Cubbington Mill

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.

There was a culture of learning from accidents and individual mistakes and sharing information with the team. Staff attended reflective supervisions to learn from incidents such as injuries and medical emergencies and regular clinical meetings ensured people's health and well-being was monitored. One staff member told us, “If a resident fell and you were there, you help them, make sure they are safe and then you go straight to a nurse. We fill in the accident form and if you’re unsure you can always get help. The manager checks everything and then we are told if we need to make some changes.” Another staff member told us, “When something happens, the manager or the nurse will explain what happened and we talk about how we could do things better. Sometimes it might be we need refresher training or we need different equipment. Everything is shared in handover and team meetings.”

The registered manager and the provider reviewed accidents and incidents to ensure appropriate action to mitigate risks had been taken and to improve safety within the home.

Relatives were informed if their family member experienced an accident or injury. One relative told us, “The staff recognised [Name’s] mobility was not as usual and informed us straight away.”

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.

People’s needs were assessed prior to moving to Cubbington Mill to ensure the home was suitable for their needs and planned outcomes could be achieved. One relative told us, “They came out to assess [Name] and got a lot of information about her. It was very individualised.” A staff member commented, “Before we have a new resident, the management do an assessment, and they share all the information with us.” When people moved to another service, information was shared with the new provider to ensure a safe and effective transition into their care.

When people had an unplanned admission into hospital, information about people’s health, medication and wishes for future care was sent with them. This ensured other healthcare professionals had important information about the person to inform their decision making.

The provider had processes to support people to attend healthcare appointments outside the home. This included arranging transport and a staff escort if this was required.

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 felt confident they were safe with the staff who provided their care and support. Relatives agreed. Comments from people included: “As a home it is very good, I am happy they look after you”, “It’s very safe, there are always plenty of people about” and “I’m as safe as anybody could be in my condition.”

Staff received training so they understood their role in reporting and escalating any concerns if people were at risk of harm or abuse. Staff were aware of the provider’s whistleblowing policy and felt confident any issues would be addressed by the management team. One staff member told us, “We have a zero tolerance for any type of abuse. That would never be acceptable. If I saw something or I was a bit suspicious, I would tell the manager straight away. I could whistle blow, but I know our manager would deal with things before it got anywhere near that point.”

The registered manager understood their responsibility to report any safeguarding concerns to the local authority and to us, CQC.

When receiving care and treatment, people can only be deprived of their liberty with the 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 (MCA) 2005. We checked how the provider managed DoLS within the home. Where people had restrictions in their care plans, they had been assessed as not having the capacity to consent to, the provider ensured DoLS applications had been submitted to the relevant supervisory body. One staff member told us, “Quite a few of our residents have DoLS. I know they are called restrictions, but they are for their own safety and that what’s important. You can see if a resident has a DoLS because it is shown here on the front screen (handheld device) and all the detail is in the care plan.” Nobody had any conditions on their approved DoLS at the time of our inspection.

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.

Risks to people’s health had been assessed and plans developed to mitigate identified risks. For example, in relation to eating and drinking, mobility and the risk of falling. Where people had more complex clinical needs, there was detailed guidance for staff on how to provide safe care and treatment and mitigate any associated risks. For example, when people had skin damage or received their nutrition or medicines through a tube directly into their stomach.

Whilst most risks were identified and managed, we identified 1 person with capacity who chose to have their bed at the highest level without a risk assessment in place. Another person had a mat to alert staff if they attempted to get out of bed which had not been risk assessed. When we shared our findings, risk assessments were immediately undertaken with people’s involvement and care records were updated.

Staff involved people in discussions about their health and wellbeing but recognised their right to make some informed decisions with risk. One staff member told us, “All the residents make their own choices. If they have capacity and we think their choice is a bit risky, we talk to them and point it out, but they still have the right to make the decisions.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Cubbington Mill was in good order and well-maintained. A refurbishment of the first floor had recently been completed, enhancing the living experience for people, staff and visitors.

The provider completed regular checks on the safety of the environment and equipment. They organised for external professionals to undertake additional checks.

There were systems to help prevent the risk of fire. Staff completed training in fire safety and there was a fire marshal on each shift. Fire drills were carried out and staff understood what action to take in the event of an emergency. Issues in relation to emergency signage by a lift and a missing personal evacuation plan for a person who had not moved from the home as anticipated, were immediately addressed.

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.

Overall, people and their relatives were happy with staffing levels in the home and felt staff had the knowledge and skills to meet their needs. Comments included: “I’m happy with the staff competency. Generally, there are no staffing issues”, “They seem well trained, a lot of them have been here a while” and “The carers are excellent, they seem well trained to me.”

The provider used a recognised dependency tool to identify how many staff were required on each shift to provide safe care. An electronic rostering system ensured safe staffing and enabled the provider to identify any shortfalls in staffing levels. The provider maintained a pool of trained bank staff who provided flexible support to cover gaps on the rota or staff absence. The allocation of staff was reviewed daily to ensure there was an appropriate skill mix across the home. There were ancillary staff to maintain a clean environment, provide administrative support and prepare people’s meals and drinks. This allowed clinical and care staff to focus on providing people with safe care.

Staff told us staffing levels enabled them to safely provide people’s planned care. One staff member explained, “It can be really busy, especially in a morning when all the residents want assistance at the same time. Routine is important to them (people), so we try very hard to meet their wishes. We all pull together. The management will be there and will step in to help.” When we asked another staff member if staffing levels were effective, they responded, “When there is no last-minute sickness, then absolutely. We don’t use agency just to give continuity of care." Staff were visible and available during the inspection.

The provider had processes to ensure all safe recruitment checks had been completed prior to staff starting with the service. Recruitment checks included staff identity checks, references and Disclosure and Barring Service (DBS) checks. DBS checks provide information including details about convictions and cautions held on the Police National Computer. This helps providers make safe recruitment decisions. One staff member confirmed, “I had to wait for my clearances to come back before I stated my 2-week induction.”

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 raised no concerns about cleanliness standards in the home. One relative told us, “They clean her room daily, it is always lovely and clean.”

All staff received infection prevention and control (IPC) training during their induction, with mandatory annual refreshers to maintain their knowledge and reinforce best practice. If any concerns or breaches in infection control were identified, these were addressed through supervision, targeted training, and additional support where necessary. Clinical equipment was clean, well maintained and ready for use.

The provider carried out regular IPC checks and audits to identify any issues relating to infection control practices in the home.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

People and their relatives shared no concerns about the availability and administration of their medicines. Comments included: “I take medication 3 times a day, the times don’t seem to vary much”, “They are very good at managing my pain” and “I take pain relief when I need it, I don’t have to wait.” We did receive some feedback that staff did not always stay with people and watch them take their medicines. Whilst these people had capacity to understand the importance of taking their medicines, the deputy manager assured us they would reinforce their expectations with staff.

Medicines were stored, managed and administered in accordance with best practice guidance. Medicines that required extra checks due to their potential for misuse were managed in accordance with legal frameworks. There were processes to ensure people received their time specific medicines as prescribed, and medicines administered via a patch applied directly to the skin were managed in accordance with manufacturers’ guidelines. When medicines were given on an ‘as required’ basis, records were maintained of why they had been given and their effectiveness monitored.