Dent House 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 good. At this assessment the rating has remained 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.

People were encouraged and supported to raise safety concerns with the provider. Relatives told us they were informed if there were any incidents, but most confirmed there had never been any concerns raised.

The registered manager told us they had a system in place to learn when things went wrong. Records confirmed all incidents and accidents were logged and reviewed for any themes and trends, and any learning was shared with staff. Staff understood the actions to take when incidents happened and confirmed they understood the importance of reporting safety concerns and had information about any subsequent learning shared with them.
 

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 system in place to support people to transition into the service. The registered manager described how people’s transitions were individualised to them to ensure a safe transition. People were listened to by the provider’s staff when their initial care plans were being created. This helped ensure people were supported to receive continuity of care when they started receiving care from this service.

Staff told us they had enough information to be able to support people safely when they came into the service. Where needed, other professionals were involved in peoples care and the advice given was included in peoples care plans and staff followed this.

The provider had standardised policies and procedures in place to ensure the way they supported people reflected best practice in terms of safe and effective ways of working.
 

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.

The registered manager had a system in place to log any incidents and report them to the appropriate bodies. There were effective systems in place to safeguard people from abuse. We saw action plans had been developed and shared to all staff following incidents, to increase awareness of the relevant policies and procedures.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. The provider had a system in place to make applications for DoLS for people, and these were monitored to ensure new applications were made as needed. Care plans reflected the information and staff understood this.
 

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’s individual risks were regularly assessed and details in care plans included how to support their care and health needs, families were involved in this process where appropriate. Staff knew the people they supported well and were aware of the symptoms and cues which might indicate they were becoming unwell or distressed.

People’s care plans were regularly reviewed and amended when people’s needs changed. Risk assessments and care plans were in place giving guidance for staff on how to manage risks and these were reviewed regularly. Relatives confirmed, “I am involved in my loved one’s care planning, if I have a suggestion I know I am listened to and if we agree it will benefit my loved one it is implemented.”

Staff told us they understood how to support people to manage any risks to their safety. Staff were able to describe how they managed specific risks relating to choking, skin integrity, epilepsy, and moving and handling.
 

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

People told us they felt the home was safe. Relatives told us the home had the equipment, and facilities people needed to have their needs met safely. The registered manager regularly assessed risks relating to the environment and had systems in place to check the building was safe and escalated any concerns to the provider. We saw evidence that identified issues had been addressed and improvements implemented, along with requests for specific maintenance and repair work to be progressed in a timely manner. We saw fire safety was assessed, and specific equipment and considerations needed to support people was in place. Equipment safety was monitored through regular checks and maintenance.
 

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 provider had robust and safe recruitment practices in place to make sure all staff were suitably experienced, competent and able to carry out their role. The provider had an effective programme of appropriate staff training in place, and staff told us they received the training they needed to support people safely.
 

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 confirmed they had received training in infection prevention and control (IPC) and understood how to minimise the risk of cross infection. We saw staff used protective equipment when supporting people. There was a policy in place to support and guide staff on managing safe IPC practice, which was in line with current relevant national 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.

Medicines were managed safely overall, supported by registered nurses’ clinical oversight and involvement from health professionals. However, we did find some liquids and creams which were not stored in accordance with good practice and suggested these should be moved to a more appropriate place. We were assured the registered manager took active and immediate measures to correct this issue.

People were observed receiving support with their medicines. Relatives told us they had no concerns about the support people received with medicines and could describe how staff supported people to take their medicines using individualised approaches. The leadership team carried out regular medicines audits to identify any errors. People’s individual care plans specified exactly what support each person needed from care staff in respect of their prescribed medicines.