met their needs and respected their preferences.