Chypons 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 our last assessment we rated this key question requires improvement. At this assessment the rating has changed to 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 had been recorded and investigated by the registered manager. Learning from incidents was used to improve the service’s performance and reduce the risk of similar events reoccurring.

Where people’s needs significantly changed the service sought advice and support from professionals promptly and acted on the information received.

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.

The service ensured people’s needs were identified and understood before they moved. The registered manager visited people at home, or in their previous care placement, whenever possible as part of the assessment process. Information gathered during the assessment process was used as the basis from which people’s care plans were developed.

Where care was transferred, or people were admitted to hospital, the service shared information effectively to ensure people’s needs were recognised and understood. Professionals told us the service communicated effectively and commented, “We are here twice a week, I haven’t any concerns”.

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.

At the last 2 assessments the service did not have effective systems to ensure the rights and freedoms of people with limited capacity were respected. As a result, we took enforcement action against the provider. At this assessment this issue had been addressed, and the service was compliant with the requirement of the regulations.

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.

The registered manager now understood these requirements and had developed an effective working relationship with the Local Authority’s DoLS team. People’s capacity to make specific decision was appropriately assessed. Where people lacked capacity to make specific decisions, best interest decision making processes had been followed to ensure people’s rights were protected. People’s care plans included information for staff on how to support people to make meaningful decisions. For example, one person’s care plan stated, "I have dementia, but still have capacity to make decisions. I need time and support when making decisions".

Appropriate and necessary DoLS applications had been made and conditions associated with authorisations complied with.

People were relaxed and comfortable in the service and told us, “I like it here, I came here just over a year ago as a break and I liked it so I stayed” and “They are looking after me”. Staff were attentive and understood their role in ensuring people were protected from all forms of abuse. They told us, “People are safe with us. I think we look after them very well” “This is the safest place I have worked so far” and “I like it, I like helping elderly people. It is nice and I am happy here”. Information about how to report safeguarding concerns was readily available to staff and people using the service.

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.

Care plans included accurate information and guidance for staff on the management of risks to people’s wellbeing. People were supported to safely mobilise around the service and were encouraged to move and reposition regularly to mitigate risks to their skin integrity. Pressure relieving equipment was used effectively to protect people from risks associated with skin breakdown.

Staff were patient and kind while providing support and responded immediately to people’s requests for assistance. One person became distressed and reported they were in pain during the morning of our assessment. A staff member promptly provided additional pain relief and then sat with the person, held their hand and provided quiet reassurance until the person was more comfortable.

The provider had identified risks in relation to staff working with colleagues with whom they were in close personal relationships. As a result, procedures to minimise these risks had been introduced and staff told us, “[My Partner] also works here, we do opposite hours as we don’t work together”.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

The service was generally well maintained and records showed maintenance issues were promptly addressed. However, some radiators in communal spaces and in one person’s bedroom were uncovered. The positioning of these radiators and furniture within the person’s room reduced risks associated with the person becoming entrapped in contact with unguarded radiators. Following feedback, the registered manager recognised the risk represented by these unguarded radiators and made arrangements for covers to be fitted.

All necessary checks had been completed to ensure the safety of the service’s utilities and lifting equipment. Fire detection systems and fire extinguishers were well maintained, appropriately serviced and tested. Plans had been developed detailing the support each person would require in the event of an emergency evacuation.

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.

At both of our most recent assessments the provider was in breach of the regulations relating to the safe recruitment of staff. As a result, we took enforcement action against the provider.

At this assessment the provider’s recruitment practices had improved, and new staff were recruited safely.

Necessary pre-employment checks, including disclosure and barring service checks, to ensure prospective staff were suitable for employment in the care sector, were now completed before new staff members began working in the service. Records showed staff had been recruited safely.

The service was safely staffed and rotas showed planned staffing levels were normally achieved. The registered manager told us they often overstaffed the rota on Wednesdays to give staff time to complete training updates. Staff comments included, “I love working here”, “There are enough staff, we have plenty of staff” and “Normally there are enough staff. We are only short if very unexpected things happen. Our sickness has gone right down”.

Staff were well motivated and received regular supervision, and training updates to ensure they had the skills necessary to meet people’s needs. Staff told us, “I have done health and safety, first aid, fire, food, and safeguarding recently. Someone comes in and teaches us normally”, “I do get supervision, about every month” and “The manager is easy to talk to and listens and gives us attention”. Staff new to the care sector were supported to complete the care certificate within the first 12 weeks of employment. This training is designed to give new staff an understanding of current best practice.

People were complementary of the staff team and we observed staff responding to people’s needs with kindness, care and compassion. People told us, “The staff are nice”, “The staff are all alright, I get on with them” and “They are looking after me”.

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 service was clean, and cleaning schedules were used to ensure all areas including people’s rooms were regularly cleaned. Staff understood how to manage infection control risks and were able to access Personal Protective Equipment (PPE) when required.

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 were safely supported with their medicines. The service used a digital electronic Medicine Administration Records (eMAR) system which prompted and reminded staff when people’s medications were due. Records showed people had consistently received their medicines as prescribed and any issues in relation to medicine administration had been promptly investigated and resolved by the staff team. Staff told us, “The meds app is so much easier than the previous system. You scan the box and it confirms you have the [correct] medicine. It alerts you and gives error messages if you try to give medicines too close together, it is a good system”.

Wherever possible people’s medicines were stored securely within people’s rooms. This helped limit opportunities for errors and ensured people’s dignity was respected. Controlled medicines were stored securely and necessary records accurately completed.

Staff understood how and when to use medications prescribed ‘as required’ for the management of people’s pain or anxiety. Records showed medication prescribed for the management of anxiety were used infrequently and appropriately. However, protocol was not consistently available to support staff new to the service to understand when ‘As required’ medicines should be used.