Tees Grange

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 following audits, incidents and assessments. There was continual learning from shared practice with other home managers, which identified and embedded good practice.

The registered manager had recognised when incidents had put people at potential risk of abuse and made the appropriate referrals and statutory notifications. Records of referrals demonstrated this.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed and monitored. They made sure there was continuity of care, including when people moved between different services.

There were systems in place to facilitate safe pathways and transfers for people. Care and support was planned and organised with people, relatives and partners ensuring continuity. Care plans detailed people's health conditions and provided the guidance staff needed on seeking additional professional health support and making appropriate referrals were needed.

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 registered manager was aware of what safeguarding information to submit to local authorities and how to notify the CQC of any potential or suspected abuse.

People and their relatives told us that they felt safe with the support of their staff team. One relative told us, “We have not had any concerns with his safety since moving to this home. I feel he is well looked after by the support staff they are brilliant.”

We received positive feedback from visiting health and social care professionals in relation to safeguarding, one said, “Detailed care plans and a consistent approach ensures that people displaying behaviours that challenge are cared for in a safe manner that meets need and ensures the safety of the person themselves.”

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.

Systems were in place to assess and manage risks. Risks were identified and assessments completed to ensure staff provided safe care in relation to areas such as falls management, wound care, nutrition and continence care. There was a team approach to managing risks, which included discussions at handovers and, regular monitoring and reviews. People, or their relatives were involved in discussions around their care and support.

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

The layout, flooring and the general environment had been designed to support with flexibility and provide a safer and more personalised environment. Equipment used to deliver care and treatment, was suitable for the intended purpose, stored securely and used properly.

Regular maintenance checks of the environment were completed, while records confirmed that equipment was serviced, and quality monitored.Personal Emergency Evacuation Plans (PEEPs) were in place and provided details about individual support needs and how these should be met 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.

Relatives generally felt there were enough staff to meet people’s needs and keep them safe. One relative said,“The support staff are excellent and good at staying in touch with me to let me know how things are going, they have built up a good rapport with him this is something he appreciates.”

Staff were recruited through an effective recruitment process. Appropriate checks had been completed prior to staff starting work which included checks through the Disclosure and Barring Service (DBS). DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

The registered manager made sure staff received support, supervision and development opportunities. New staff completed an induction and probationary period. Mandatory training had been identified and provided to staff according to the needs of the people the home. This included training in areas such as safeguarding, moving and handling, the Mental Capacity Act, deprivation of liberty safeguards (DoLS) and infection, prevention and control. Mandatory training modules where at a good compliance rate.

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 assessed and managed the risk of infection well. Our observations confirmed this. Relative’s spoke positively about the cleanliness of the home. One relative said, “His room is clean and tidy, the communal areas look clean and well maintained.”

IPC checks and audits were completed to ensure compliance with the provider’s policy and to detect trends. Staff received IPC training and demonstrated a good understanding of how to prevent the spread of infection. A dedicated housekeeping staff and cleaning schedule ensured the environment was kept hygienically clean, completed laundry and safely disposed of clinical waste.

The provider made sure medicines were administered safely and in a way which met people’s needs, capacities and preferences.

Staff received training in the administration of medicines and we observed safe administration from staff using these systems.

Medicines were stored safely and securely; the treatment room was clean and tidy and temperature monitoring was in place. Staff knew people well and could describe how they supported them with their medicines.