Lord Hardy Court

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 72 (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. Accidents and incidents were analysed and trends and patterns identified to prevent future risks. Staff and leaders had processes in place to learn lessons when things went wrong. Practice was changed as a result of lessons learnt and improvements made to 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. Detailed hospital passports were available to assist with continuity of care and passing on information. These included things that mattered to people including their likes and dislikes. Information regarding clinical appointments were documented in care plans and staff followed guidance from external professionals. One external professional said, “The staff ensure they [people] attend their hospital appointments and any social activities they are scheduled to attend.”

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. Leaders kept a record of safeguarding concerns and took action to improve practice where appropriate. Staff were knowledgeable about safeguarding people and were confident they would identify and address safeguarding concerns without delay. One relative said, “I have never seen anyone lose their patience and they [staff] are respectful.”

The principles of the Mental Capacity Act 2005 (MCA) were understood by the registered manager and there were processes in place to review people’s capacity in line with the MCA.The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We found the service was working within the principles of the MCA. People had care plans in place to ensure DoLS were recorded and people supported in line with them. Where people lacked capacity, best interest decisions had been completed to ensure their views, wishes and preferences were considered.

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 associated with people's care were identified and managed to keep safe. Risk assessments were in place to ensure care and support was delivered safely. For example, where people required the use of a hoist to transfer position, risk assessments were detailed and included loop configuration, the size and type of the sling and explained how people may present. Information regarding modified diets was also provided and care was delivered in line with people’s care plans. One staff member said, “I follow individual risk assessments and care plans, complete regular observations, report concerns promptly, and adhere to safeguarding, health and safety, and organisational policies. I ensure people are supported in a way that balances their safety with their independence, rights, and personal choices.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Comprehensive records regarding the maintenance of the service were available and were organised and maintained to a high standard. Risks associated with the care environment were assessed and action taken to mitigate risks. Personal emergency evacuation plans [PEEP’s] were in place to ensure people were supported appropriately to exit the home in an emergency.

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. Staff were recruited safely, and pre-employment checks were completed appropriately. Staff had access to a well organised and well managed training programme. Training included supporting people with a learning disability and autism. Leaders carried out observations of staff practice which ensured staff were delivering care in line with expectations. Staff received regular supervisions and appraisals. Staff told us they felt supported. One staff member said, “I receive regular supervision and appraisal meetings where performance, development needs, achievements, and any concerns can be discussed. I feel supported by my manager and am comfortable approaching them for guidance and advice when needed.” A relative said, “Staff seem qualified, they know what they are doing.”

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 carried out a tour of the service and found the home to be clean and well maintained. We saw staff adhered to good infection prevention and control guidance.

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 received their medicines as prescribed by staff who were trained and competent in the safe administration of medicines. However, we identified some minor concerns which were actioned immediately. These were in relation to storeroom temperature recording, checking expiry dates and no risk assessment was in place for paraffin based topical creams. People who were prescribed medicines on an as and when required basis, had protocols in place to ensure safe administration.