Frinton 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 78 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The registered manager 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 reported and recorded, and any learning was quickly shared with all staff. For example, a person had a fall in the community, seeing something that attracted them resulted in them suddenly running and then slipping. No significant injury had been caused and an immediate investigation revealed they were wearing shoes with poor grip. This was immediately resolved with new shoes being purchased and staff reminded of what shoes they needed to wear in the community. There had been no repeat accidents. The registered manager told us, “We have staff debriefs after every incident so the entire team is aware. We look weekly for any patterns or where any lessons can be learned.” Relatives told us that communication from the service was always prompt, one saying, “They keep in touch if things happen. There have been a few falls over the years and always let me know. Nothing serious has ever happened.”

The registered manager 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. Systems and processes were in place for when people needed to leave the home either for short term stays in hospital or in the event of a longer-term move. When people attended Hospital for treatment and in some cases for operations, Hospital passports, a concise summary of people’s health and social care needs, had been prepared in advance of this. . An emergency admission pack was accessible and printable from people’s care plans, providing more in-depth information for prolonged visits to hospital. This ensured the receiving health care professionals had all the key information needed. In addition, staff always accompanied people on Hospital visits and if people had to remain overnight of for longer periods of time, staff would remain with them for reassurance and communication purposes. The registered manager told us that they would try to keep people living at the home as long as possible and ideally for the rest of their lives. They acknowledged however, that if medical needs could not be provided at the home, there might be a need for a more permanent move. The service worked well with other professionals to make sure people had all the support they needed at the home.

The registered manager 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 lived safely at the home, protected from avoidable harm. People and their relatives all told us they were safe. A person said, “It’s lovely here, I feel safe.” Relatives told us, “They are safe and well cared for” and “I don’t need to worry, they are safe and looked after.” All staff had completed safeguarding training and were able to tell us the circumstances that would lead them to report an incident as a safeguarding. A staff member said, “Anything that harms the individual, incident or accident or risks, if I saw it, I would report to supervisor or the manager.” Staff were aware of thew whistleblowing policy at the home and told us they were confident to use it if needed. Whistleblowing allows staff to raise concerns whilst having their anonymity protected. People’s mental capacity had been assessed relating to specific decisions, for example, receiving personal care, support with medicines, community access and locked doors. Decisions had been made with people, their relatives or advocates and professionals, in their best interests and this had been recorded. People were still encouraged and supported to make day to day decisions for example, food choices, what to wear and what activities they wanted to do each day. People’s ability to make decisions was regularly reviewed. Deprivation of Liberty Safeguards (DoLS) were in place for everyone living at the home. These had been applied for and renewed in a timely way. DoLS provide a legal framework protecting people who lack aspects of mental capacity who are under constant supervision in care home settings.

The registered manager always worked well with people to fully understand and manage risks by thinking holistically. Staff provided care that fully met people’s needs and was safe, supportive and enabled people to do the things that mattered to them. Risks were managed well and were not viewed by the registered manager and wider staffing team as being restrictive to people’s lifestyles or preventative to what they wanted to achieve. For example, most people living at the home lived with epilepsy. Often when people arrived at the home they were on strict medicine regimes to prevent seizures. The medicines however often made people drowsy and unable to fully take part each day in tasks or activities. The home had successfully reduced some people’s medication and introduced programs of stretching, massage and gentle exercise which had helped to improve their quality of life. These changes were carried out with full support from people’s GP’s and their families. This change in regime had resulted in fewer epileptic seizures and people being able to lead a more active life. Some people were at risk of falls and this in part was due to people’s physical presentation which increased the likelihood of stumbling or falling. These risks were not viewed as restrictive and steps had been taken to mitigate, using simple, unobtrusive, equipment to allow people to be able to walk around with minimal chances of falling. We saw one person who used an extended belt, supported by staff, get up and move rooms and move to where they wanted to be. This had not previously been possible due to the constant risk of falling which had reduced the confidence of the person. People were now able to attend college and to go on holiday due to the risks to them being managed well. A ‘now and next’ board for each person described what people were currently achieving and what their next goals and ambitions were, keeping personal progress and risk management in focus. Staff worked 1 to 1 with people and knew them well. Staff knew about the risks people lived with but told us they were managed well and did not prevent people achieving their goals. A staff member said, “I know they are at risk from living with autism, environmental, communication and the frustrations they can feel. We know the best way is to be calm, remove loud noises and create safe spaces for them.” Risk assessments were clearly documented within care plans which were updated at regular intervals and more frequently in the event of an incident. Relatives told us that their loved one’s lives had been transformed due to the careful management of risk.

The registered manager detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The home was well maintained. Physical adaptations had been made to the home to enhance people’s lifestyle and wellbeing. For example, a ramp had been installed leading from the back door into the garden which was now easily accessible to everyone. A lift connected the ground and first floors and everyone’s bedroom was en-suite and spacious. People’s bedrooms were decorated according to their wishes. All bedrooms contained personal effects, photographs and sensory fixtures according to people’s needs and wishes. Bedrooms and communal areas were free from any trip or other obvious hazards. Maintenance certificates showed that all safety checks had been completed and were in date including, gas, electrical testing and legionella. The most recent fire service inspection was positive with only minor concerns documented and all of these had been promptly addressed. Personal emergency evacuation plans (PEEPs) were in place within care plans with a printed copy for each person in an easily accessible grab bag close to the front door of the home. PEEPs provided attending emergency services information about people’s support needs and understanding in the event of an emergency evacuation. A recent unannounced fire evacuation took place involving the night staffing team which was successful and carried out within specified time frames.

The registered manager 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. 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. Staffing levels were determined by the registered manager based on a balance of needs and skill set. These could be altered as required for flexibility of needs. Staff had been recruited safely with the required employment checks in place. New staff completed an induction process with shadowing opportunities to ensure they were competent before being able to support people. One member of staff told us, “Had a 3-day induction, then 2 days working with staff, shadowing with people. We do a lot of training before supporting an individual.” Night staff also complete a health assessment record with any “yes” answers being risk assessed by the registered manager prior to employment. Staff told us they felt well supported and have training that gives them the skills needed to safely support people. One member of staff told us, “We do support each other, there is excellent staff morale, the best place I have ever worked.” Staff have monthly supervision meetings which provide the opportunity for feedback with one staff saying, “Have supervision, and yes I could speak up if I wanted to.” The registered manager promoted staff development and successfully pushed for a deputy manager role to be created to ensure the home was always well managed in her absence. There are promotion options for staff, with courses regularly offered. One staff told us “She (the registered manager) always pushes us to develop.” Staff completed e-learning training and competency assessments in medications and manual handling, and staff at all levels had opportunities to learn. Specialist training was provided for more complex conditions supported within the home, for example, epilepsy.

The registered manager assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. People were encouraged to do activities and interact with the wider community, and this increased risk of infection was managed well by the staff. The home had Personal Protective Equipment (PPE) available to staff which minimised the risk when people were out, for example when people attended college. If any infection had been identified within the college environment, PPE use would be implemented. Hand hygiene was promoted with washing instructions and reminder notices displayed in people’s bathrooms, and people were encouraged to wash their hands when returning from outings. People were supported to maintain personal hygiene, with staff being trained appropriately in accordance with people’s needs and preferences. The registered manager told us that if any outbreak were to occur, they would isolate people in their rooms, with staff support, and if required would seek advice from specialist infection control teams. Cleaning responsibilities were shared between staff and the people they supported, with cleaning schedules in people’s rooms that showed the routine and areas cleaned. The premises and equipment were clean and well maintained. Required standards of food safety were adhered to and the latest inspection by the Food Standards Agency had awarded the home the highest possible score.

The registered manager 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 needed staff to support them with all medication needs. Medicines were safely stored in people’s rooms, in secure, wall mounted cupboards with a file of relevant paperwork and information. Medicine Administration Records (MAR) were completed correctly and all stock numbers that were checked matched the person’s records. Staff were observed administering medicines and wore gloves, following recommended good practice. All staff were trained to administer medication and were assigned to support a person for their shift; they only administered to that person. There were no general medication rounds, everything was based around individuals and their specific needs. Care plans documented people’s preferred methods of taking medicines. Annual competency assessments were completed by all staff and noted on the training system. Staff signed to show they understood individual’s needs and the medication policies that were in place. Errors and any refused medicines were recorded, and if required advice would be sought from medical professionals and a safeguarding raised. Additional information on specific risks such as seizure management were available in people’s rooms including instructions on giving emergency medications. When people attended college or were out in the community, they had continued access to their emergency medications if needed. Medication was signed out for social leave so there were updated stock numbers daily for medicines in and out of the home. The deputy manager, registered manager, and team leaders shared responsibilities for the ordering and booking in of monthly medicines. The deputy manager told us the GP was very supportive if they needed any interim medicines, for example, antibiotics for an infection. Staff told us they have a good relationship with the local surgery. The home had a supply of homely medicines in stock, these were medicines which could be bought over the counter and given when required, for example pain relief. Opportunities to reduce the over medication of people had been considered with one person having their medicines reduced and responding in a positive way, becoming more interactive and socially involved. There are regular audits carried out weekly and monthly, with any identified concerns being immediately addressed.