Court House 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 requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

The service was previously in breach of the legal regulation in relation to safe care and treatment. Improvement was found at this assessment, and the provider was no longer in breach of this regulation.

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. There was a learning culture in the care home, which the new manager was improving. Staff were aware of procedures to follow to report and record incidents. The manager reviewed and analysed accidents and incidents to identify themes and trends and feedback was provided to the staff team. The manager shared this with staff through daily meetings and regular team meetings. Staff told us communication had improved, and they were listened to ensuring lessons were learnt.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. Staff made sure there was continuity of care, including when people moved between different services. Pre-assessment tools were completed. Records showed people were referred to other healthcare professionals when needed. There was a weekly GP review which included input from other members of the multi-disciplinary team, and nurses told us it was easy to contact a GP or ANP for advice between weekly visits. Staff told us they worked well with health and social care professionals and had developed good working relationships. Staff followed clear processes to ensure people’s current information was safely shared.

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.

Staff received training in safeguarding and demonstrated their understanding of safeguarding issues, including the procedures for reporting concerns. They expressed confidence in the management team responding appropriately to any concerns they raised.

Relatives we spoke with said they believed their relative felt safe living at the care home. Reasons for this included, “From day one I can’t find anything to fault them on” and “The carers are very attentive”. Relatives confirmed people were given information about their rights as a resident and what to do if they did not feel safe. Relatives told us they felt able to raise any concerns or worries they might have with staff or the manager. The manager submitted statutory notifications appropriately and worked with other agencies to keep people safe. We saw evidence that recent safeguarding referrals had been made appropriately.

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. The management team completed risk assessments and reviewed these monthly or as required. Relevant people were involved to make sure all issues were captured. Staff completed training about how to support people when they experienced distress and had good knowledge about how to care for people during these periods. Staff considered and recorded what may have contributed to different situations, to help them understand how to support people better in the future.

Some people had been assessed as being at risk of malnutrition or dehydration. In these instances, care plans included information for staff such as food preferences, frequency of monitoring people’s weight and any specialist advice that had been sought. When people were having their food and fluid intake monitored, records showed people were provided with enough to eat and drink. We saw the daily handover records that showed staff monitored people’s fluid intake and had acted if concerns were noted. We saw people were offered regular drinks and snacks during both days of the inspection.

Staff had assessed some people as being at risk of skin damage. Care plans informed staff of any pressure relieving equipment in use and how often people needed staff to support them to change position. Staff set air mattresses correctly and recorded position changes to show people had their position changed in line with care plan guidance.

The provider detected and controlled potential risks in the care environment. Staff received training in how to use the equipment safely and made sure equipment, facilities and technology supported the delivery of safe care. The management team carried out regular audits to ensure the environment and equipment was maintained. We did find some areas that needed minor redecoration and the provider shared with us their improvement action plan they were working through. The provider had recently secured planning permission to replace the existing care home with a modern, purpose-built home that would better suit people’s needs.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. Staff worked together well to provide safe care that met people’s individual needs. However, feedback from people and their relatives was mixed regarding this area of care, with some expressing a view there were not enough staff at times on shift to meet people’s needs in a timely manner. During our site visit we observed people’s needs and requests were met in a timely manner and people didn’t have to wait long for support.

Systems and procedures for recruiting new staff were robust. We looked at records for 3 staff, which showed managers conducted thorough checks during the recruitment process. This included full Disclosure and Barring Service (DBS) checks being completed, appropriate risk assessment, references and employment histories.

The provider assessed and managed the risk of infection. Staff detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. There was a small number of items within the building that did not meet current infection prevention and control (IPC) standards; however, these had already been identified by the manager and steps had been made to address this.

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. The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning where appropriate, including when changes happened. Administration of medications was managed safely. Members of staff had access to policies and procedures which supported safe clinical practice. Staff were knowledgeable about peoples’ medicines and specific requirements. Staff were trained and received competency checks. We observed staff administering medicines safely and staff were able to explain people’s medication needs.