Casa Mia 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 remained the same. This meant people were safe and protected from avoidable harm.

This service scored 81 (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.

A review of the provider’s lessons learned records showed clear documentation of incidents, the individuals involved, and consideration of how these events affected people. Actions were taken to learn from these incidents to reduce the likelihood of reoccurrence. For example, the service had issues with their online medication system, which delayed verifying administration, the devices required refreshing to ensure accurate times could be logged. This was discussed during a staff meeting and additional training was provided following the incident which included hypothetical scenarios and visual reminders of what to do should the incident happen again.

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.

Pre-admission assessments were completed with people and relatives prior to a person moving into the service to ensure their needs could be met. People had accessed healthcare when they needed it, and in the event of an emergency information was available about people’s needs and wishes.

The provider worked well with people and healthcare partners to fully understand what being safe meant to them and the best way to achieve that. Staff had a clear focus 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 always shared concerns quickly and appropriately. People told us they felt safe living at the service and relatives shared the same views. A person told us, “The staff here make me feel safe, especially [staff member], they are great. They make me feel happy and glad to be here”. Another person said “I’m very safe here. I like all of the greenery around. It’s very good for my mental health. It makes me feel calm”.

All relatives told us how reassured they were knowing their loved ones were safe and well cared for living at Casa Mia Care Home, some of their comments included, “I feel they are safe here, I just trust the staff they let me know when anything is wrong. They tell me everything and keep me updated” and “They are safe here because the door is locked but they can go to the shop down the road by themself. They monitor their time away. There have been no attempts to abscond at all since being here and they no longer have a substance problem. I trust the staff 100% to contact me if anything went wrong or there was a problem”.

Relatives expressed confidence staff actively prioritised people’s safety and wellbeing and felt assured staff maintained a secure and protective environment. Feedback from families confirmed they trusted staff to manage safety and mitigate risks effectively. All staff we spoke with shared consistent knowledge and understanding of how to support people safely, considering whether people were able to make unwise decisions about their own care needs. Staff had received training in safeguarding and vulnerable adults and understood how to recognise concerns and what their roles and responsibilities were to ensure people were safe. Staff told us they felt confident raising concerns to leaders, and these would be responded to quickly and appropriately. The home manager monitored people’s Deprivation of Liberty Safeguards (DoLS) referrals by having a DoLS tracker to ensure people’s referrals were being submitted within the appropriate timescales.

The provider always worked well with people to fully understand and manage risks by thinking holistically. Staff provided care which fully met people’s needs and was safe, supportive and enabled people to do the things which mattered to them.

We saw multiple examples of where people were involved in positive risk taking, which was supported by robust risk assessments and guidelines which involved people, relatives, staff and medical professionals. Comprehensive assessments, specialist advice, and management protocols were implemented to enable people to exercise choice whilst reducing potential risks as far as possible. Some of these risks included people choosing to eat at risk and taking holidays independently.

We spoke with a person regarding their decision about choosing to take risks in relation to their wellbeing, they told us staff had consistently respected their wishes and had supported them. They told us, “Staff have been brilliant”.

People were also supported to manage risks within the service, 1 person told us,” I’m safe here. They have taught me how to use the fire hydrant. They have also taught me how to smash the window in case of a fire. I have a tool on the wall next to my bed I can use. I do feel safe though”. A relative shared, “They allow them that bit of independence, its positive risk taking. We can learn to trust them more too”.

The provider was fully aware of all potential risks in the care environment and controlled them well. They made sure equipment, facilities and technology supported the delivery of safe care. Environmental adaptations were thoughtfully tailored to respect individual preferences, culture, and specific support needs. Additionally, the service offered a variety of communal areas to promote social engagement and wellbeing, including a coffee shop, lounges, games rooms, and a dedicated arts and crafts room. People’s arts and crafts were displayed in communal areas so they could be enjoyed by relatives and visitors. The provider told us, “We have invested in maintaining attractive and accessible outdoor spaces, including a well-maintained garden which can be enjoyed by all people using the service. Access to outdoor environments supports wellbeing, social interaction, physical activity, and overall quality of life”.

During our visits we saw people enjoying the garden areas which offered communal spaces for people to engage with others, whilst there were quieter areas where people could relax or spend time alone. Some rooms had outside areas which were more private, accessing directly from people’s rooms. One person told us, “I love it as I can just open the doors and go and sunbathe”. A relative shared “It’s amazing there, they are constantly decorating or improve the internal facilities too”.

The provider told us they had reflected on some feedback from people and staff regarding the games room, people were not accessing it as much as they would like as it did not have direct access to the garden area. The provider had made plans to relocate the games room to the ground floor to ensure the environment more effectively met the needs and preferences of the people living at the service.

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. People spoke fondly of staff, they told us, “I like all of the staff, they are all nice” and “There’s enough staff to give me the help that I need when I need it. They make me feel happy. I have a buzzer, but I don’t need to use it”. Relatives also said, “The staff are 100%, good staffing numbers to ensure people are safe” and “They get on with staff, they are really good, they don’t leave, 1 did and went back again. There is always plenty of staff and the same people”. All staff spoke passionately about their roles and the support they received from the provider.

Staff told us they had received the relevant training and had the required skills to meet people’s needs. One staff member told us, “When I started I had online and some face-to-face training. I then worked on floor shadowing for 3-4 weeks doing a mix of lates and earlies. I found it very interesting, all staff were very helpful, they talk you through everything and the reasons why”. Some staff did share they thought an extra staff member in the afternoon would be beneficial, leaders told us they would review this.

The service had a consistent stable staff team; many had worked at Casa Mia Care Home for several years. Some staff had completed additional training which complimented the effectiveness of service delivery. This included additional clinical training and In-house Manual Handling Train the Trainer programmes, enabling staff to receive immediate, high-quality support and guidance when care needs or risk assessments changed. 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. Staff had received online and face to face training to ensure they had the knowledge and skills to support people safely and effectively. Where people had specific needs and diagnosis's, staff had completed additional training.

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. We observed the service to be clean and well maintained. The service had dedicated housekeeping staff which maintained the cleanliness of the home. The kitchen was well managed with effective temperature monitoring and safe handling practices in place. The local authority’s Environmental Health Department had issued a food hygiene rating of 5. We observed staff wearing appropriate personal protective equipment (PPE) and knew when and how to use this appropriately. Staff had received training in infection prevention and control (IPC).

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. There were systems and processes in place to support safe storage, administration and disposal of medicines. Staff had received the appropriate training and had their competencies checked and reviewed.

The provider had a medicines policy and British National Formulary (BNF) was available for staff to refer to. People and relatives told us they were satisfied with how medicines were managed, 1 person said, “They give me my meds. I have lots of them, they do all of that. No problems with them ever. I get them every day. I have a specific condition so sometimes I need a medicine; I can ask for it when I need it. I can tell when I need it. It’s called PRN”. Another person said, “They put cream on my skin for my condition; it’s clearing up now. They give me tablets for my brain too. I check on them to make sure I get them every day. They have never forgotten, they put them in pots for me to take”. A relative shared “There’s no problems with their medicines. They didn’t used to take them before moving here, now they take them all”.

The service supported some people with self-administrating their medication, promoting independence whilst maintaining appropriate levels of oversight and safety.