Preston Private 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 was 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 service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People and their relatives suggested there was an open dialogue of communication with the management and staff in the home. Staff knew how to report concerns, and any concerns along with lessons learned were shared at team huddles. Partners felt the management worked with them, and took appropriate action when things went wrong. One professional said, "Yes (they work with us and take appropriate action), definitely. We have a good relationship with them." Lessons learned were taking place following incidents. We were able to review examples of lessons learned shared in various ways, including at staff meetings and after safeguarding’s. Accidents and incidents were being recorded, and appropriate action was being taken.

The care teams and management 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.

People felt the staff team worked well together to ensure they received the care and support they needed. One relative told us, “The staff have been amazing not just with my mum, but they have really helped me and my family. This was all new to us and we didn’t know anything about care homes or dementia. The managers and staff guided us, listened to us, and supported us throughout the whole experience.”

Staff spoke about information being shared at handover and by senior care staff and managers. Professionals felt the service made referrals in a timely way. One professional said, "Yes (they make appropriate referrals in a timely manner), they are very good." Handover sheets were in place to support sharing of information with staff who were coming onto shift. We were able to see examples where appropriate referrals had been made when people needed external support.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They 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 service shared concerns quickly and appropriately.

Staff completed safeguarding training and were generally knowledgeable about safeguarding. One staff member said they would report "If there is any neglect or abuse." Appropriate safeguarding’s were being made based on the accident and incident log we reviewed. A safeguarding policy was in place which needed some work to ensure it detailed necessary information. The registered manager took immediate action to resolve this.

A Mental Capacity and Deprivation of Liberty Policy and procedure was in place, and staff were able to confidently explain about mental capacity. One staff member said, "Yes (I have had training), it is about assuming people have capacity until we know otherwise. It's about supporting them with choices, if we have concerns, we escalate it around their support." We reviewed examples of mental capacity assessments that had been completed.

The registered manager confirmed people could access advocates if they needed this support and we reviewed documentation relating to this.

A signing in book was in place which ensured the home had an accurate record of any visitors which helped keep people safe. People told us they felt safe. One person said, “Yes I feel safe here, they are very good.”

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People and their relative’s felt risks were being managed. One person told us, “I feel safe here, I have everything I need. They look after my medicine, it’s safe and I have had no falls in here.” Staff spoke about how they managed various risks. The registered manager said, "We do encourage people to go out if they can, we have someone who goes to Tesco, and we just make sure they take their mobile."

Necessary risks assessments were in place when needed relating to people’s health and potential risks. We found appropriate personal emergency evacuation plans were in place for people, though recording regarding peoples preferred names needed to be amended, this was actioned immediately by the deputy manager.

The service generally detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

People and their relatives felt they/their loved one was in a safe environment. Necessary environmental risk assessments were in place and fire safety checks were being completed, although some work was required in some areas to ensure fire safety. The registered manager confirmed that the necessary works had been booked in.

The environment was generally safe. Radiators had necessary covers in place and windows had necessary restrictors in place. Necessary safety certificates were in place to support safe environments in areas including gas safety, electricity, legionella checks and lifting equipment. We did find that some wardrobes were not secured to the walls, this was rectified immediately. One staff member said of the environment, “The environment here is very safe.”

The environment was mostly neutral and well maintained. People’s doors had their names on, and on the unit which supported people with dementia, each room had a memory box next to the door, which detailed things the person liked. Some people had been involved in choosing their wallpaper in their rooms and bedrooms were personalised with items important to people.

The service generally 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.

Staff told us they completed an induction when they started and records indicated that staff training was up to date. Safe recruitment practices were being followed, and appropriate pre-employment checks were in place. Staff supervisions and appraisals were taking place.

Staff told us they felt there was enough staff. One staff member said, “There is staff everywhere, you can’t turn around without seeing staff.” Agency staff were occasionally being used to help ensure staffing levels were consistent. The service had a dependency tool to help calculate required staffing levels based on people’s needs, and staffing levels were generally in line with this.

People’s feedback on staffing levels was mixed. Generally, people felt there was enough staff around, but said call bells were not always promptly answered. One person told us, “I prefer my door open, there is enough staff, sometimes there’s a bit of a wait when I call but I know key members of staff they support me well.” We did witness a couple of times in one unit where a lounge was briefly left unattended. This was fed back to the registered manager and appropriate action was taken.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The home was clean and tidy and there was a dedicated area for laundry. Cleaning records were up to date and were being appropriately completed, and necessary personal protective equipment was in place.

People felt the home was clean. One person said, “The cleanliness is second to none”. Staff told us how they try to prevent or control the spread of infection. One staff member said, "We change gloves after personal care and we don't take things from room to room, we wash hands."

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened. Some areas of medicine record keeping varied in clarity and detail across the service.

We saw staff provided patient support to people when administering medicines, completing the medicines administration records individually to help ensure their accuracy. People who were able and wished to self-administer medicines were supported to do so.One person we spoke withwas happywith the arrangements made for them to manage some of their own medicines.People’s medicines needs were checked on admission to the home and care home staff worked with other professionals to review people’s medicines needs. Arrangements were in place should the covert (hidden) administration of medicines be needed.

Medicines related records were generally clearly made. However, we did find some areas for improvement where practice varied across the service. For example, there were occasional gaps in recording the use of prescribed ‘fluid thickeners’. Staff we spoke with knew when people took time sensitive medicines such as, medicines for Parkinson’s disease and when these were due, but the actual time was not always recorded in order that practice could be reviewed. The administration of ‘when required’ medicines prescribed for when people were distressed or agitated was kept under review. One record we viewed had clear written information about how the ‘when required’ medicine was used as part of a wider plan of care, however a second record was more limited.

Regular medicines audits were carried out so that should any shortfalls be identified, they could be promptly addressed. Medicines were administered by nurses and senior staff who received training in the safe administration of medicines. Medicines including controlled drugs were safely stored. Homely remedies were available for the prompt treatment of minor ailments.