Coldwells 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 good. At this assessment the rating has remained good. This meant people were safe and protected from 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 and reported safety events. Lessons were learnt to continually identify and embed good practice.

The provider regularly reviewed accident and incident records to ensure any events within the service were appropriately identified, managed, and acted upon. Information was communicated effectively across the home. The registered manager held daily meetings with staff to discuss any issues related to people’s care, and where they could identify any potential staff learning needs related to providing safe care.

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.

Staff planned and organised care and support with people and their relatives, to ensure there was a positive, collaborative and joined up approach when people moved into the home. The GP supported the service with regular weekly visits. The management prepared a list of people that needed to be seen. This contained information about why the visit was needed, as well as clinical observations.

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 had completed safeguarding training and understood their responsibility to keep people safe. Staff felt confident raising concerns. A member of staff told us, “[We] would report our concerns to the local safeguarding team and CQC.” Where required, applications had been submitted to lawfully deprive people of their liberty and staff received training in relation to the Mental Capacity Act. Care plans recorded if people had capacity to make day to day decisions for themselves. Best interest meetings were also recorded to confirm any agreements made to support people’s needs.

People and their relatives told us they felt safe. One person’s relative told us, “I know she’s safe, I can happily go away and know she will be looked after so well.”

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.

Staff knew people very well and people told us they were involved in developing their risk assessments. People were supported to manage risk while maintaining independence and the service promoted positive risk taking. For example, people were assessed for risks related to diabetes, catheter care and mobility. Relevant support and equipment were provided, where required, to help minimise potential risks. Care plans contained information about people’s preferences and views in relation to decisions about risk. People and relatives told us that measures to mitigate risks were appropriate. One person’s relative told us, “We feel secure that things are in hand when we’re not around.”

The provider 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 had their own bedrooms which they personalised with furniture and belongings. People had equipment they needed to help keep them safe, such as wheelchairs, walking aids, and bath and shower equipment. These were regularly checked to make sure they were safe to use. The provider assessed and maintained the environment and equipment used, for example, fire alarm system, portable appliances and gas safety. Checks and audits were also carried out on water safety, call bells and regular fire drills were conducted.

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. Staff provided us with mixed but mostly positive feedback on staffing levels. A member of staff told us, “Staffing levels are mostly good. Sometimes people are off sick, but we manage most of the time.” Most people and their relatives told us that there were enough staff to meet their needs. One person told us, “There’s usually enough staff, I don’t have to wait.” Another person’s relative said, “There is always someone to help and no time when staff have been unavailable.” We observed staff were present in lounge areas where people were seated and also saw them attending to people who were cared for in bed. Staff did not appear to be rushed, and people did not have to wait for staff to assist them.

The provider followed safe recruitment practices. Pre-employment checks were carried out to ensure appropriate vetting of staff. The registered manager had a training matrix in place which evidenced most staff had completed all training and competency assessments to ensure they were able to meet people's individual needs.

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.

Staff had access to appropriate supplies of personal protective equipment (PPE). Members of staff had access to infection prevention and control policies.The provider employed domestic staff to oversee cleaning and laundry. We observed that the service looked clean throughout. Records confirmed regular cleaning was taking place.

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.

Staff received medication training, and their competency was checked to ensure they understood the requirements for the safe administration of medicines. Staff supported and involved people to manage their medicines and followed best practice guidance for administering medicines. People received their medicines as prescribed. Some ‘when required’ medicines protocols did not always include sufficient information to guide staff when and how to administer these ‘when required’ medicines.We shared this with the deputy manager who addressed this issue during our inspection. We reviewed medicines administration records (MAR’s) for some people and found the recorded stock levels matched the medicines in place. Medicines were stored securely, and the service had protocols for administration and storage of homely remedies.

All medicine administration errors, near misses and missed signatures were recorded and investigated by the management team. Lesson learned were discussed during handovers and supervisions.