Chegworth Nursing 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 69 (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 had developed a positive learning culture within the care home. People were encouraged and supported to raise safety concerns with managers and staff. Managers and staff understood the importance of reporting safety concerns. Systems were in place to support staff to report and record safety concerns and events when they arose. Any safety concerns or incidents that did occur were investigated and when lessons needed to be learnt this was used to continually improve staff practice.

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.

Managers gathered information about people’s individual needs and wishes, and risks to their safety, prior to them being admitted to the home. This information was used to develop person-centred care and risk management plans, which were shared with staff to help them provide safe and appropriate care to people from the moment they started living in the home. Managers and staff worked closely with all the relevant external health and social care professionals and bodies to make sure care plans and risk assessments reflected people’s current needs and wishes.

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.

People told us they felt safe living in the home. One person said, “I do like living here where I feel safe.” A relative added, “I feel my [family member] is kept safe by the staff. I am confident the manager and staff would deal with any abuse, neglect and or associated allegations appropriately.” Managers and staff understood how to safeguard people. They knew how to recognise and report abuse and were able to articulate how they would spot signs if people were at risk of abuse or harm. Managers worked proactively with the relevant agencies, when a concern was raised, and took appropriate action to safeguard people from further risk, when this was required.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (Dols), which is part of the Mental Capacity Act 2005 (MCA). We found managers and staff liaised with the relevant local authorities to ensure appropriate DoLS arrangements were in place to ensure people’s safety. Managers and staff confirmed they had received Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) training.

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.

Systems were in place to ensure risks people might face were routinely assessed, monitored and reviewed. People’s care records contained sufficiently detailed information for staff to follow to ensure risks to people were mitigated, so people remained safe when taking part in activities and events of their choice. Managers and staff were fully aware of the potential risks people might face and the steps they needed to take to reduce or safely manage them. A relative told us, “My [family member] is kept very safe at all times by staff because they know the risks he faces and how to manage them.”

Throughout our site visit we observed staff were visibly present, attentive and aware of people’s whereabouts in the home and any changes that might indicate they needed additional support. An external care professional said, “Staff are kind and compassionate with residents if they become distressed.” Risk assessments and management plans were reviewed at regular intervals and updated accordingly to reflect any changes in people’s needs.

The service did not always detect and control potential risks in the care environment. They did not always make sure the environment was well-maintained and dementia friendly.

Chemicals and other substances hazardous to health (COSHH) were found unsafely stored and unattended in unlocked cupboards and spaces in multiple locations throughout the home. This failure contradicts recognised best health and safety practices. Although no one had been harmed as a direct result of these unsafe practices, it had placed people at risk of harm.

We discussed this issue with the provider at the time of our site visitand they responded immediately by ensuring all the places where COSHH products were kept were either made secure or these products removed to a safer space. The registered manager has also reminded the staff team about the importance of safely storing COSHH products in designated secure places when they were not in use. In addition, the registered manager told us they would arrange for all staff to refresh their COSHH training in the next 3 months.

Furthermore, the care home environment was not fully ‘dementia friendly.’ For example, there were not enough easy to understand pictorial signs used throughout the care home to help people living with dementia orientate themselves. Easier to read and accessible signage would help people identify the function of rooms that were important to them, such as toilets, bathrooms, lounge, dining room, kitchen and bedrooms. We discussed this issue with the registered manager at the time of our site visit who acknowledged easier to read and understand signage used throughout the care home would benefit people living in the care home. The registered manager told us they planned to take action to address this issue within the next 3 months.

Apart from this the home environment was free from unnecessary slip or trip hazards, which enabled people to move freely and safely around the home. Safety systems and equipment was maintained and serviced at regular intervals. Staff told us they had clear guidelines available to help them deal with emergencies. Personal emergency evacuation plans were in place to help staff evacuate people in the event of a fire.

The service made sure there were enough staff, who received effective support, supervision and development, however, there were some gaps in staff training. They worked together well to provide safe care that met people’s individual needs.

Staff were supported to continually improve in their role. They received a mixture of e-learning and in-person practical and theoretical training and competency-based assessments.

However, staff did not always receive all the relevant and most up to date training they needed. For example, no staff had received any training in relation to supporting people living with a learning disability or people with autism or mental health awareness. In addition, some staff had not updated their dementia awareness and positive behavioural support training. We found no evidence that people had been harmed by these gaps in staff training, but it had placed people at risk of harm. We discussed these gaps in training with the registered manager at the time of our assessment who acknowledged this was an issue and who agreed to ensure all staff were suitably trained within the next 3 to 6 months.

The provider employed enough permanent care staff and only used temporary agency staff in exceptional circumstances. This meant people received their personal care from staff who were familiar with their individual needs, preferences and daily routines. Staffing rotas were planned based on people’s dependency and individual needs. Staffing levels matched the staff duty rota on the day of our unannounced site visit. Managers, nursing and care staff were visibly present throughout the service during the assessment and were quick to respond to people’s questions and requests for support. People told us the home was adequately staffed. One person said, “Staff come as quickly as they can whenever I call them with my alarm bell.” A relative added, “There always appears to sufficient numbers of staff on duty to deal with any eventuality.”

Staff had ongoing opportunities to reflect on their working practices and to identify any further training, learning or support they might need. Staff had regular individual and group meetings with their managers and co-workers.

The provider operated safe recruitment practices and only suitable staff were employed to work at the service.

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.

People lived in a clean, hygienic environment. Staff followed current best practice to reduce the risk of infections spreading. A relative told us, “The home is exceptionally clean and odour free. You always see the cleaning staff constantly carrying out their cleaning duties.” Staff were provided with relevant training to help them prevent and control the risk and spread of infection in the care home. They had access to resources and equipment to help them reduce infection risks and used this appropriately, which included adequate supplies of personal protective equipment [PPE]. Staff appropriately maintained cleaning and food safety records to provide a clear audit trail of measures taken to reduce infection risks at the service.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened.

Medicines systems were well-organised and safely managed. Medicines stocks, balances and records showed people consistently received their prescribed medicines as and when they should.

Care plans included detailed guidance for staff about how people needed and preferred their medicines to be administered. Staff received relevant training and their competency to continue managing medicines safely was routinely assessed. Controlled medications were on site, staff were able to demonstrate how to correctly store these medications as per the providers policy.