Attlee Court

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 assessment for this newly registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 69 (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.

Accidents and incidents were being recorded, patterns analysed, and actions taken.

There had been several falls at the home. We reviewed the provider’s systems in place to assess risks, plan interventions, record incidents and train staff. We found that people who were at risk of falls had appropriate risk assessments in place, equipment to manage the risks and had been referred to appropriate healthcare professionals. The provider had acquired additional technology to prevent and manage risks of falls and told us they had plans in place to extend the use of this new technology. Staff had received additional training from local healthcare professionals around falls prevention and management

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.

There were processes in place to ensure people’s needs were assessed before moving into the home. This included a face-to-face meeting with the person and relatives, if appropriate, to gather information about people’s needs and preferences to ensure care plans were centred around that. We reviewed the care plan of a person who had recently been admitted to the home and we found evidence of good partnership working with relevant professionals to meet the needs of this person.

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.

There were safeguarding policies and procedures in place, and these were being followed.

Staff had received training in safeguarding adults and knew how to report abuse and neglect. Their comments included, “Report [safeguarding concerns] to senior first, I could also take it to the safeguarding lead.” Staff were confident about how to follow the provider’s whistleblowing processes if required. Staff said, “If I see something that isn’t correct, that I don’t think should be happening, then I would speak up to seniors or management about what I have seen” and “I would speak to Wakefield Council, or some senior manager, I’ve got their email and phone number.”

Most people told us they felt safe at the home, and their relatives agreed care was delivered in a safe way. People’s comments included, “Yes I am safe here because the care they give is one hundred percent;” “I feel safe, as there is always someone there;” and “I am safe, the staff are beautiful and they are all really nice.”

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.

We found the provider had systems in place to monitor risks to people’s safety and well-being. Risks to people's care were assessed and care plans were put in place to manage these risks. This included the support people required should they be at risk of falls, guidance for staff on how to support people who required support with their emotions and behaviour and how to ensure the environment where people lived was safe. Staff we spoke to were aware of how to support people and provide their care safely, in line with their care plans.

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 provider ensured the equipment used to support people such as lifts, hoists and fire systems was safe and regular checks were completed at the required intervals.

The registered manager told us extensive work had been completed to modernise and renovate the home to meet the needs of people. This had been done in consultation with people, relatives and staff. A relative told us, “The refurb has been pretty thorough.”

The provider used a dependency tool to determine the number of staff on shift and in our review of the rota, we found this was in line with the dependency assessment. However, we received mixed feedback from people, relatives and staff about the number of staff on shift.

People told us, “There are not enough staff”; “They are understaffed, they are very busy and you have to wait” and “They could do with more staff.” We asked people how long they had to wait when they called for assistance. People told us, “It depends if they are busy”; “Sometimes you have to wait. When the shift changes at eight o’clock, you usually have to wait longer”; “I just buzz if I need help. Sometimes they are quick and other times you have to wait a while. It all depends what they are doing and how busy they are” and “The times you have to wait changes, it depends. They do come as soon as they can get to you. I call in the early hours if I need to use the commode, they do come, fairly quickly.”

We asked relatives for feedback about staffing levels and they told us, “I don’t personally think they have enough staff because they are constantly on the go. It can take a little time to get out, it takes time to find somebody to let you out;” “There are barely enough, on a good day. Sometimes it’s hard to find the staff to let you in” and “They have enough staff most of the time. When you press the buzzer, they can take a while to get around to seeing [person].”

We shared our feedback with the registered manager. After our visit, they told us they had completed additional observations of care and additional staff were placed on the top floor of the service. Although we did not find evidence of staffing levels not being safe to meet people’s needs, we recommend the provider continues to review and implement good practice guidance in monitoring staffing levels and deployment.

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.

Accidents and incidents were being recorded, patterns analysed, and actions taken.

There had been several falls at the home. We reviewed the provider’s systems in place to assess risks, plan interventions, record incidents and train staff. We found that people who were at risk of falls had appropriate risk assessments in place, equipment to manage the risks and had been referred to appropriate healthcare professionals. The provider had acquired additional technology to prevent and manage risks of falls and told us they had plans in place to extend the use of this new technology. Staff had received additional training from local healthcare professionals around falls prevention and management

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. We did not find medication errors, but we found areas where improvements were required with medication records to ensure these were always contemporaneous and complete.

People’s medication needs were assessed and planned for. Staff had received training to complete this task and their competency assessed in line with best practice guidance.

We reviewed the protocols in place to guide staff who supported people who had been prescribed medication to be administered ‘as and when’ required. We found examples where these protocols were detailed but also examples where these required additional information. For example, for ‘as and when’ medication used to support people with bowel care.

One person required their medication to be given at specific times. This was record in the person’s care plans and medication record. Staff used alarms to ensure this was given on time however staff were not keeping a record of the times this medication had actually being administered.

We shared these issues with the management team and after our inspection the registered manager showed us the actions that had been taken to address the issues.

We did not find evidence of the issues identified having a negative impact on people's health and the provider took action on the issues identified. We recommend the provider reviews and monitors their medication records in line with best practice guidance.

We received positive feedback from people about the support they received with their medication. Comments included, “I know what have, I get it and it’s on time.”