Speirs 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 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.

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. This included the management of incidents and accident taking place. Lessons learnt in relation to individual people were appropriately recorded and shared with the staff team to continually identify and embed good practice. Actions were taken as a result of any trends identified.

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 were continually assessed, making sure the service was able to provide the necessary care for them. Support was requested from healthcare professionals where a change to a person’s care needs was identified, and the person required more assistance to ensure their safety.

The provider worked with people to understand what being safe meant to them and the best way to achieve that. People felt safe living at the care home. A person told us, “Yes, that’s why I’m here to be safe. That’s [care home’s] priority to keep me safe.” A relative commented, [My family member] is absolutely safe, I can go away from here and I don’t have to worry about them.” 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. The registered manager said, “We are working well with the safeguarding team, and we feel very supported. They provide good guidance, and we are able to discuss issues openly.”

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. A person told us, “I’m under strict instructions to use the call-bell and not to get up unaided, I tend to end up on the floor otherwise. [Staff] come in, turn the alarm off and then get me moving from the horizontal position. As long as I [follow staff’s] instructions, I’m OK.” Staff were aware of how to use manual handling equipment safely. They said, “If using any equipment, it will be 2 staff members. We need to check that everything is up to date, like slings or any other equipment.” Staff were observed to safely transfer people in wheelchairs.

The provider did not always detect and control potential risks in the care environment. Systems in place had not ensured preparedness for emergency and security of people because visitors were not always asked to sign in when entering the premises. A family member told us, “We as a family are unhappy about the door-bell system, [the service] don’t check who is coming in and out.” This was also evidenced by staff not requesting everyone from the inspection team to sign in the visitors’ book on the day of the assessment. The management team told us that following our visit, an email was sent to families and friends of Speirs House informing them about the new electronic system of signing in. This was also addressed with the staff team who we were told will ensure all visitors signed in going forward.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. Staff were required to attend training to help them continuously apply best practice. There now was a process in place to regularly observe staff on the job. Staffing levels ensured safe care delivery, even though some people and healthcare professionals told us that staff appeared busy and rushed at times. Most people’s and relatives’ comments included, “There’s always someone around so I don’t have to bother calling them” and “I think that there are enough staff, you can always find someone to help if needed.” During our visit we observed staff being available to meet people’s care needs and in good time.

Appropriate recruitment checks were carried out by the service making sure staff were safe to work with people. Pre-employment checks included a job application form, interview and references. Standard Disclosure and Barring Service (DBS) checks on staff had now been completed every 3 years. Additionally, the provider was in the process implementing a basic yearly DBS check to ensure staff were suitably recruited. DBS checks provide information including details about convictions and cautions held on the Police National Computer.

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. A person told us, “Cleaning is good, [staff] put things in the right bins. [Staff] wear masks and aprons when needed.” The home appeared clean and well maintained during our visit.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. People were involved in managing their medicines, commenting “[Staff] usually bring me my medication, I then take it myself. I know what I need to take.” Systems and processes were in place to administer, record and store people’s medicines as necessary. People's medicines were managed by staff who had received the required training. Actions were taken promptly by the management team to address a concern where we found records only include some basic information relating to a person’s 'as required' (PRN) medicines. The missing PRN protocol was produced on the same day of our visit, making sure the person’s medicines were managed safely.