Regent 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 changed to requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

This service scored 59 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff 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 and shared with staff. Accidents and incidents were reported to the relevant external agencies, reviewed and followed up by managers. Managers completed a monthly accident and incident analysis, this helped staff to identify themes and trends for people who had falls, skin concerns, episodes of anxiety and accidents. Staff told us they were kept informed of any accidents or incidents and this was evidenced through daily handover notes and meetings with leaders of the service.

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. The provider completed pre assessments to gather information before a person moved into the service. People’s care plans demonstrated they were supported to access healthcare when needed, and healthcare professionals had advised on people’s healthcare needs. Staff proactively escalated concerns and shared updates about changes in people’s health, ensuring timely intervention. One healthcare professional told us, “Normally I see the team leaders. Staff are knowledgeable about people. They are very efficient and will always provide more information if needed”.

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 at the service, 1 person said “I came from hospital to here, it was not safe to go home. It ticks boxes for safety and care. It was years before I eventually came here. I should have moved here years ago”. Staff were trained in safeguarding and knew how to protect vulnerable adults. They felt assured managers would listen and act if any concerns were reported. One staff member told us, “If I had any concerns, I wouldn’t hesitate to raise them and action would be taken”. Managers monitored safeguarding concerns by keeping a safeguarding tracker which helped review open, in progress and closed cases.

The provider worked with people to understand and manage risks; however, some care plans and risk assessments did not always accurately reflect people’s needs, and some held conflicting information. This may make it difficult to ensure staff provided a consistent approach. Staff shared their knowledge of how they provided care to people, however this sometimes differed from what we saw in people’s care plans. We shared this with managers who took a proactive approach to make changes to ensure guidance for staff, care plans and risk assessments were amended to provide a consist approach to people’s care and support.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care. During our visit we identified some environmental risks. Not all heavy furniture in communal areas was safely secured to walls, which may pose a toppling risk to people. There were large amounts of continence aids and clinical items stored on wardrobes which may cause a risk of items falling on people from height. People had personal emergency evacuation plans (PEEPs) in place which detailed what support was required in the event of an emergency. However, we identified some information in the PEEP’S was inaccurate which meant in the event of a fire, there may be confusion with how many staff were required and what equipment should be used. We shared our feedback with the deputy manager who updated the PEEP file following our onsite visits. The service environmental checks which had been completed had been carried out by both external contractors and internal staff to ensure the service was safe and had regular compliance checks. However, some of the provider’s checks had not identified the concerns we found during the inspection.

We observed people enjoying the accessible garden, where activities and family visits were taking place. People were able to access the garden area safely and at their own leisure.

There were improvements being made to the environment during our visits, with new flooring being laid to the downstairs of the service and some new soft furnishings had been purchased, this was part of the providers improvement plan.

Whilst we saw no impact to people, the provider did not always make sure staff had received the appropriate training to understand and meet people’s needs. For example, staff had not received training to support people with an acquired brain injury or Parkinsons disease, despite providing care to people with those support needs. The provider organised some mandatory training but this did not cover the needs of all of the people they were currently supporting. Staff told us they were keen to develop their skills and knowledge further. We shared this with managers, who started to make arrangements for all staff to attend these training courses without delay. The majority of people and relatives felt there were enough staff to meet people’s needs. However, some staff told us another carer on a specific unit would be beneficial. They said, “Another staff member would be beneficial as we generally only have 2 staff, and some people require double handed care”. We shared this with managers of the service who told us they are continually reviewing their dependency document to ensure staffing requirements meet the needs of people living at the service. We observed a call bell in 1 unit which was unattended to for 29 minutes, whilst there was no impact to people, staff had not checked the persons room to ensure people were safe. Staff were recruited safely and pre-employment checks were carried out to ensure members of staff were safe to work with vulnerable people. These included references and Disclosure and Barring Service checks (DBS). A DBS is a criminal record check to ensure the staff member is of good character to work with people at the service.

The provider did not always assess or manage the risk of infection effectively. We identified the kitchenettes across all 3 units required further cleaning, we saw food debris on the floor, and cupboards and drawers had food crumbs and spillages. Not all food in the cupboards and fridge were labelled; therefore, we could not ascertain how long they had been opened. We shared this with managers and action was taken to clean these areas which we observed had improved by our second visit.

We saw some wheelchairs required cleaning but had been labelled as being cleaned. Some staff were wearing false and painted nails and were wearing their long hair loose when carrying out tasks, which could pose risk of cross infection and poor maintenance of IPC. We shared this with managers for them to ensure staff revisited the providers Infection Prevention Control (IPC) policy.

There were areas throughout the home where we identified there were chips in doors, walls and skirting boards which may contribute to the effectiveness of maintaining IPC standards. Managers were aware of this and there were plans to improve these areas over a period of time. Staff had received training in infection prevention and control and had plenty of access to personal protective equipment such as disposable gloves and aprons. There were regular audits completed by staff. However, these audits were ineffective as they had not identified the concerns we found during our inspection.

The provider had a process in place to manage medicines, but these did not always make sure medicines and treatments were safe and met people’s needs. Whilst we saw no impact to people, some documentation supporting people’s medicines required improvements. For example, PRN medicine administration was not always instructed with dosage times, making it unclear whether people had received those medicines as prescribed. Some documentation with how covert medicines should be administered was conflicting. We were reassured as team leaders demonstrated good knowledge of how these medicines were administered, and managers updated the relevant guidance following our feedback.

Further strengthening was needed with some specific medicines guidance for people who were required to have medicines before food, and with the instruction of ensuring they remained in an upright position after administration. There were records about the application of peoples prescribed medicated skin patches to sites on their bodies. However, the records did not always show these had been checked to ensure they were still in place. There were regular checks of medicines and records, and the service worked with a pharmacist to carry out audits. However, some of these had failed to identify the concerns we found during our inspection.

Managers were proactive with taking action from our feedback and made the relevant changes to improve their medicines processes and oversight.