Rest Haven Residential 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 assessment for this service. This key question has been rated 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.

The provider had systems in place for staff to follow following an accident or incident. This included keeping clear and accurate records and raising safety concerns. Accidents and incidents were routinely reviewed by the management team to identify trends and opportunities for improvement.Information was shared following incidents so that any learning could be shared and measures taken to keep people safe.

The registered manager understood their responsibility under duty of candour to fully investigate accident and incidents and shared the outcomes of these with relevant parties. Notifications were raised appropriately to the CQC and local council.

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.

Before people came to live at the service the registered manager or other senior staff engaged with people, relatives and professionals involved in their care to ensure any transition from home or hospital to the service was appropriate. Relatives told us they were not only involved in the admission process but also emotionally supported by the registered manager during the process, which they valued.

The registered manager confirmed they had a process to ensure continuity of care. For example, if a person was admitted into hospital key information from their care records, that hospital staff may need, went with them.

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 systems to ensure people were protected from the risk of harm, abuse or discrimination. The provider worked with safeguarding agencies where required and relevant information was shared. The provider had raised concerns with the local authority where safeguarding concerns had been identified. Staff were able to clearly describe to us how they would identify potential abuse and what action they would take to escalate this appropriately. No concerns were raised by people or their relatives about the care and support they received from staff.

There were additional measures in place to seek the views of staff and others about safeguarding and safety within the service. Relatives and advocates had responded very positively to a survey sent out relating to safety and safeguarding. The provider completed detailed safeguarding audits to ensure all appropriate actions had been undertaken in response to concerns. Audits also ensured that staff practice was observed and that the culture within the service was aligned to service values. Staff were trained in safeguarding and were periodically surveyed to ensure their knowledge of recognising and reporting safeguarding concerns was current and accurate.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service.

We found the provider had systems and processes to monitor approved and pending DoLS applications. There was a tracker that showed where DoLS had been approved and others that were pending with the relevant local authority.

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 had all the information they needed to support people to manage risks. Care plans and risk assessments were kept up to date and contained information to support staff to mitigate risks to people. For example, risk assessments identified how to support people safely who may be at risk of falling or developing pressure sores. Risk assessments identified how to support people safely who may be at risk of choking when eating and drinking. Where appropriate, care plans included supporting information from health professionals.

Staff supported people to maintain their independence as much as possible whilst mitigating risks. For example, staff had guidance on how to safely support people who wished to walk with purpose or wanted to access external areas independently. We observed staff promoting people’s independence when supporting them with moving and handling during our assessment visit.

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 assessment visit, we observed the provider had significantly invested in the environment in provisions such as wet-rooms, and bedrooms were decorated when required. We observed some areas of the service were nicely decorated and well maintained, and other areas such as some of the walls, skirting boards and door frames required further maintenance which was part of a refurbishment plan. There was an outside garden and patio area which people used during our visit. The provider was undertaking fundraising schemes to significantly invest further both internally and externally.

The provider undertook regular audits to monitor the safety of the home environment and equipment. There were dedicated maintenance staff employed by the provider to monitor the environment. Mobility, fire equipment and emergency lighting were tested regularly to ensure it was in good working order. There were also water temperature checks, legionella testing, gas safety certificates, electrical hard wiring and portable electrical appliance tests. We highlighted an environmental concern in relation to unrestricted access to all staircases within the service. The registered manager told us this risk was managed through environmental and personal risk assessments and that no current restrictions were identified as needed.

People had individual Personal Emergency Evacuation Plans (PEEPs) to aid them in being safely evacuated from the service in the event of an emergency. The provider had a continuity plan in the event of an evacuation being required or the loss of essential supplies such as electricity or water.

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.

The provider used a dependency tool aligned to the electronic care planning system to assess and maintain safe staffing levels. People and relatives did not raise any concerns around staffing levels. One person said, “They will come and see me if I ring the bell.” No concerns were raised by staff in relation to staffing levels. One staff member said, “I think the staff ratio is high and they [the provider] do all they can with that, so they do their best.” The registered manager told us that at the time of their assessment there was 1 staff vacancy, and interviews had already taken place to fill this.

There was an appropriate induction in place for new staff, and we saw records to support this were completed. The provider had a continuous training programme in place for staff and staff spoke positively about this and how it supported them in their roles. Staff received supervision and appraisal to support them and develop them in their role. Staff were recruited safely with appropriate checks taking place to ensure their eligibility to work and suitability to work with vulnerable adults. This meant people were consistently supported by suitable, skilled and competent staff.

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 assessment visit, we observed that the environment was clean and there were no malodours present. Staff were seen wearing appropriate Personal Protective Equipment (PPE) when required and used it correctly, demonstrating good awareness of infection prevention and control practices. There was sufficient PPE available for staff throughout the service.

There was an Infection Prevention and Control (IPC) policy operated by the provider to support good practice. The laundry was well managed, and cleaning products were stored safely. The provider used auditing systems and processes to monitor the cleanliness of the service.

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.

People’s records showed they received their medicines as prescribed for them. We saw them being given in a safe and caring way. There were suitable arrangements for ordering, storage and disposal, including for medicines needing cold storage and those requiring extra security. Temperature monitoring was carried out to check that medicines would be safe and effective.

If medicines were prescribed to be taken ‘when required’ there were protocols and care plans in place to guide staff when these might be needed. Records were in place to show that risks were considered for people using higher-risk medicines such as flammable topical preparations, and anticoagulant blood thinners.

Staff were knowledgeable about residents and their medicines needs. They had regular training and competency checks to make sure they gave medicines safely. Regular medicines audits took place and any areas for improvement were identified. For example, improvements were being made to the way creams and external preparations were being recorded. Any errors or incidents were investigated and reported, so that systems could be put in place to prevent them recurring.