Parkfield House Nursing 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.

At our last assessment, we rated this key question requires improvement. At this assessment, the rating has changed to good.

This meant people were safe and protected from avoidable harm.

The service was previously in breach of the legal regulation relating to safe care and treatment. At this assessment, the provider had made improvements. The service was no longer in breach of this legal regulation.

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.

There were systems to learn when things went wrong. There were procedures for responding to accidents, incidents, complaints and allegations of abuse. Staff understood these and knew how to report concerns. The registered manager and/or senior managers investigated concerns and carried out an analysis of what had gone wrong. They shared outcomes with staff to help them learn and improve practice. The provider supported staff with training updates and improved guidance when needed. Staff liaised with external professionals to help make sure people’s care plans and risk assessments were updated when they identified changes in their needs. Staff told us they had opportunities to learn together. They explained managers were open and transparent. People and their relatives said they were informed when things went wrong. The provider apologised and made sure people and relatives were involved in making improvements.

The provider worked in partnership with external professionals to help make sure people had safe transitions between services. Managers carried out comprehensive assessments of people’s needs before they moved to the service. This helped to ensure they were able to meet these needs. They liaised with health and social care teams to make sure they had the support and equipment needed to keep people safe. People and their relatives explained they were happy with the support they had received when moving to the home. A relative commented, “I am impressed at how well they have supported [person] to settle.”

Staff created easy to access guides about people’s health and communication needs. These were shared with external professionals, including ambulance staff and hospitals. These helped other professionals to understand how to provide safe and person-centred care.

There was a bespoke palliative care unit. Staff worked closely with the local hospice, hospital and palliative care teams to provide a safe pathway for people being cared for at the end of their lives. This helped to reduce the need for people to be admitted to hospital when their health declined.

There were systems to help safeguard people from the risk of abuse. Staff undertook training about safeguarding adults. They knew how to recognise and report abuse. Managers and staff worked closely with local safeguarding teams to investigate allegations of abuse. They took action to help keep people safe from avoidable harm. People using the service told us they felt safe. They knew who to speak with if they had concerns about neglect or abuse.

The provider requested legal authorisations where restrictions amounted to a deprivation of liberty for people who did not have the capacity to consent to these. Decisions about people’s care were made in their best interests and for their safety.

Staff assessed risks to people’s safety and wellbeing. They discussed these with people, their relatives and external professionals. People were supported to make decisions about risk taking. Risk assessments were regularly reviewed and updated when needed. Staff supported people to develop plans to mitigate risks and help to keep people safe.

Staff undertook a range of training to understand how to care for people in a safe way. For example, how to support people to move safely, when eating and drinking and with good skin integrity. Staff monitored people’s safety and acted when they identified concerns. We observed staff supporting people in a safe way.

A relative explained staff were good at supporting a person to feel calm when they became anxious or showed signs of distress. They commented, “Staff have been able to calm [person] and this has been really good.” We also witnessed interactions where people had started to express distress. Staff supported them in a personalised and caring way. This helped people to feel safe and secure.

The environment was safe, well-maintained and met people’s needs. The provider was quick to address repairs and damage. They organised for equipment to be serviced and checked to make sure this was safe to use. Staff were aware of hazards within the environment and acted to mitigate the risks relating to these.

The building was attractively decorated with good quality and comfortable furniture. The building was well-lit, a comfortable temperature and well ventilated. Throughout the building there were features designed to enhance the ambience and attract people. For example, displays of people’s artwork, memorabilia and features of interest. People told us they liked their bedrooms and communal rooms.

There were posters and leaflets providing information about the service and other services people could access. There was signage to help orientate people.

The provider ensured there were checks on fire safety. Staff were familiar with fire safety procedures. There was enough equipment. There were personalised plans to help evacuate people in the event of an emergency.

There were enough staff to keep people safe and meet their needs. People told us staff were available when they needed them and they did not have to wait for care. Their comments included, “I can always find a carer when I need”, “They come quickly when I use the call bell” and “They are pretty prompt when I call.” There was good staff retention. People were cared for by familiar staff who they knew well and liked. Staff told us there were enough of them on duty and they did not feel rushed.

The provider had systems to ensure staff were suitable through recruitment checks, induction, training and regular support. Managers assessed staff skills and competencies. Staff had opportunities for regular supervision meetings and appraisals to discuss their work. A staff member commented, “We have a lot of training and meetings with our manager.”

Staff explained they had information they needed to provide good quality person centred care. The provider deployed some temporary staff (agency) to help cover staff absences. They used the same regular workers. We spoke with 1 agency member of staff who told us there was always a good handover of information to help them understand about people’s needs.

There were procedures to help prevent and control infections. Staff completed training to understand about infection prevention and control, including hand hygiene. The registered manager, nurses and heads of department had regular meetings to discuss any risks relating to infection outbreaks. There were schedules to ensure the building and equipment were regularly cleaned and checked. There were appropriate systems for disposal of waste and laundry. Managers carried out regular audits to make sure cleaning schedules and other systems were being followed. People using the service told us they were happy with the cleanliness of the environment. Their comments included, “It is always nice and clean”, “They clean really well and keep the place spotless” and “I am happy with the cleaning and laundry service. We do not have to worry about anything.”

People received their medicines safely and as prescribed. Clinical staff from the local GP practice reviewed medicines for people regularly. The home management worked with the GP practice and local health agencies to meet people’s health needs.

Staff developed person-centred care plans to support people with their medicines. There was an electronic medicines administration (eMAR) system. Staff completed this appropriately.

Some people were prescribed medicines to be administered on a when-required basis for health conditions such as constipation and pain. There was guidance in care plans and protocols for these medicines to be administered consistently. However, the protocols did not always have information about medicines prescribed with variable doses. We discussed this with the registered manager who agreed to update the information.

Medicines, including controlled drugs, were stored securely and at appropriate temperatures. There was an adequate stock of prescribed medicines. However, blood glucose monitors were not always quality checked as per the manufacturer’s instructions. The provider took immediate action, and quality checked the blood glucose monitors when this was highlighted during this assessment.

There was a medicine policy in place. There was a process to report and investigate medicine errors and incidents. Staff carried out medicine management audits to identify gaps and make improvements. The provider responded appropriately to medicines errors and when they identified areas for improvement. For example, the management team had made changes in the process of transcribing medicines on eMAR by staff after a recent medicine error to avoid such errors in the future.

The staff received training and were competency assessed to handle medicine safely.