Coralyn 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. 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 in breach of legal regulation in relation to people’s safe care and treatment at the last inspection. They are no longer in breach of this legal regulation at this inspection.

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.

Lessons learnt were identified from complaints, compliments, accidents, incidents and safeguarding referrals. They were also identified from external assessments such as by the Local Authority. We saw evidence of identified actions, for storage of COSHH (Control of Substances Hazardous to Health) chemicals, being taken forward via discussions at staff’s supervision and team meetings, to ensure changes were embedded into practice. We found this change in practice had been made at our inspection.

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 being assessed for the service, were encouraged to visit for the day or overnight to see what they thought, be introduced to people who already lived there and to staff. Their families were also encouraged to visit as well. This was a two-way process to ensure they felt it was suitable, that their needs could be meet and to ensure people who lived there were happy with them moving in.

There were effective working relationships with external professionals such as the GP to ensure people’s changing needs were meet. Handover systems were effective to ensure continuity between staff ensuring changes to people’s care was communicated and team meetings provided staff with opportunities to openly discuss people’s care, wellbeing and safety as well as raise any concerns or share information.

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.

People told us they were happy and felt safe at the service. During the inspection we observed staff providing care in a safe and respectful manner. Safeguarding procedures were in place, and staff had a clear understanding of how to report concerns. Staff told us they felt confident the management team would respond to concerns promptly.

The management team had knowledge of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA 205. In care homes this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were met. The service followed the principles of the MCA and the DoLS application was managed in line with regulatory requirements. There was oversight of authorisations and staff received relevant safeguarding and MCA training to support them in protecting people from avoidable harm or restrictive 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.

People had detailed care plans and risk assessments in place to guide staff in supporting their safety, independence and choices. People were supported to take positive risks including accessing the community via motorised scooters and participating in activities they enjoyed. Staff supported people who experienced anxiety or distress with patience and reassurance.

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 environment was comfortable and had recently been refurbished with improvements made to bathrooms and communal areas. People had been involved in making choices for these changes such as the flooring and colours. This had helped create welcoming communal areas where people felt at home.

Effective systems were in place to ensure the premises and equipment were safe, including regular maintenance checks to meet health and safety regulations and fire safety arrangements. This included staff training and drills to ensure staff understood their roles in an emergency. Personal Emergency Evacuation Plans (PEEPs) were in place, accessible, reflected people’s individual needs and provided clear guidance for staff.

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.

There were safe recruitment practices in place which ensured suitable people were employed. New staff completed a full induction including their mandatory training to ensure they had the knowledge and skills to undertake their duties. Competencies and observation of practice were in place as well as refresher training to ensure staff had up to date skills and experience. Staff told us their induction and training had prepared them for their role, and they knew they could ask for additional training if required. We found there were sufficient staff to meet people’s needs and feedback from staff, people and their relatives reflected this.

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.

Staff completed infection prevention and control (IPC) training. Although there were sufficient supplies of personal protective equipment (PPE) available we found some of the products were out of date. These were removed immediately from use. The service was clean, tidy and well maintained. Good IPC practices were followed daily, with regular schedules to help maintain safety and compliance.

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 received their medicines as prescribed and staff followed safe medicines procedure. Clear guidance was in place and people’s needs and preferences were considered.

Medicines were safely ordered, stored, administered and disposed of, with accurate stock levels maintained. However, we did identify a prescribed cream which did not have an open date. This was immediately removed and disposed of and appropriate action taken to stop this happening again. Staff received medicine training and regular competency checks. The management team carried out audits to identify and address any issues, helping to ensure medicines were managed safely.