Chimnies Residential Care 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.

Records showed incidents, accidents and safeguarding concerns were investigated and lessons learned were shared with staff through handovers and discussions.The provider had identified learning following a fall and a review of the incident identified opportunities to strengthen post-fall monitoring, reassessment and escalation processes. In response, the provider introduced additional induction and competency checks for agency staff and reinforced expectations regarding incident reporting and escalation procedures. Records demonstrated this learning had been discussed with staff and embedded into practice.

Staff understood the importance of learning from incidents and felt supported to raise concerns. One staff member told us, “If I made an error I think they would be positive because we learn from these things, they would be ‘how do we make sure that doesn't happen again. Learn from mistakes.’” Another staff member told us, “If something goes wrong, you're not penalised, we just try to find a solution and work it out.”

These arrangements demonstrated an open and honest culture where concerns were investigated, learning was shared and improvements were made to promote people’s safety.

The provider had systems in place to support safe transitions between services, including pre-admission assessments, hospital transfer documentation and information sharing with healthcare professionals. Staff worked with other healthcare professionals to share relevant information about people's needs and risks when they moved between services. However, systems were not always consistently followed.

The registered manager identified occasions where agency staff had not completed or shared all necessary information within hospital transfer documentation. This meant people may not always have had all relevant information transferred with them when accessing other healthcare services.

The registered manager had recognised this concern and taken action. They had discussed this shortfall with the provider of the agency staff. They had also strengthened induction and training arrangements to reinforce expectations regarding information sharing and safe transitions.

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 living at the service. One person said, “I do feel safe. I feel quite safe, the staff are lovely. I couldn’t ask for better.” Another person told us, “Yes, I feel safe. Everything makes me feel safe – the staff and the environment.” We observed people were relaxed and comfortable in the presence of staff, who responded to them with kindness and respect.

Staff had completed safeguarding training and told us they would report any concerns immediately to senior staff or the registered manager and were confident concerns would be acted upon appropriately.

The registered manager understood safeguarding processes and their responsibility to share concerns promptly with relevant agencies. Safeguarding concerns were reported and managed appropriately to help keep people safe.

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, wellbeing and daily lives were assessed and regularly reviewed. Risk management plans provided staff with clear guidance on how to support people safely whilst promoting choice and independence.

We reviewed a range of risk assessments, including catheter care, skin integrity, mobility, malnutrition, falls management and bed rail use. These included measures to reduce risks and support people safely. Where bed rails were in use, appropriate risk assessments, consent records and best interest decision-making documentation were in place.

Staff understood people's risks and described how they monitored changes in health and wellbeing, escalating concerns to healthcare professionals when required. People told us they were supported in a safe way and received care that met their needs. Staff balanced managing risks with enabling people to remain as independent as possible.

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 provider had systems and processes in place to ensure the environment, equipment and facilities were safe and supported the delivery of care. The premises were well maintained, free from environmental hazards and provided people with a safe place to live. Equipment used to support people's care was regularly serviced and maintained. Records showed portable electrical appliances, emergency lighting, fire safety equipment and electrical systems were appropriately tested and maintained.

The provider had effective fire safety arrangements in place. Regular fire alarm testing and fire drills were completed, and staff understood the fire evacuation procedures. A fire risk assessment had identified improvements required to some fire doors and the provider was progressing these actions.

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 their relatives told us there were enough staff available to meet people’s needs. One person said, “Absolutely caring. If I press the button they come quickly. They check regularly when I’m in my room.”

During our assessment, we observed sufficient staff available throughout the home. Staff supported people with personal care, activities and mealtimes and regularly checked on people who chose to spend time in their bedrooms. Interactions were calm and unhurried, and people were not left waiting for support.

The provider used a dependency tool to determine staffing levels and adjust these in line with people's needs. Recruitment processes were robust and included appropriate pre-employment checks. Staff received training, supervision and competency assessments to support them in their roles. This was also to ensure they had the skills and knowledge required to meet people's needs such as dementia care, and moving and handling. Staff told us they felt well supported and had access to ongoing learning and development opportunities to help them provide safe and effective care.

Staff told us they felt supported and had enough time to provide person-centred care. Comments included, “Workload is absolutely fine - I don't feel rushed,” “We have enough time to have a chat with residents,” and “There's always time to spend time with people.” Staff also spoke positively about the support they received from leaders and colleagues. One staff member said, “You can go to anyone there, head seniors and management. They're amazing.”

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 and their relatives spoke positively about the cleanliness of the home. One relative told us, “The care home cleaners do cleaning every day.” Another said, “It’s nice and clean. They’re hot on that.” Other comments included, “Always seems very clean” and “It’s very clean.” One person also told us the cleaners and staff cleaned every day.

During our visit, we found the home was clean and well maintained, with no unpleasant odours. The sluice room and communal equipment, including commodes, were clean. People had their own individual slings to reduce the risk of cross-contamination, and cleaning schedules were in place to support effective infection prevention and control practices.

These arrangements helped ensure people were protected from the risk of infection and received care in a clean and hygienic environment.

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.

The provider had systems and processes for receiving, checking, storing, administering and returning medicines. People spoke positively about how their medicines were managed. One person told us, “They’re very good with medication. I’m diabetic so have insulin 3 times a day and they’re very good with it.” Another person said, “They’re done when they’re supposed to be. The senior staff does it.”

Medicines records accurately reflected the medicines people were prescribed and how they should be administered. Staff followed clear instructions to ensure people received their medicines safely and as intended. Medicines were stored securely and the medicines room was clean, organised and well maintained. Fridge temperatures were monitored and recorded to ensure medicines requiring refrigeration were stored safely. Medicines no longer required were disposed of safely and regular stock checks were completed.

Staff responsible for supporting people with medicines had received appropriate training and competency assessments.