Frenchay 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 requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

The provider was previously in breach of the legal regulation in relation to the premises and equipment. Improvements were found at this assessment, and the provider was no longer in breach of this regulation.
 

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. Staff told us they completed incident forms and we saw the registered manager investigated and analysed incidents and concerns to review themes and prevent recurrences. ‘Lessons learned’ were shared with staff to identify shortfalls and embed good practice. Staff meetings regularly included practical learning activities to encourage the team to learn together and promote high standards. Policies and procedures provided guidance about how staff should report and respond to incidents, accidents and complaints.

Professionals told us they had seen positive changes and improvements at the service. This included to people’s care and the home environment. One professional said, “We’ve had a really positive response from the team. They’re not there yet, but there have been good changes.”

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.

Since the last inspection, some people had been admitted to the service who presented challenges due to their complex needs. The management team worked with other agencies to establish and maintain systems of care in which safety was managed and monitored. They made sure there was continuity of care, including when people moved to different services.

The registered manager or their deputy carried out assessments before people were admitted to the service. Sometimes they found information they received had been lacking or inaccurate but worked with people and the staff team to ensure people’s needs could be safely met. A staff member told us, “When we had people staying here with different needs, we had training about how to look after them. It was good to know more about how to do that.”

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 when they were being supported by staff. Their relatives said they were confident that staff kept their family members safe. One relative informed us that their family member had left the home without staff knowledge. Since then, changes had been made to the environment and staff practice to prevent a repeat occurrence.

Staff believed they kept people safe at Frenchay House. They received training in safeguarding and were able to describe the action they would take if they had concerns. Staff told us they were confident that concerns would be managed appropriately. A staff member said, “I think everyone understands how important safeguarding is and why we need to be open about it. We report any concerns.”

The provider had effective safeguarding systems and processes to make sure people were appropriately protected from abuse. Policies provided guidance, and safeguarding concerns and referrals were raised and monitored. The registered manager described how they collaborated with other professionals to keep people safe. During the inspection, professionals shared recent safeguarding concerns with us. We reviewed these with the registered manager and were assured that people were safe and concerns were being shared as required.

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). Staff worked within the principles of the MCA and DoLS were managed to ensure any restrictions or limits on people were the least restrictive possible and in the individual’s best interest.

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.

The registered manager and deputy completed risk assessments with people or their families. For example, relating to medication, choking and the safe use of equipment. Care plans were developed and were available to staff to help them safely manage identified risks. Risk assessments and care plans were regularly reviewed to ensure they continued to reflect people’s needs and preferences.

Relatives told us staff balanced the needs of their family member with safety and risk management. They felt staff knew people well, and this helped keep them safe. Staff received training in subjects such as moving and handling, continence care, food safety and skin health to ensure they were able to safely meet people’s needs.

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

At the last inspection we found the facilities and equipment did not always support the delivery of safe care. At this inspection we found improvements had been made to communal areas and some bedrooms. A plan was in place to continue updating and refreshing the home. We saw repairs had been made to floors, walls and the stairlift and people were able to access the lounge using a ramp. Some areas continued to need minor repairs. For example, bedroom walls which had been damaged by beds. The registered manager was very aware of the ongoing need to continually repair and refresh the home in a timely way. This needed close monitoring because of the age and complexity of the building.

Regular checks of equipment and building safety were carried out. We saw testing records relating to lifting equipment, windows, gas and water safety and wheelchairs and hoisting equipment. A fire risk assessment had recently been completed by an external agency and fire drills were regularly carried out. Personal emergency evacuation plans described the support individuals would need in an emergency and a ‘grab bag’ was available for staff.

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.

There had been several changes to the staff team since our last inspection. There was a hierarchy of care staff, as well as an activity co-ordinator, housekeeping and kitchen staff.

At the time of our inspection, the rotas and our observations showed there were enough staff to safely meet people’s assessed needs. There were some unoccupied bedrooms, and some staff were concerned that they would be very busy when the home was full. However, the registered manager gave assurances that they would continue to review people’s needs alongside staffing numbers to ensure an appropriate balance was maintained.

People and relatives told us there were usually enough staff, and they felt they were good at their jobs. One relative said, “Staff have been nothing but helpful.” Relatives described staff as kind and caring, and said they treated people with dignity and respect. One staff member told us, “There are a lot of new staff. Now there are enough staff. We work together to make sure everything gets done.”

Staff received regular training and supervision to ensure they had the knowledge and skills for their role. The management team monitored staff compliance to ensure they were up to date with training and supervision. Staff were positive about the training provided. One staff member told us, “Training is really good. The company has helped me learn and develop.”

Staff were recruited safely by the provider, and relevant checks were carried out before new staff started working at the service. This included criminal record and employment checks to confirm staff were suitable to care for people.

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.

At the last inspection we found some areas of the home did not meet required cleanliness standards. At this inspection we found improvements had been made, although some areas required ongoing attention. We observed, and some relatives and people told us, plates and cups were often not removed from people’s rooms until long after mealtimes had ended. We raised this with the registered manager for their attention.

Communal areas were clean and pleasant and bathrooms and toilets were hygienic. Cleaning schedules and compliance checks were completed. However, we found some bedrooms smelled strongly during our first day at the home. On the second day this had improved, although we highlighted to the registered manager that one person’s bedroom still smelled strongly. They told us they planned to explore alternative flooring solutions in the room.

Since the last inspection, the provider had changed how they provided meals and food to the service. Meals were now prepared in a central kitchen by experienced professional chefs. People were positive about the food they received. A recent Environmental Health inspection had awarded the service a rating of 5, the maximum score. This showed food safety management systems, hygiene training, cleaning schedules, safety checks and records were compliant with regulations and standards and were met to a high standard.

Staff were seen to be following the provider’s infection prevention and control policy and wore personal protective equipment (PPE) appropriately.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.