Coniston Court

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 changed to requires improvement.

This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The provider was in breach of legal regulation in relation to premises and equipment. Potential risks and hazards around the home had not been identified or rectified and some equipment services were out of date.

This service scored 62 (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. There were processes in place that demonstrated how learning was taken forward. Staff knew how to report any incidents or accidents. Staff told us, "Yes they tell us what we should and shouldn't do, especially if there is a safeguarding, we have a meeting."

One relative told us, "I’ve no concerns that [Person] is being safely cared for, and I think they are doing a really good job. [Person] is always showered, clean and tidy when I see them. When they fell out of bed, they put crash mats in and then a detector mat to pick up when they get out of bed. When they fell, they told me about it straight away and discussed what they were going to do."

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 had smooth transitions into the home and staff knew people well and how best to support them. People were supported to attend appointments.

One relative told us, "We discussed their care plan when they moved in. They phone me if there’s any problem."

Community professionals told us, "I do not have concerns about this provider and are always satisfied with the level of care given. Coniston Court has a good working relationship with the Local Mental Health Service and Adult Social Care."

The provider did not always share concerns quickly and appropriately. They did not always concentrate on improving people’s lives or protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. Safeguarding concerns had not always been raised appropriately to ensure people were kept safe from harm. For example, a person was at risk of potential abuse. They had not raised safeguarding concerns promptly. A safeguarding should be raised in the event where an incident has occurred that may have resulted from abuse or neglect.

One staff member said, “The registered manager will listen, but I think they like to resolve things internally rather than escalate.”

However, people told us they felt safe. One relative told us, "[Person] is very safe there. Whenever I visit, they are clean and comfortable. They’ve handled [Person’s] medications without any problems, and they keep me informed if there are any changes to their condition." Another relative told us, "[Person] is safe and well looked after there."

Community professionals told us, "When safeguarding’s have been triggered the registered manager, deputy Manager and staff always work together with Adult Social Care to make adjustments to care to improve the service."

The provider did not always work well with people to understand and manage risks. People had risk assessments in place, however not all risks for people’s individual needs had been documented. For example, some were out of date or certain risks that could pose harm to people had not been risk assessed. Some of these risks related to environmental hazards which were pending repair, people were at increased risk of falls due to these potential hazards. Once these concerns were raised with the registered manager and provider, action has been taken to reduce the environmental risks. Where people had risks assessments in place, these were detailed. Staff knew people well and knew how to manage risks safety.

One relative told us, "There are always staff around looking out for [Person]. They walks around all day and wants to come home and they watch [Person] closely and look out for them as they wander around."

The provider did not always detect and control potential risks in the care environment. They did not make sure that equipment, facilities and technology supported the delivery of safe care.

For example, equipment had not been routinely checked to ensure it was safe to be used, such as lifting equipment. Regular walk arounds took place, but this had not always ensured that areas of improvements were identified. Some areas of the environment were unsafe, and people were at risk of potential harm from matters such as trips hazards, areas with no lighting and a faulty fire alarm system. We identified areas that needed improving regarding auditing and recording safety checks in a timely manner. However, once these areas had been identified the provider had rectified several issues to ensure people were kept safe. Improvements to the environment were still ongoing. The provider had an improvement plan in place.

We observed people enjoying the communal areas and staff supporting people to access the home safely.

Community professionals told us, "Some of the rooms could do with smartening up but that is my only observational negative comment."

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. There were processes in place to ensure staff were recruited safely. This included references, a full employment history and other appropriate checks. This included, checks to ensure nurses had the appropriate registration to work as registered nurses. Appropriate checks for staff from overseas to ensure they had the Right to work at the service and Disclosure and Barring Service (DBS) checks had also been completed. DBS checks provide information including details about convictions and cautions held on the Police National Computer. People and relatives told us there were enough staff around.

One relative told us, "Whenever I visit there seem to be plenty of staff around in communal areas." Another relative told us, "There are plenty of staff around and [Person] hasn’t complained to me about having to wait a long time for them."

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. Personal Protective Equipment (PPE) was available around the home and staff were observed using PPE appropriately. Staff had Infection Prevention Control (IPC) training. There were cleaning schedules in place.

One relative told us, "Whenever I’ve walked into their room, I’ve always found it immaculately clean." Another relative told us, "Cleaning is done on a regular basis."

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. Systems were in place to ensure medicines were managed, ordered, stored, administered and disposed of correctly. Only nurses who had received medicine training and had been assessed as competent gave people their medicines. Nurse competencies were reassessed each year. Staff were knowledgeable about the medicines people had been prescribed. There was information in the medicine administration records about how people liked to take their medicines. Some people had been prescribed ‘as required’ (PRN) medicines. There was guidance for nurses about why these medicines were needed and how they should be taken, and details of whether they had been effective, or further actions taken.

Medicine audits were completed regularly to ensure people were receiving their medicines safely and appropriate processes were being followed.

One relative told us, "They handle [Person’s] medications and if there’s anything that’s not quite right with them, they call a doctor and let me know about it."

Community professionals told us, "During our visit to Coniston Court, we reviewed their medicine administration systems and processes and also completed their resident annual medicines review. The management team were engaged and supportive of the actions we suggested, and they have been receptive to the support provided."