Chartwell House

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 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. Staff had recorded and reviewed when people had fallen to identify trends or reasons. Care plans had been updated when reasons had been identified for a person falling. For example, when people’s clothing had been identified as a contributory factor, care plans had been updated, and family asked to provide different clothing.

Staff had organised for people’s medicines to be reviewed and referred people to the falls clinic when they had multiple falls. The action taken had been reviewed to check it had been effective and further changes were made if needed such as further medicine changes.Staff told us they would always check the care plans when people’s needs had changed or they had fallen before supporting them.

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. People met with a member of the management team, to assess their needs to make sure staff could support them safely.

A pre-admission assessment was completed and covered all aspects of their lives, this was used as the basis of their initial care plan. Staff built the care plan up from this base as they got to know the person. Each person had a care plan summary, which gave staff and other professionals the essential information to support them safely.

When people were admitted to hospital, staff generated a hospital pack from the electronic care plan system. The document contains all the relevant information including equipment used, medicines and risk assessments.

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 knew how to recognise signs of abuse and discrimination, they understood their role to report concerns. They were confident the registered manager would take the appropriate action. Staff were aware of the agencies they could report concerns to if they thought action had not been taken. The registered manager understood their responsibility to report any concerns and work with the local authority.

People told us they felt safe living at the service. Relatives felt their family member was kept safe and staff would act if they observed anything they thought was wrong.

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. Potential risks to people’s health and welfare had been assessed. Care plans contained guidance for staff to reduce the risks, including when and how to act to mitigate risk. For example, when people were at risk of urinary infections, there was clear guidance about supporting people to drink and how often. Guidance included people’s habits and behaviour which put them at risk, such as not waiting for staff to support them when they wanted to go for a walk.

Some people were living with diabetes and required insulin to be administered regularly. Care plans included general information about the signs of high and low blood sugar. There was person centred guidance about what to do when the person had low blood sugar. The guidance was reviewed regularly with the diabetic nurse to make sure it was effective.

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 building was purpose built and was accessible for people. There were systems in place to make sure people could not access stairs and areas such as the laundry. The lifts and stairs were protected by keypads so only people with the code could access them. People had access to equipment such as bath hoists to make sure people were safe while having a bath.

There were effective systems in place to check the environment and equipment remained safe for people to use including the fire safety system and hoists. Staff reported any concerns to the maintenance staff, and these were dealt with promptly.

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 registered manager used the occupancy and people’s dependency to calculate staffing levels on each floor, this was completed daily. During our inspection the number of staff on duty matched the number on the dependency tool. Staff covered any gaps such as annual leave or sickness as overtime.

Staff told us they thought there were enough staff to meet people’s needs. We observed call bells were answered quickly, and staff did not appear rushed. Relatives told us staff spent time with their family member, comments included, “They seem to have time and will chat and take their time.”

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. There were effective processes in place to make sure the service was clean. There was an infection control policy and procedure including infection control audits. Staff had completed training including infection control and food hygiene.

There was personal protective equipment (PPE) including gloves and aprons, available around the building. We observed domestic staff cleaning all areas of the service during the day. Staff wore PPE appropriately when supporting people, the building was clean and odour free.Relatives told us staff wore PPE and there were posters with information about infection control around the building.

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. There was an effective system to order, store, administer and dispose of medicines. Staff had received training and had been assessed as being competent to administer medicines.

Some people were prescribed medicines ‘when required’ such as for agitation or pain relief. There was guidance in place for staff about when to give the medicine, how often and what to do if it was not effective. People’s records showed these medicines had been given sparingly and only when all other options had been tried first.

Medicine administration charts (MAR) had been completed accurately and reflected the medicines given to people. Medicines were stored at the correct temperature and in the required cabinets, following legal requirements.

Relatives told us they were kept informed of any changes to their family members’ medicines. People had been supported to administer their own medicine when able. A relative told us, “You can do your own medication if you want, and (relative) did. They do keep an eye on you though. They did get a bit muddled and so they asked them if they can do it for them and they do.”