Claremont Parkway

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 66 (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.

Processes for investigating, analysing, and responding to accidents, incidents, complaints, and safeguarding alerts were in place. Staff understood their responsibility in relation to reporting all accidents and incidents. These events were used as a learning opportunity and any lessons learnt were shared with the staff, for example, increased monitoring of people’s skin condition. People and relatives had a range of mechanisms to raise concerns or share their views. People were confident managers would act on feedback, for instance, to arrange suitable transport to enable a person with mobility needs to attend outpatient appointments. Management and staff worked with health care professionals such as doctors, social workers etc, to ensure people received appropriate care.

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.

Managers and staff had good awareness of people’s needs and risks and the support they needed to promote their safety and wellbeing. For example, when paramedics attend to take a person to hospital or attending outpatient appointments, staff shared relevant information about the individual to ensure their needs were fully understood. Managers and staff worked in partnership with others to ensure there was continuity of care, including when people moved into care home or moved between services.

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 with the staff and care provided. A person said, “‘I feel safe, it’s a safe place.” A relative said, “I have no concerns about [Person’s] safety. Very safe in hoisting her. they explain to [Person] what they are doing. No falls at all.” Staff received safeguarding training and understood their responsibility to keep people safe and how to report concerns. A staff member said, “Safeguarding is protecting our residents from harm, neglect and abuse.” Management worked closely with the local safeguarding team and responded appropriately when safeguarding concerns were raised.All safeguarding concerns were recorded in detail and people’s health and well-being were closely monitored following any concerns or incidents.

The provider worked with people to understand, and risks management plans were in place. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People told us their care needs were met. A relative said, “[Person’s] skin is very thin and if there’s a problem, they send me photos and inform me. They are very on the ball in notifying me.” People’s care plans and risk assessments were detailed and personalised. Care plans contained clear instructions and best practice guidance to enable staff to provide safe care and support, for example, how staff were to provide support to promote a person’s mobility and healing of a wound. However, a person’s records showed they should be re-positioned every 2 hours, but charts indicated this occurred every 3 hours. Monitoring charts for people on food and fluid balance and catheter care were not always completed fully. Although there was no impact on people’s health, the lack of accurate, reliable and inconsistent record keeping puts people’s health at increased risks, such as infections and dehydration. Records viewed relating to a person becoming unwell and the clinical deterioration escalation procedure lacked clear instructions for staff to follow. These issues were all raised and addressed by the provider and management during the on-site assessment. Staff knew people well and told us they had access to care plans and risk assessments. Staff were trained in areas to manage risk such as moving and handling, first aid and health and safety. We observed staff using equipment correctly to move people safely. People’s personal evacuation plans were kept up to date and under review, to enable staff to support safely in the event of an emergency.

The provider detected and controlled potential risks in the care environment. Checks carried out to ensure equipment and facilities supported the delivery of safe care were not fully effective.

People and relatives were complimentary about the environment, décor and equipment provided to promote people’s safety and independence. A person said, “The environment is very nice. Housekeeping and maintenance is good.” A relative said, “I’m more than happy with the general environment.” There was good lighting, clear signage and free of obstacles and hazards, enabling people to move around safely. However, we found environmental risks which included an unsecured wardrobe, which could fall onto a person, and inappropriate equipment had been stored in the treatment room. These issues were all raised with the provider and maintenance staff, and action was taken. Systems were in place to inspect the building, fire safety, and equipment such as hoist and slings, used to meet people’s needs was serviced. However, actions required following external safety inspections had not been addressed. This was raised with the provider to address. The provider’s business continuity plans covered all eventualities such as managing outbreaks, loss of power, fire and other emergencies.

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 relatives told us there were enough staff to meet their needs reliably. A person said, “I’m safe yes, there’s always someone about.” A relative said, “There’s always staff doing something for [Person] when we are there. They do their best for them.” Although some people and relatives told us at times there was a delay in staff responding, they all confirmed their care needs were met. There were enough staff deployed, in line with the rotas. Any unplanned staff absences had been covered by existing staff. Comments included, “Staffing is good and great team work” and “At the moment, the number of staff at night is good.” New staff and nurses were recruited safely and some had started their induction training. Staff received training to meet people’s specific needs and refresher training to keep up to date with best practice. Staff competencies were assessed and checked periodically. Nurses were supported to maintain their professional skill, practice and knowledge up to date. Staff were supervised and received feedback on their performance.

The service 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 relatives spoke positively about the hygiene and cleanliness. Comments included, “I’m very happy with my room they clean it regularly” and “The hygiene is great no smells, they keep [Person] very clean.” Robust cleaning schedules and management oversight ensured all areas within the care home was clean and staff practices monitored. Appropriate policies and procedures were in place to support effective infection control and prevention. Staff were observed wearing suitable personal protective equipment (PPE) when it was required. We found cleanliness issues in the treatment room, some soiled items left in the toilet and damaged outer cover of a recliner chair, which increased the risk of spreading infection. These issues had not been identified by staff or the management. We shared the concerns with the provider and action was taken immediately. New equipment and recliner chairs were also ordered. The provider further assured us that action would be taken to strengthen management oversight.

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.

Prior to this assessment there were concerns about medicines management and administration.At this assessment people told us they received their medicines at the right time. A person said, “I take a lot of medication, no issues at all, they always wait until I’ve taken them. They give me pain relief [tablets] when I need it.” A relative said, “The nurses are very good with [Person’s] medication. It’s well organised and they let me know of changes to it.” We observed staff administered medicines safely and interacted with people in a kind and supportive way. However, we observed a nurse had not administered the medicine correctly for it to remain effective. This was raised with the nurse and the provider, and action was taken immediately to address the gap in training. Safe medicines administration and recording system was in place. There was clear recording where variable doses and time sensitive medicines, such as Parkinsons medicines, was prescribed and administered correctly. People’s care plans and protocols for ‘as required’ medicines were person-centred and contained sufficient information for staff to support people with their complex needs. We saw staff followed hospital discharge advice and examples of good practice. For instance, staff carried out additional monitoring for medicines when necessary to ensure people were safe and effective such as regular blood glucose monitoring as per insulin protocol. Medicines were stored securely. This included controlled drugs, which requires more control due to their potential for abuse, were stored securely with access restricted to authorised staff and recorded appropriately. Medicines with a limited shelf-life such as liquids and creams were dated appropriately. However, we found a medicine was still in use after the use by date. Staff had ordered a new stock, but a fault on the GP clinical system meant the new stock was not received. The provider took immediate action and new stock was received the same day with no impact on the person’s health. Medicines were disposed of safely when no longer required however record keeping should be improved and kept up to date. The provider further assured us that action would be taken to strengthen management oversight.