Anglebury 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 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.

The service had a system in place for reporting, reviewing and analysing incidents and accidents. The manager reviewed accidents and incidents across the service regularly, to identify trends and themes. Staff recorded and reported any safety concerns that occurred and told us any lessons learned were shared with them in staff meetings to prevent recurrence.

People’s care plans and risk assessments were updated following incidents if required.

Referrals had been made as necessary, including notifying the Care Quality Commission (CQC) of specific events as required.

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.

Staff obtained information from the person and their family such as who was important to the person, their health conditions, what support they needed with personal care, mobility and nutrition, as well as details of their religious beliefs, interests and social history. Health and social care professionals were also involved to support people moving between services. This gave staff clear information about how to support the person and enabled a smooth and safe transition to the service.

Staff supported people to attend medical appointments and shared information when they were admitted to hospital. This helped ensure the person received care that was in line with their wishes and preferences.

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.

Everyone we spoke with told us they, or their loved ones felt safe, and that staff knew people well. A relative said, “It is reassuring to know [person’s name] is safe and well looked after here.”

Staff were aware of their responsibilities to safeguard people from avoidable harm. Staff told us, “I am aware of the Safeguarding and speaking up policies.” They had completed safeguarding adults training and were aware of how to report and record any concerns identified. The management team worked with the local authority safeguarding team to learn from and implement recommendations following any concerns raised.

The provider had a robust process in place to ensure concerns were reported to the local authority without delay. The manager had oversight of all concerns raised, this allowed them to identify patterns and monitor outcomes. This supported continuous improvement in safeguarding practices.

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.

Risks were assessed and measures taken to ensure people were safely cared for at Anglebury Court. Risk assessments were reviewed each month and updated as needed. People’s risk management plans included communication profiles that informed staff how people communicated so staff could respond quickly to people’s immediate needs, this included how people expressed if they were in pain. Relatives believed staff knew their family members well and understood any potential risks.

People had personal emergency evacuation plans (PEEPs) in place, which were easy to locate. PEEPs provide staff and emergency service personnel with critical information on the evacuation needs of each person in the event of an emergency.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

At the time of our assessment, we identified several environmental safety concerns that put people at risk. A radiator cover needed fixing, not all doors labelled as needing to be locked, were locked, not all waste bins had lids, food items in lounge kitchenettes were not always dated when opened, and not all air mattresses were at the correct setting for the person’s weight. None of these areas had been identified as a risk during 'walk arounds' or audits. The manager confirmed during our assessment the areas of concern we raised had been actioned and people were no longer at risk from these issues.

There was a system in place for staff to report any maintenance issues, and staff told us requests were usually promptly addressed.

Relatives commented positively about the layout of the home, one relative told us, “I very much like the small group lounges/dining areas that are domestic in size and therefore not overwhelming for the residents”.

The provider made sure there were qualified, skilled and experienced staff, who received effective support, supervision and development. However, there wasn’t always enough staff available to meet people’s individual needs.

People and their relatives felt care and support was delivered safely. One relative told us, “Staff know people well, and are always able to fill me in on how [person’s name] has been since my last visit." However, 14 out of 31 people required assistance from 2 staff for their personal care needs. Staff told us they sometimes felt ‘rushed’ and other relatives described how the home sometimes appeared understaffed. We informed the provider of this who increased the staffing levels for busier times of the day, such as during early evening. The management team told us they would monitor this to ensure it was effective and would speak with the staff for their feedback.

Ongoing support for staff included scheduled supervisions and regular spot checks. Records demonstrated these meetings were meaningful, two-way discussions and staff told us they received regular supervisions they found useful. A member of staff told us, “So far, I am very happy with the support I have received from my manager, I had supervision every two months.”

The electronic system highlighted when staff needed any refresher training. This ensured staff were up to date with their knowledge and skills. Staff told us they received regular training and support that enabled them to meet people’s individual needs. Comments from staff included, “We have good trainingeither online or face to face” and “We are offered opportunities to gain further qualifications to progress within the care role”.

Records showed staff had received training appropriate to their role and there was evidence of observation and competency checks.

Staff confirmed they understood their roles and responsibilities and knew how their work contributed to the overall quality of the service.

Recruitment procedures were in place to ensure the required checks were carried out on staff before they commenced their employment. This included enhanced Disclosure and Barring Service (DBS) checks for adults. DBS checks provide information including details about convictions and cautions held on the police national computer.The information helps employers make safer recruitment decisions.Any new staff completed a comprehensive induction and were introduced to people and worked alongside a senior member staff. Staff told us, “My recruitment and induction experience went smoothly and good communication throughout the process”.

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.

We observed the service to be clean. The service employed dedicated domestic staff who were responsible for cleaning the home and laundry.

Infection prevention and control measures were in place. Staff had access to and wore appropriate personal protective equipment (PPE).

We observed staff using handwashing facilities and using PPE correctly.

Everyone we received feedback from felt the service was clean and ‘homely’.

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

Medicines records were clear, and current records we checked showed that people received their medicines in the way prescribed for them, including for creams and external preparations. When medicines were prescribed ‘when required’ there were some protocols in place to guide staff on when these might be needed, but these were not in place for all medicines prescribed this way. Some copies of people’s medicines care plans had not been updated when people’s medicines changed. However, staff knew people well and were knowledgeable about their medicines and needs.

We observed medicines being given by a safe method during our visit, and people were asked if they need any ‘when required’ medicines such as painkillers. However, there were distractions during the morning medicine round and staff were being interrupted whilst giving medicines. This also contributed to the length of the round, which increased risks that subsequent doses could be given too close together. However, staff were aware and any late doses were recorded to be handed over at shift change. We saw records to show that this had been effective in preventing some doses being given at inappropriate times.

Staff had training and regular competency checks to assess whether they gave medicines safely. People’s preferences were recorded about how they liked to take their medicines.

Records were in place to show that risks were considered with some higher risk medicines. However, these were not always detailed enough to provide the information required for staff to fully manage these risks. We were told by the manager that these would be updated to provide further detail.

When medicine patches were applied, records were kept showing the site of application had been suitably rotated. There were suitable arrangements for ordering, storage and disposal of medicines, including those needing cold storage and for controlled drugs.

Medicines policies were in place to provide guidance for staff. There had been some medicines errors and incidents, however these had been identified, managed and were investigated with staff so that any learning could be put in place. The manager and deputy were also assessing trends and patterns to try to reduce these occurrences going forwards. Regular medicines audits took place to identify improvements. However not all of the areas for improvement we found had been identified.