The Chimneys Residential 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 good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 72 (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. For example, the registered manager and senior staff reviewed any incidents and near misses to see if any learning could be taken from these. One staff member told us about learning which was taken from a person experiencing a fall and told us the layout of the person’s room had been changed to reduce the risk of impact injuries. A senior staff member told us, “We do consider the little things. We will pull staff together and explain why we need to do things in a different way.” A health and social care professionals told us they were made aware of any safety events at the home. We found appropriate action was taken to support future learning, including discussions with staff to alert them to lessons learned.

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 and relatives told us they could rely on staff making appropriate referrals to other organisations when people wanted these. Staff told us communication was effective when new people moved to the service, and they were told about people’s care needs promptly. Staff understood the importance of ensuring agreed key information was sent to other health professionals when people wished to use their services. This helped to ensure people’s safety and care needs were met.

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. Relatives were positive about the measures taken to keep people free from abuse. Health and social care professionals told us staff informed them if they had any concerns about safeguarding people. Staff had received training in recognising and reporting abuse and were confident if they raised any concerns these would be promptly and robustly investigated. Staff were supported to raise any concerns externally, through the display of contact information for external organisations, such as local authority safeguarding teams.

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 and their relative’s views were considered when people’s risks were identified and measures planned to reduce risks. These included risks in relation to falls, choking and people experiencing poor well-being or physical health. One relative told us their family member was at risk of poor skin health and said, “Staff are excellent at identifying this.” Relatives also gave us examples showing how staff adapted how they cared for people when they became distressed. For example, staff provided additional comfort to people who became anxious at specific times. One staff member said, “You ask for family input, if things would work better if done differently and you keep relatives in the loop.” People’s care plans provided staff with a detailed account of their risks and measures to take to mitigate these. However, guidance given to staff in people’s care plans need to be further improved to make this clearer. Some standard wording about people’s level of risks was automatically assigned by the provider’s IT systems. This may lead to confusion about the level of support people required. We found no impact on people, to date. The registered manager gave us assurances they would address this.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities supported the delivery of safe care. People gave us examples showing how they had been supported to change their furniture and furnishing to meet their own needs. One person told us they had chosen to have new blinds installed, so they were able to exclude light from their room, which helped them to sleep well. Relatives told us their family members enjoyed spending time either in sociable areas within the home, or in quieter lounges as they chose. Staff regularly checked the environment and people’s equipment, so they could continue to be assured they were safe and met people’s needs.

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. Relatives highlighted there was good continuity of staffing and said this had a positive impact on their family members and their own well-being. One relative told us, “All the staff here today have been here for a while, you get a cuddle from them. All the seniors here are so lovely and are familiar faces.” Another relative, who regularly visited the home, said, “I feel the staffing levels are good, there are no pinch points.” The provider sought references and completed Disclosure and Barring Service DBS checks before staff commenced employment. This information helps employers make safer recruitment decisions. The registered manager gave us assurances they would introduce new checks to ensure full date details of previous employment was consistently obtained for staff. Staff had completed a range of training to make them suitably trained for their role. One staff member said, “I did manual handling and induction before I started here. I also did shadow shifts, [initially working with more experienced colleagues].” Staff were confident they would receive additional training to meet people’s specific needs, should this be required.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and knew their responsibility to share any concerns with appropriate agencies promptly. A relative who regularly visited the home told us, “It is spotless here.” Staff had received training and understood what actions to take to reduce the likelihood of the spread of infections, should they occur. Staff said PPE, [personal protective equipment] was always available for them to use. A staff member said, “[Senor staff] check how you are disposing of and using PPE.” Staff were supported to reduce the likelihood of the spread of infection through guidance on display. For example, in relation to handwashing techniques. A staff member told us, “I feel the infection prevention is good here. We haven’t had any recent outbreaks.” Surfaces in the home were sealed well, and hand sanitizer was available in key areas of the home. Cleaning of the home was regularly undertaken. We recommended some unlidded bins were replaced, to further reduce the risk of infections spreading. The registered manager took immediate action to begin to address this during the assessment.

We found some instances where medicinal cream records were not always completed contemporaneously or accurately. This is not in line with NICE best practice guidance and increased the risk staff and health professionals would not have the information they needed to decide if people’s medicinal cream regimes were working effectively. There was no evidence of harm to people as a result of this. The registered manager took immediate steps to address this. However, the majority of medicines records kept by staff were completed well, which helps to ensure risk to people were manged. 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. People were administered their medicines by staff who had received training and had their medicine competency assessed, to ensure they followed correct procedures. Staff ensured people’s medicines were securely stored and disposed of. People told us staff supported them to have the medicines they needed to remain well. We asked one person if staff would give them extra medicines if they were in pain. The person said, “Oh yes, staff would sort out some medicines for me.” Some people living at the home may not be able to tell staff if they were experiencing pain. We found staff understood what signs may indicate a person was experiencing pain, such as changes in their body language or sleep or eating patterns. Staff explained the action they took to ensure people had the medicines they needed when this happened.