Blossomfield Rose 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 good. At this assessment the rating has remained 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.

People told us they felt safe and supported by staff who knew them well and listened to concerns. Staff understood the importance of reporting incidents, with systems in place for them to do so. For example, when a resident experienced episodes of distressing behaviour, staff were provided with guidance on de-escalation strategies, including what approaches had been effective, and those that had not, the support that should be offered to other residents who may have been affected.

Policies guided staff in managing safety events, and lessons learned were reviewed by managers to make changes and improvements. We found evidence that complaints and incidents were used as opportunities for learning and improvement, with measures implemented to reduce the risk of recurrence. The service operated an electronic tracking system that supported the timely recording, investigation and resolution of concerns, helping to ensure actions and outcomes were completed within expected timescales. The system also provided effective oversight by senior staff and facilitated prompt escalation where necessary. Learning from incidents and complaints was shared with staff, and additional training was provided when identified as appropriate. People who raised concerns were kept informed of the outcomes and any actions taken in response.

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.

Pre-admission assessment processes were in place, ensuring people and, where appropriate, their family members were fully involved in decisions about their care and support. People told us they received information about the service before moving in and, where possible, were given the opportunity to visit beforehand. Staff told us they were provided with information about people’s needs prior to admission, which enabled them to prepare for their arrival. Care plans and risk assessments were developed in partnership with people to help ensure support reflected their individual needs and preferences.

We saw evidence that people returning to the service following a hospital stay were supported to ensure a safe and well-coordinated discharge. Healthcare professionals told us the service made timely referrals to appropriate agencies when required and worked effectively with external partners, including hospitals, GPs, dentists and other healthcare professionals. Information was shared appropriately to promote continuity of care, and people were supported to access the healthcare services they needed to maintain their wellbeing.

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.

Staff had received training in safeguarding and demonstrated a good understanding of how to recognise and respond to potential signs of abuse. Staff were clear about their responsibilities and the reporting procedures they should follow to help protect people from harm. They also understood the importance of obtaining people’s consent before providing support and were aware of any restrictions in place, including the reasons these had been implemented.

People told us they felt safe when supported by staff, and relatives expressed confidence in the care provided. People and their family members said they would feel comfortable raising concerns and were confident that these would be listened to and acted upon appropriately. Feedback from people and relatives indicated that staff promoted people’s wellbeing, respected their rights and took appropriate action to keep them safe. A person told us, “I feel safer here, I have made friends.” A Relative told us, “I feel that [name of person] is safe because I know that there is always someone around.”

Where it was necessary to deprive people of their liberty to keep them safe, the provider ensured that Deprivation of Liberty Safeguards (DoLS) applications were submitted to the relevant local authority. All applications had been made in line with DoLS legislation, ensuring people’s rights were protected. The registered manager maintained oversight of DoLS applications, authorisations, and any associated conditions.

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.

Staff involved people in decisions about managing risks and respected their choices, preferences and rights. Risk assessments were personalised, regularly reviewed and provided clear guidance on how risks could be reduced while promoting independence and maintaining people’s quality of life. For example, one person’s risk assessment described how they expressed feelings of anxiety and frustration, identified known triggers and outlined the most effective ways staff could respond to provide reassurance and support.

Staff told us care plans and risk assessments contained the information they needed to support people safely and were able to clearly explain the risks relevant to the people they supported. Risks were managed in the least restrictive way possible, ensuring an appropriate balance between keeping people safe and respecting their individual rights and choices. Staff demonstrated a good understanding of people’s needs and were confident in supporting individuals to take positive risks and maintain as much independence 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.

During our inspection, we observed that environmental safety was well managed. Security measures were consistently followed, with doors kept locked where required, and the premises were maintained to a high standard. A dedicated maintenance team carried out regular health and safety checks and ensured any repairs or identified issues were addressed promptly.

The registered manager was able to provide examples of incidents that had occurred and demonstrated how these had been reviewed, with appropriate action taken to reduce the likelihood of similar events happening again. People told us they felt safe living at the service and raised no concerns about their environment or the measures in place to protect their wellbeing.

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 arrangements were effectively managed to help ensure people received consistent and continuous care. Staff completed a comprehensive programme of mandatory and role-specific training, which was regularly reviewed and refreshed to ensure they maintained the skills and knowledge required to support people safely and effectively. Staff development was further supported through regular supervision, team meetings and additional learning opportunities.

The provider followed safe recruitment practices and carried out appropriate pre-employment checks to ensure staff were suitable to work with people. These included obtaining employment histories, seeking references from previous employers and verifying applicants' identities.

We received mixed feedback from people and their relatives regarding staffing levels. Some felt there were enough staff available to meet people's needs, while others felt additional staff would be beneficial at certain times. One person told us, "There is enough staff, the staff come quite quickly if called." Another person said, "I think that there is enough staff, but could do with more at night and weekends." During the inspection, we observed there were sufficient staff available to meet people's needs. Staffing levels were consistent with planned rotas and reflected the dependency levels of people using the service. The Registered Manager and Nominated Individual acknowledged the feedback received and told us they would discuss staffing arrangements with people and their relatives to ensure they understood how staffing levels were determined and ensure they remained satisfied with the support provided.

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.

During our inspection, we found the home to be clean, tidy and free from unpleasant odours. A dedicated housekeeping team supported care staff and demonstrated pride in maintaining a clean and welcoming environment. People and their relatives consistently told us that bedrooms and communal areas were cleaned regularly and spoke positively about the efforts made to keep the home well maintained.

Staff had received training in infection prevention and control (IPC) and understood their responsibilities for reducing the risk of infection. Regular cleaning schedules, audits and monitoring checks were in place to ensure high standards of cleanliness were maintained, with any identified issues addressed promptly. There was an adequate supply of personal protective equipment (PPE), and we observed staff using PPE appropriately when providing care and support.

People’s personal living spaces and communal areas were clean, comfortable and well maintained, helping to promote a safe and hygienic environment. Staff encouraged and supported people to follow good hygiene practices, such as regular handwashing, ensuring they were involved in maintaining their own health and wellbeing wherever possible.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

We identified some areas where improvements were needed. Controlled drugs were being stored in a medicines cabinet that did not fully meet requirements, and although medicine rooms and cupboards were fitted with key-operated locks, these were not always kept locked. We also found oxygen cylinders were not always stored securely. For example, portable oxygen cylinders were kept in a storeroom but were not secured to prevent them from falling. Monthly medicines audits had been completed; however, these had not identified or addressed these concerns. We did not identify any evidence that people had come to harm as a result of these issues. The Registered Manager and Nominated Individual responded positively to our feedback and took immediate action to address the concerns raised. New controlled drugs cabinets were ordered, portable oxygen cylinders were relocated and secured appropriately, and the audit process was strengthened to improve oversight and ensure similar issues would be identified and addressed promptly in the future.

Medicines management systems were in place, and people told us they received their medicines as prescribed and had no concerns about how their medicines were managed. Staff responsible for administering medicines had received appropriate training and their competency had been assessed to help ensure medicines were administered safely.