Maiden Castle House

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 inspection we rated this key question good. At this inspection 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 service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People were supported by a service who continually sought to learn from accidents, incidents and events. Staff told us there were clear procedures in place following an accident such as a fall. The registered manager carried out analysis of accidents and incidents, this had included a focused, thorough examination of falls. The review considered environmental factors, clothing, footwear, general health and wellbeing. Health and social care professionals told us the service was proactive in supporting learning from events. The provider had oversight of all information contained on the electronic systems and this helped to ensure safe processes were followed when dealing with events in the service.

The service 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 care and support was clearly planned, this included all care documentation, which included comprehensive information about people. The providers electronic care planning system summarised people’s care and support needs. This meant information could be easily shared with the person as they moved through other services, such as the hospital. Staff told us they had connections with external professionals and information was shared to enable joined up care. A person told us, “They would call a doctor if I needed one, but touch wood I have not needed it yet.” Health and social care professionals were positive about working with Maiden Castle House and one said, “The partnership is good.”

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They 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 service shared concerns quickly and appropriately.

Safeguarding procedures were in place to ensure people were protected from avoidable harm. People told us they were safe and happy living at the service. One person said, “I feel safe here, we get on reasonably well.” Staff received training in safeguarding adults, they told us how they would raise concerns both internally and externally and were confident the registered manager would act immediately. A staff member said, “We have a whistleblowing policy and if needed I would speak to the local authority or CQC.” Staff told us they would not hesitate in highlighting practice which did not meet the expectations of themselves or the service. Posters displayed within the service reminded people of contact details for reporting concerns. We observed staff working in safe ways around the service. Records showed safeguarding referrals had been made as necessary and this included notifying CQC of certain events as required by law. A health and social care professional told us, “They are proactive in raising anything.” All legal applications had been made in accordance with DoLS, this meant people’s rights were fully respected. The registered manager had oversight of DoLS applications, authorisations, and conditions and used records to ensure all documentation was in date.

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People’s needs had been identified, assessed and measures to reduce risks put in place. Staff told us the information they had to keep people safe such as, care plans and risk assessments, were clear and accessible. We observed staff working in line with these assessments, for example, when supporting people to eat and drink safely. The providers electronic care planning system meant information and changes about people’s care, risks and support was updated immediately. The assessment of risk was carried out with the person and in their best interests, this had included positive risk taking. For example, a person was supported to maintain their independence whilst ensuring they remained as safe as possible. Staff considered all information, views, hazards and balanced the risks against the outcomes.

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

People were safe from hazards in their environment, the service had processes and risk assessments in place to ensure all utility, maintenance and upkeep was carried out. There was dedicated staff working on repairs, changes and updates, they had additional oversight and support by the provider’s management team. We observed the environment was accessible and maintained. The service had worked on decorating spaces with items to encourage conversation such as beach scenes, football memorabilia and gardening areas. The provider informed us the service had an extensive refurbishment and redecoration plan in place. Equipment and utility checks were in place and closely monitored to ensure safety. The service used specialists and contractors to undertake some checks, particularly where there was need for a specialism, such as gas, electrical and fire safety.

The service 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, relatives and professionals told us there were enough staff on duty at the service. Staff were skilled and had received sufficient training to support them with meeting people’s needs. Staff received training and support to ensure they could carry out their role effectively. A member of staff said, “Training is spot on, you always learn something.” Staff told us they felt supported fully by the registered manager, management team and provider. Verbal and written supervisions were carried out and staff told us they could access support as needed. We observed the service to be calm and relaxed; staff were busy without being rushed. There was a process in place to measure people’s needs which had been used to calculate safe staffing levels within the service. A person told us, “When you press the call bell you do get a quick response.” Staff were recruited safely, and recruitment records reflected this. Procedures were in place to ensure the required checks were carried out on staff before they commenced their employment. This included enhanced Disclosure and Barring Service (DBS) checks for adults. DBS checks provide information including details about convictions and cautions held on the police national computer. The information helps employers make safer recruitment decisions. Staff learning and development was in place to ensure staff were properly inducted into the service and their knowledge developed. The registered manager and provider had oversight of training within the service.

The service 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 their relatives told us the service was clean and tidy, this included people’s own bedrooms which were cleaned daily. A person told us, “I regularly have a deep clean, it’s really nice to be clean.” Staff had received training in infection prevention and control, and this included practical hand washing checks. Dedicated staff ensured the service was clean. We observed the service to be clean and hygienic. Personal protective equipment (PPE) was worn correctly by staff. Safe infection prevention and control procedures were in place, and this underpinned practices within the service. Infection control procedures and audits were in line with good practice guidance. Staff had plentiful supplies of cleaning materials, products, and PPE.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened.

People received their medicines as prescribed. There were safe processes in place for ordering, storage, administration and disposal of medicines. Staff who were responsible for giving people medicines were trained and had their competency assessed. Staff told us they worked well as a team to ensure medicines were managed safely, this was supported by a ‘medicines champion.’ A medicines champion was a member of staff with additional training and a special interest in medicines safety who supported staff, checked compliance and promoted best practice. A robust programme of monitoring was in place to support safety including daily, weekly and monthly checks. The provider’s electronic medicines system contained accurate recordings including stock counts. The registered manager had oversight of the system which alerted them to late or missed medicines. Medicines were stored at safe temperatures and checks were in place to ensure this was maintained. Guidance supported staff to ensure medicines taken occasionally were given consistently, this was developed further during the inspection. Medicines which required stricter controls were monitored and correct control measures were in place.