East Dean Grange 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 require improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm. At the last assessment, the provider was in breach of legal regulation in relation to poor management of wound care, poor cleanliness of the environment and safety concerns around potential fire risks. Improvements were found at this assessment and the provider was no longer in breach of this regulation.

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.

Lessons were not always learnt to continually identify and embed good practice. Some care plans lacked detailed information or did not have up to date information on people’s current mobility needs. Although some shortfalls had been identified in audits, the registered manager had not reviewed this, and it was not always clear on what actions had been completed. People were not at immediate risk because leaders and staff knew them well. However, there should be effective processes in place to ensure lessons were learnt. The provider and leaders were open to this feedback and took immediate actions to make service improvements. However, this will take time to be addressed and embedded in the service. Processes were in place to analyse accidents and incidents monthly. Learning from this was shared with the staff team.

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 were supported to access other services should they be required. One relative said, “If I ring [registered manager] in the morning, they will tell me exactly how [person] is because they have done the round or if [person] is not well, they will contact me to tell me they’ve contacted the doctor.” Staff told us how they worked with external professionals to ensure continuity of care. One staff member said, “When a new person comes from hospital, we work with them to make sure everything goes smoothly. We get the handover through care plans, chats, or emails so we know what support they need. When they leave, we also share the information with the next team, so their care continues without any gaps.” The registered manager told us they had good working relationships with external professionals. One external professional said, “[Registered manager] has welcomed the support from [our team] and is keen to work in partnership.”

The provider worked with people to keep them safe. The provider shared concerns quickly and appropriately. People told us they were safe, and relatives had no safety concerns for their loved ones. A relative said, “I have no safety or safeguarding concerns now. I did initially but not now. There is always staff wandering about checking on people.” The provider had safeguarding and whistleblowing policies. Staff had training in safeguarding and leaders performed competency checks to test staff’s knowledge. The provider shared events with appropriate external agencies quickly and had documented actions taken.

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. Where people required specialised support such as a modified diet, leaders told us how they worked with external professionals to ensure this was provided safely. Guidance was documented in care plans and shared with care and kitchen staff to ensure good outcomes for people. Leaders had made improvements for the management of wounds. The registered manager said, “We have a tracker in place. We do first aid only and the district nurse team does the dressings. We do the referrals. We enter anyone with a wound onto our [electronic care planning system]. We also record information in the district nurses’ communication book.”

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 carried out environmental and fire risk assessments. Where issues were identified, actions had been taken. Improvements to the environment had been made. This included removing clutter that was potential fire risks, replacing broken equipment and redecorating the building. The registered manager said, “We still have a plan in place for decorating. Some carpet changes have been done but some are still due. We are waiting for a decorator to start working with us.”

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. Feedback from people and relatives about staff was positive. People had support when they needed it. We observed a visible staff presence in communal areas throughout the day. One relative told us about improvements to staff deployment under the new management team. They said, “There are staff around so if anything happens, they spot it right away and reassure the residents. They deal with it in a professional way. Before, I don’t think staff knew their roles because of the poor leadership. Now, if anyone’s upset, the residents are distracted straight away to reassure them. Staff show a duty of care to those residents.” Staff told us there was enough time to spend with people. Staff had been safely recruited. They had received training, and competency checks were completed to ensure staff were suitably skilled to do their roles. Staff spoke positively about the support they now receive from leaders. Comments included, “I had a 2 day induction before I started, and I also did online training. It wasn’t enough at first, but we now get more training which is very helpful” and “I have regular supervision, which I find supportive. It gives me a chance to talk about how I’m doing, get feedback, share concerns, and learn from mistakes. My supervisor listens and helps me feel confident and supported in my role.”

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 environment was clean and tidy. Comments included, “I definitely think it seems cleaner than about a year or so ago. The place smells nicer. [Person’s] room is always clean, and their clothes are nicely laundered” and “It wasn’t very clean in the place at all. The new housekeepers have turned things around. It’s clean and fresh.” We observed the laundry room to be clean with no signs of damp or bags of dirty laundry present. There were no unpleasant odours throughout the home. The provider had an infection prevention and control (IPC) policy in place. Staff had undertaken IPC training and personal protective equipment (PPE) was readily available. We observed staff wearing this appropriately.

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 safely. Comments included, “They bring it to me. It’s roughly the same time every day” and “Medicines are given when I am there and it’s always on time and staff are so calm in their approach. If [person] won’t take it, staff come down and talk to [person] at their level. Before there was none of that. I ask staff if there is something different and they tell me what it’s for. I come away knowing [person] is safe, so I feel safe.” Staff had received training, and competency checks were completed to ensure staff were suitably skilled to do their roles. Medicine audits had been completed, and any issues were rectified. There had also been an inspection by the local Medicines Optimisation Team who did not identify any concerns.