Tixover 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. Lessons were learnt to continually identify and embed good practice.

The provider had effective systems to learn when things went wrong. Staff told us incidents were investigated thoroughly, and lessons were shared during reflective supervision and team meetings. Records showed trends and patterns were analysed, and actions were implemented to reduce risks. Duty of candour was evident, and staff understood their responsibilities. Staff told us, “There are ‘lessons learnt’ information posters in the staff room to read.” and “The manager reviews what happened, discusses it in team meetings or supervisions, and explains what changes have been made to prevent it happening again. This helps us learn and improve practice.” Learning was embedded through case studies and audits, with improvements being made such as reducing the amount of falls people experienced.

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 experienced safe admissions and transitions. Pre-admission assessments were detailed and included health needs, preferences, and risks. Processes were in place such as daily walk-rounds to identify emerging risks. Care plans were comprehensive, covering hydration, nutrition, mobility, and personal care. Staff worked with external professionals, such as GPs and physiotherapists, to ensure continuity of care.

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 and systems were in place to protect people from abuse. The registered manager and staff acted promptly and appropriately to ensure people were safeguarded from the risks of ill-treatment or abuse. Staff had received the required safeguarding training and were confident in identifying and reporting safeguarding concerns. A staff member said, “Anything that affects the safety of the residents I would whistleblow.” 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 checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that appropriate processes had been followed to ensure people were not unlawfully deprived of their liberty.

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.

People were supported to make decisions about their safety. Care plans included detailed risk assessments for identified risks to people such as falls and skin integrity. People told us they felt safe. A person said, “They (staff) come and check on me every hour, I hear them opening the door at night” and a relative said, “[Person] has been here since August and hasn’t fallen once."

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 environment was well maintained and safe. Health and safety checks and audits were completed regularly, including fire drills and water temperature checks. People and relatives praised the premises. A relative said, “The home has been spruced up a lot in the last couple of years, and it looks really nice now."

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 and relatives consistently told us staff were available and responded promptly. A staff member said, “The staff are very flexible and will always come in to help out whenever they are needed if available, it really is like this, we genuinely love our residents and our roles so much.” Staff were recruited safely and induction processes and ongoing training ensured staff had the skills and knowledge to support people well and safely. Staff spoke positively about the support and training they received. A staff member said, “The training is very helpful and makes me feel confident in my work. Barchester offers different types of training like group sessions, online learning, webinars, and face-to-face sessions. We also get regular updates, and yearly refresher training keeps our skills up to date.”

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 was observed to be clean. People told us, “You can’t fault the cleanliness” and “There are no bad smells”. Staff understood infection prevention and control (IPC) policies and wore personal protective equipment (PPE) appropriately. A recent audit carried out by the local authority IPC team, found staff met expected standards and awarded them with 100% compliance.

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.

People were given their medicines, including time sensitive medicines, at the right time to ensure that they were effective. Systems were in place to ensure medicines, including controlled drugs were stored and administered safely. We saw good practice in the management of medicines patches. Staff had completed medicines training, and their competency was regularly assessed. Care plans were person centred and contained clear guidance to help staff support people with complex needs. Staff understood and used tools to assess pain in people who were unable to communicate verbally. Staff knew the people they supported well, which helped to reduce the use of medicines to manage behaviour. They used individualised approaches and de-escalation techniques to support people in a way that respected their dignity and preferences. People were able to take their own medicines if they had been assessed as safe to do so. Staff had access to information about how each person preferred to take their medicines. Best interests’ decision meetings had taken place for people who received their medicines covertly (disguised in food or drink) and pharmaceutical advice was in place to ensure this was done safely. Medicines audits were completed regularly to check that systems were safe. Staff were knowledgeable about the steps to take in case of a medicine-related incident, with systems in place to ensure lessons learned were shared.