Archived: Guysfield Residential 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 the last inspection, we rated this key question as requires improvement. At this inspection this key question has improved to 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.

People and relatives told us the management and staff team asked for their views and took any action that may be needed. They said feedback and updates were shared with them.

Staff told us learning from events, complaints and updates was shared through meetings and handovers. A staff member said, “Any lesson learned has been discussed in staff meeting, and we discuss the policies and procedures that can be found in a folder in the station in outer office.” Another staff member said, “I am kept up to date with policy and legislation changed. From time to time the manager will discuss about cases, incidents or safeguarding that has happen in other homes so we are aware of our do's and don'ts, so that we should be mindful that it does not happen in our home.”

Learning was taken and shared with the staff team. This was discussed at handovers, team meetings and as part of day-to-day discussions. The registered manager was committed to an active learning culture to improve consistency of care and safety for people using the service.

The provider compiled an overview of events that had occurred within the care sector and shared this with the home to help ensure there were appropriate measures in place.

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 and relatives felt the move into the service had been very positive. They told us the registered manager, and the whole staff team had ensured the move was as easy as possible and they felt very supported. A relative told us, “The manager at Guysfield was very supportive when we were looking and offered advice regardless of where we chose. They visited my relative at home and worked hard to make sure their transition was as smooth as possible.”

There was positive feedback from visiting professionals. They told us the team worked with them to help ensure people received the right care.

People received a preadmission assessment prior to moving in. Records were held on file and information to be shared with healthcare professionals as needed. This was used to help inform the care planning process. A staff member said, “I have access to the pre-admissions assessments, and the senior team with the management and the family create together the care plans and risk assessments based on individual needs of residents.”

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 very safe living at the service. Relatives also felt their family members were safe, and they felt a sense of ease seeing how staff were with people. A relative said, “It was a really difficult decision to move my relative into a care home, but I am so pleased we picked Guysfield as I am confident that [person] is safe and well cared for.”

Staff told us they knew how to recognise, and respond to, abuse. A staff member said, “In case of concerns, I will escalate it with the manager, manager on call or regional manager, for immediate action. I did not witness any concerns.” Staff told us they would speak up when needed. Another staff member said, “If I am worried about a person's safety and welfare, there are several starting options depending on whom the person I am worried about. However, the normal chain would be to report to your line supervision, manger or regional manager. It could be I escalate to whistleblowing or report to local authority for vulnerable adult and CQC. I have never seen or needed to raise concerns in relation to any abuse.”

Staff were observed being kind in their approach and gentle when supporting people. People were very relaxed and comfortable with staff. However, during our visit, 2 people told us there was a staff member who they found to be ‘strict’ or ‘shouts’. We raised this with the management team for their investigation, and reporting, should this be needed. The management team told us they had spoken with staff, carried out observations and a member of the provider’s quality team was working in the home alongside staff, providing supervision and guidance where needed. There had been no concerns observed, or additional concerns shared.

Safeguarding concerns were processed, reported and recorded appropriately. Staff received training and information was displayed around the home.

The provider worked with people to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People and their relatives told us they felt staff supported them safely. A person said, “I feel safe here, I like it here.”

Staff told us about risks to people and the action they took to help reduce those risks. For example, in relation to falls, dietary needs and pressure area care.

Staff were working safely. We saw staff supporting people to move around safely, respond to calls for assistance and carry out regular checks. Staff ensured people were sat up when eating. There were sensor mats and call bells accessible for those who were able to use one.

People had individual risk assessments, and these gave guidance to help ensure staff supported people safely and were regularly reviewed.

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

People told us they enjoyed the facilities and could move around freely. People who were at risk of falls had sensor mats to alert staff to their need of assistance. Most relatives were also positive. A relative said, “The home is always clean and, in many ways, seems more like a hotel than a care home - my mother has a lovely room which has recently been redecorated, and we were consulted about the colours.” However, another relative told us they felt cleaning could be improved and felt the floors were always sticky. They also felt some repairs and updates were needed. We noted we found these same points that needed to be addressed. Action was taken to resolve this issue.

Staff were aware of hazards and how to reduce these. Staff had attended fire drills and people had individual evacuation plans based on their needs.

The environment was free from hazards and fire safety equipment was in place. People had access to call bells, and the home was maintained. The service had various sitting areas and people could choose where they wanted to sit and spend their day. We observed people moving around the home and staff helping to orientate them as needed.

There were regular checks carried out on the environment and equipment to help ensure the appropriate servicing was carried out and everything was in working order. We noted a footstool with a piece of trim trailing on the floor, without being told, the deputy manager also noticed without us raising it, and removed it.

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 said there were enough staff to meet their needs. A person said, “They come when needed.” Relatives said they felt there were mostly enough staff, and staff were trained for their role. A relative said, “When I visit, there always appear to be plenty of staff and they are aware of my relative’s needs.”

Most staff said there were enough of them to meet people’s needs in a person centred and timely way. A staff member said, “The home is staffed as per guidance lines of carer ratio to the number of residents and their dependency. Care will be late or delayed from time to time as many factors such as Dr visit, social worker visits or any unplanned emergency or event.” Staff felt they received enough training and support to carry out their role. A staff member said, “I have enough training and are all up to date. I have regular supervision with my manager.” We reviewed the training provided and saw this was completed and covered all key areas.

Staff were visible and prompt when people requested support. Staff were taking their time when supporting people and carrying out regular checks.

Recruitment followed a robust process carrying out checks to ensure staff were suitable to work in a care setting. These checks included criminal record checks, verifying applicants’ identities and written references. A checklist was completed to ensure all was in place and verified. A staff member said, “The recruitment process was fair and prompt, I had the interviews scheduled and the process was quick, once the checks finished and the references were given, I signed the contract and start working.”

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 if and when needed.

People’s bedrooms and most communal areas were kept clean. Some areas, such as woodwork, needed a deeper clean as appeared grubby.

Staff knew how to practice good infection prevention and control (IPC). A staff member said, “Visual charts demonstrating what to do in and event we have any suspected case are place all around the home. There are allocate PPE station and all floor and restocked each shift. It may affect a typical working day as we would need to limit visitor amount per residents and ensure proper infection guidance lines or being followed by staff and visitor as well as residents.”

Staff were practicing good IPC in their day-to-day roles. We observed correct handwashing and use of personal protective equipment (PPE).

There were IPC audits and checks in place.

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

People received their medicines in accordance with their needs and as the prescriber intended. Staff were carrying out administration tasks safely and in a timely manner.

Staff responsible for managing medicines were aware of safe practice.

Systems were in place to help ensure the safe management of medicines. We reviewed a sample of audits and found these were checking the appropriate elements, such as quantities, entries and storage of medicines, and identified any actions needed.