Dean 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. Learning from incidents was used to update practice and prevent recurrence.

Accidents and incidents were logged and actions arising were recorded and addressed. Information relating to any incidents was shared at staff meetings so learning could take place. The registered manager explained, “We have a specific thing we focus on, like safeguarding or infection control, accidents and incidents analysis, trends and how to prevent it from happening again. Under duty of candour, we inform other agencies, including the local authority. We will ring the family as soon as any incident happens, and anything we can do better.”

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.

A healthcare professional told us, “The service takes a proactive approach to safety, working closely with individuals and partners to ensure smooth, well-maintained systems. It prioritises safety with clear procedures, especially during transitions, to keep care consistent and reassuring.” For example, 1 person was having their care and support needs reassessed to decide whether they now needed nursing care. The home was working with the family towards the decision and the person’s GP was also involved.

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 Dean House. One person said, “I feel very safe. Everyone is so nice. They treat me like a queen.”

All staff were required to complete mandatory safeguarding training, which was delivered online.

. Staff understood the actions they needed to take if they suspected abuse. One carer told us, “Any signs of abuse or neglect, anything that is not ok needs to be escalated and you need to say something about it, report it. If needed, we can whistle blow as well.”

The manager understood when to report any safeguarding concerns to the local authority and any incidents of abuse or alleged abuse to the Commission. They understood people’s rights in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) legislation. Staff completed training in these areas. Records showed when DoLS had been applied for and whether they had been authorised by the local authority. Some authorisations included conditions for the provider, such as a review of people’s medicines within a stipulated time frame. These had been completed as required.

The provider worked with people to identify and manage risks holistically, taking account of people’s individual needs and circumstances. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

We asked people whether they felt their risks were managed well, for example, if they had a fall. One person said, “I’ve had a couple of falls. One of the carers came to the door and saw to me straight away; they had the paramedics and everything.” A relative told us, “She’s frail when she uses the frame, but she’s closely attended to. Her mobility has improved since she came out of hospital. They’re very professional in handling people with frailties; they’re really careful.”

People’s risks were identified, assessed and recorded in their care plans. For example, where people were at risk of falls, information for staff provided guidance, including monitoring people’s whereabouts, and the use of sensory equipment such as sensor mats. Everyone living at Dean House had a falls risk assessment, whether they were at risk of falls or not. A staff member said, “Some residents have a DoLS because of their dementia or their mental health; it keeps them safe. We have manual handling training. Anyone here with a falls risk has a sensor mat, half-hourly checks or motion sensors to avoid any risk of falls. Some residents have poor appetites, and some may be referred to the GP for food supplements or shakes.”

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 home provided a safe environment for people, with a lift and ramps to facilitate mobility. Staff completed fire safety training, and each person had their own personal emergency evacuation plan. The home and equipment were maintained to a good standard, and audits such as Legionella control in water systems and other health and safety issues were completed.

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.

We asked people if they felt there were enough staff at the home and whether they attended quickly when asked for support. We received mixed feedback. One person said, “They could do with a few more. I get exasperated when I have to wait and I wonder if I’ve done anything wrong.” A relative told us, “There’s always plenty of staff. You can always ask them a question, and if they don’t know, they’ll ask someone else.”

Staff had expressed their concerns about the number of staff during the day, and staffing levels had recently been increased to meet people’s needs. A staff member said, “The majority of time there is enough staff, but obviously not when staff are sick, it can be difficult then. Sometimes agency staff come in.”

Recruitment systems were effective, and appropriate checks were made to ensure new staff were safe and suitably qualified to work in a care setting. New staff completed an induction programme and a range of training to enable them to undertake their role and responsibilities effectively. Staff completed training on learning disability and autism awareness. The Health and Care Act 2022 introduced a statutory requirement that CQC registered providers must ensure staff receive learning disability and autism training appropriate to their role. Staff demonstrated their understanding of the training they had received and had regular supervisions with their line managers.

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.

The home provided a clean and comfortable environment for people. One person said, “It’s beautifully clean, until we get our hands on it!” Another person told us, “It’s Hoovered within an ounce of its life!”

Staff completed training on infection prevention and control. Personal protective equipment was in use as needed, for example, disposable gloves and aprons and hand sanitisers when staff provided personal care. A staff member told us, “If people have coughs and colds, we do regular hand washing. We had a resident with a chest infection, and made sure we wore a mask, and gloves and completed barrier nursing.” Barrier nursing is a technique used to prevent the spread of infection from 1 person to another.

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 told us they received their medicines as needed. One person said, “One of the helpers has the duty of administering it. They’ve got different uniforms, they’re able to handle the pills. I take them at mealtimes. They wait and check I’ve taken them.”

We observed a staff member giving people their lunchtime medicines. This was completed patiently and sensitively. People were asked if they had any pain and required analgesia. One person had problems with shoulder pain, so the staff member gently rubbed some Ibuprofen gel into the affected joint.

Medicines were ordered, stored, disposed of and managed safely. Staff completed medicines training and their competency to administer medicines was assessed. The provider had completed audits of medicines management.