The Old Garden 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.

This is the first inspection since the provider changed their name. They were previously rated good. At this inspection the rating has remained good. This meant people were safe and protected from avoidable harm.

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. Lessons were learnt to continually identify and embed good practice. Staff described the home as “wonderful” and said they felt supported by management. ‘Lessons learned’ audits were in place and used to improve practice following incidents. For example, following a moving and handling concern, the staff member involved completed a reflective account and received further training. Wider learning was implemented across the home to ensure the risk of this reoccurring was minimised.

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. Systems and processes supported safe transitions and care pathways. People had access to healthcare professionals including GPs and nurse practitioners, and staff supported them to attend appointments. Handover records were detailed and included changes to medication, skin concerns, and clinical observations. Some people had chosen to remain at the home after a period of respite.

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 home. One person said, “Yes, I feel safe here and I’m very comfortable.” Staff were able to describe safeguarding procedures and knew how to report concerns. Safeguarding training was up to date, and family members told us they felt confident their relatives were protected.

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. People were involved in managing risks related to their care. Risk assessments were personalised and included input from people and their families. Risk assessments were in place for falls, choking, moving and handling and pressure care. Staff supported people to eat and drink safely, and we observed good practice during mealtimes.

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 environment was safe, clean, and well maintained. Health and safety certificates were in place, and fire safety action plans had been completed. Spot checks confirmed compliance with electrical, fire, and portable appliance testing (PAT). Infection prevention and control walkarounds were completed. The home included dementia-friendly signage, a sensory garden, and secure access. People told us the home was “very clean and tidy” and “homely.”

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 adequate. Staff files showed robust recruitment processes, regular supervision, and training. Staff retention was good, and incentives such as loyalty schemes were in place.

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. Infection, prevention and control (IPC) practices were strong. Staff were trained in infection control and followed safe procedures, including wearing appropriate personal protective equipment (PPE) during mealtimes. The environment was clean and fresh, and audits were in place.

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. Medicines were safely stored and administered by trained staff. People received their medicines in line with prescriber instructions, and protocols were in place for ‘as and when required’ (PRN) medicines. Handover records showed changes to medication were communicated effectively. Staff described the process for managing medicines and demonstrated good understanding.