The Sloane 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

The last rating for this key question was good. At this assessment the rating has remained good.

This meant people using the service were protected from abuse and 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 when required ensuring safety events were appropriately reported and managed. Lessons were learnt to continually identify and embed good practice. Policies and procedures were in place for responding to incidents, accidents and complaints and staff we spoke with were knowledgeable about these. Daily staff handover meetings were held providing effective communication between staff at shift changes. These provided staff with information regarding any changes in people’s needs and any service improvements and lessons learnt. Records showed that following events and investigations, managers actioned changes where required which were reviewed and monitored to ensure they were embedded.

The provider worked with people and health and social care partners to establish and maintain safe systems of care, in which safety was managed and monitored. They made sure there was continuity of care, including when people moved between different services.

Assessments of people’s needs, risks and wishes were completed upon admission to the service and continually reviewed to ensure they were reflective of people’s needs. People felt confident their needs would be met by staff and any health-related details would be shared with health and social care professionals to promote continuity in care. Information from visiting health and social care professionals was documented within people’s care and support plans and staff told us information was available to them when they needed it. We observed a visiting health professional using the provider’s care planning system to document their interactions and treatment. Care plans were developed and shared with health and social care professionals when required to ensure individuals continued well-being. Staff worked effectively with health and social care professionals to ensure people received appropriate support when meeting their physical and mental health needs.

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. People told us they felt safe, and staff were available when required. A person told us, “I feel safe in my home, staff are good, I have quick access to the GP and there are no delays in my treatment/medication.” Another person said, “This is a safe environment, and I get good medical care.” There were safeguarding policies and procedures in place and staff were trained to recognise and respond to concerns, potential abuse and harm. Staff told us they felt confident any concerns would be managed appropriately. We observed staff working in safe ways throughout our assessment, for example, ensuring people were safe when mobilising.

There were systems in place to ensure oversight of all safeguarding concerns and accidents and incidents. The home manager showed us tools used to manage these, and which supported staff to learn when things went wrong. Records showed that appropriate actions were taken by staff where required and there were good working partnerships in place to minimise the risk of reoccurrence. Where people needed to be deprived of their liberty to keep them safe, the provider ensured a Deprivation of liberty Safeguard (DoLS) authorisation was applied for through the relevant local authority. All legal applications had been made in accordance with DoLS, this meant people’s rights were fully respected. The home manager had oversight of DoLS applications, authorisations, and conditions and used records to ensure all documentation was in date.

Staff worked well with people to fully understand and manage identified risks by thinking holistically. Staff provided care that met people’s needs and was safe, supportive and enabled them to do the things that mattered to them.  People were involved in assessing the risks to their wellbeing; their needs were identified, and measures were put in place to reduce risks. Staff told us care plans and risk assessments were clear and accessible which supported them to help keep people safe. We observed staff working in line with people’s assessments and care plans, for example, when supporting people to mobilise and transfer around the service using equipment. A relative told us, “A complete assessment of all [loved ones] needs, risks, wishes, preference and likes and dislikes was done. I am able to ask for the care plan at any time.” Care plans were developed following assessments to support, manage and review identified risks. For example, risk of falls, skin integrity and nutrition and hydration.

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

The design of the premises was safe and met people's needs. People and their relatives told us they liked the home environment and that it was kept clean. The registered manager told us the service was in the process of some renovation work which included the lounge and dining room areas. The service was spacious, well-furnished and well decorated. There was a separate dining and lounge area on the ground floor, and a conservatory which was also used as an activity area.

People's bedrooms were personalised to their individual preference. There were adapted bathrooms, and quiet areas with suitable furniture to support people with limited mobility. People had access to a well-maintained garden to the rear of the service. People were safe from hazards in the environment, and the service had risk assessments in place to ensure all maintenance and upkeep was carried out. There was dedicated staff working on changes and updates to the home environment. We saw servicing records for the fire alarm system, gas safety and legionella and portable appliance testing. Checks and audits were also carried out on hoisting equipment, water temperatures, baths, the call bell system and the fire alarm system was tested on a weekly basis.

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 their relatives told us they felt there was enough staff to meet their needs in a timely manner. A person said, “There are always staff around if I need anything. They [staff] do come quickly if I need them.” However, a couple of people told us that on occasions they may have to wait until staff are available to assist them. We discussed this with the home manager who told us they regularly monitored call bell response times and were working to improve this. Records confirmed that staff meetings were held and this was discussed as an area for improvement.

We observed there were enough staff deployed throughout the service to meet people’s needs. Staff told us staffing levels were good. A staff member said, “There is enough staff to make sure people get the care and support they need. A few staff have left recently, but this isn’t a problem as we use regular agency staff and they know people very well.” Robust recruitment procedures were in place. Recruitment records included proof of identification, application forms with employment histories, employment references, health and right to work in the UK checks. We saw evidence that Disclosure and Barring Service (DBS) checks had been carried out. 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 completed training in areas relevant to people’s care and support needs. The providers training matrix showed that staff had received training on dementia awareness, wound care, diabetes, end of life care, fire safety, first aid, moving and assisting people, safeguarding adults, learning disabilities and autism, the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). A staff member told us, “We get in person and online training to do which we get paid to do at home. I recently did fire safety, medication and dementia training. There is lots of training in all areas and its very good. We also had the dementia bus visit which was a really good training experience.”

There were systems in place to help prevent and control infections. We observed the service looked clean throughout with no malodours and staff assessed and managed the risk of infection. Policies and procedures were in place and staff understood their responsibilities to promote safe infection control practices. Staff were observed to wear personal protective equipment (PPE) appropriately and PPE stations were located throughout the service. Training records confirmed that all staff had received training on infection control.

Staff ensured medicines and treatments were safe and met people’s needs, capacities and preferences. People received their medicines as prescribed. There were safe processes in place for ordering, storage, administration and disposal of medicines. Nursing staff responsible for administering medicines were appropriately trained and had their competency assessed. We observed medicines being administered and staff demonstrated a good understanding of medicines management principles and practice.

Records of medicines management were well-maintained and followed national guidance. Medicines administration records were kept on an electronic medicines management system which staff updated on a regular basis. Medicines audits were conducted on a regular basis to ensure good safe oversight. Medicines were stored safely and securely, with no excess medicines observed. Stock control measures were in place to prevent the accumulation of expired or unwanted medicines.