Shawford Springs 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 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.

Accidents and incidents were reported appropriately and contained all relevant information. Safeguarding referrals and Care Quality Commission notifications were made appropriately. Complaints and concerns were managed and resolved.

Incidents were analysed to identify any trends and actions identified were completed. For example, we saw records of one person who had fallen on more than one occasion during the night trying to get to the toilet. The person was keen to maintain their independence and so staff had positioned a commode by their bed to reduce the risk of them falling when walking to the bathroom. Any lessons learnt following incidents or complaints were shared in various formats including lessons learnt forms, individual supervision sessions or group supervisions detailing the lessons learnt and what actions had been taken to minimise the risk of the incident happening again. One staff member said, “If we make a mistake we might go through a supervision and have extra training. They [management team] are all supportive.”

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.

The provider regularly reviewed people’s care and support plans to ensure these were fully up to date and reflective of people’s needs. This enabled staff to provide up to date information to healthcare partners when people’s needs changed. We saw staff update a visiting health professional about one person who they were seeking advice about. Another health professional told us, “The staff team are very much keen for us to work together rather than us being seen as a separate team and they always ring for advice if they need it.”

We saw records that showed people were referred to other health professionals for advice when required.

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 felt safe living at the service. For example, one person told us, “I feel totally safe here with this 24-hour care which is a really lovely thing to have.” One person’s relative said, “I feel that my [relative] is safe. The staff are warm, friendly and competent. [Relative] keeps well there and is looked after.”

Staff were trained in safeguarding and understood their responsibilities in reporting safeguarding concerns. One staff member said, “Safeguarding people is important because dementia patients have memory loss, and they don’t remember what happens. They are vulnerable people, and we need to protect them from any harm.”

There were safeguarding and whistleblowing procedures in place. The management team understood their responsibilities regarding any action needed to protect people from harm. The necessary internal documentation was completed including accident and incidents logs and body maps. The provider ensured referrals and notifications were made to both the local authority and the Care Quality Commission in a timely manner.

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 been assessed for risks such as skin damage, falls and choking, and when risks were identified care plans provided information for staff on how to reduce the risk of harm.

Records showed people were given enough to eat and drink. People’s weight was monitored, and their risk of malnutrition was regularly assessed and monitored. There were monthly nutritional meetings, and we saw minutes of these. Clinical Governance meetings took place, and reviews were held for people at risk of malnutrition, skin damage and choking. When actions were identified, records showed these had been completed.

The management team told us they were working with staff on ‘triangulation’ of care plans, ensuring that when risks were identified, that where appropriate, links were made within additional areas of care planning. We saw this was a work in progress.

Daily records evidenced staff were caring for people in a safe manner taking into consideration their care plan, their risk assessments and their overall safety.

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 visibly clean and well maintained. Staff were able to report any maintenance requirements. Equipment that we looked at was fit for purpose. For example, wheelchairs and moving and handling equipment were in good condition and clean.

There was a well-maintained secure garden area for people to use. This included some shaded areas to protect people from the sun.

We reviewed records of checks carried out to ensure the premises were safe. This included gas, electrical and fire safety checks. Regular checks of equipment were carried out. Personal evacuation plans were in place. These had been regularly reviewed to reflect people’s support needs in the event of needing to evacuate the building in an emergency.

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 service used a dependency tool to calculate staffing levels based on people’s care and support needs. The staff rota showed that staffing levels were maintained. Overall, people using the service told us they felt there were enough staff on duty. For example, one person said, “All the carers; they are ever so lovely, kind and caring, nothing is too much trouble for them, and there are enough people around to help. Obviously, there's sometimes when it's busier than others and some people ring their bells, so just occasionally you have to wait, but not for long at all.” People told us they had call bells in their bedrooms and had pendant alarms to wear when they moved around the home and garden so that they could easily call for help. One person said, “If you ring the buzzer they [staff] certainly come quickly, and I have a pendant as well. It all helps to make you feel much safer.”

People’s relatives told us they felt there were enough staff on duty. For example, one person’s relative said, “The staff seem to be patient; they seem to deliver care proficiently and never seem to be rushed at all.” Call bells were answered in a timely manner. The service audited response times to call bell alerts to help ensure that appropriate numbers of staff were in place at key times of the day, and staff told us they utilised a ‘whole home’ approach which meant other staff would help support people with food and drinks at mealtimes for example.

Safe recruitment processes were followed. Staff told us they had regular supervisions and were trained to carry out their roles. Training records showed staff had completed training. Staff told us additional training was available such as for senior care staff roles, NVQ qualifications and the provider’s ‘champion’ roles. Training was also provided by external health professionals. One staff member said, “I get so much training, I do standard training, and I can do extra.” A health professional told us, "We did some refresher training with all the homes on our patch, but Shawford Springs were the only home who arranged to have 10 staff on each training session. We have also provided some catheter management training, and the staff do follow our guidance.”

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.

The home was visibly clean and well maintained. People told us they were happy with the cleanliness. One person said, “It's as clean as a whistle here; hoovering all the time they are, and very pleasant with it too.” People’s relatives told us the service was “spotless.” One person’s relative said, “The home is always clean. In fact, the cleaner comes into [relative’s] room every day. The home is more like a hotel than a care home.” Housekeeping staff were on duty seven days a week. Cleaning chemicals were safely locked away when not in use by staff.

Staff had been trained in infection prevention and control and knew when and how to apply personal protective equipment (PPE) and when and how to safely discard it after use. There was enough PPE available for staff to use.

Regular infection prevention control audits had been carried out, including staff hand hygiene audits.

The provider maintained an oversight of any infections at the service, including any prescribed treatments.

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.

Staff responsible for managing medicines were aware of safe practice, had completed training and had their competence assessed. Staff were confident and knowledgeable regarding the medicines they were administering, and we observed one staff member demonstrating a calm and skilled approach when supporting people with their medicines.

Medicines were stored, administered, recorded and disposed of safely. Robust processes were in place to ensure people received their medicines in line with their prescriptions.

People could choose to manage their own medicines if they wished. We saw records of assessments which showed staff had assessed people’s understanding of their medicines and saw that weekly stock checks were carried out. When people managed their own medicines, we saw they were stored securely in people’s bedrooms.

Some people were prescribed additional medicines on an as required (PRN) basis. PRN protocols were in place and these guided staff to consider alternatives to medicines where possible. When PRN medicines were administered, staff recorded the reasons why and the outcome. This meant it was easy to assess the effectiveness and to identify any trends.

Regular medicine audits were carried out. When issues were identified, action plans were put in place. We saw that actions had been completed in a timely manner.