Vine House Older Persons Residence

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

This means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good.

At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 62 (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 identify and embed good practice.

People and staff were engaged in developing and updating care plans. Accidents and incidents were being reviewed and there were plans in place to improve this system to provide a better overview and further capture any trends developing.

A complaints policy and procedure were in place and evidence of its use was found during the inspection which identified the provider was responding appropriately to issues people raised.Staff told us they felt confident speaking with the managers about changes in care plans where they were identified contributing to continuing change to reflect people's needs.

The provider generally worked with partners to gather relevant information needed to assess if they could meet people's needs. Health professionals gave mixed views about the ongoing assessing of need and transfers to other homes. One professional said, “Care staff are generally kind, caring and hard working. I feel that the frequent turnover of managers has provided a significant challenge to the rest of the staff.”

Some care plans were not current, and the provider had begun work to address the plans which needed updating. However, care plans were accessible to staff using an electronic system which they access using devices at the point of care. Staff explained that they could use the device to check previous notes providing them the information needed to give ongoing care and support.

We saw people were supported to transition between homes. Where possible the provider had supported families to seek a change of home for their loved one when it was acknowledged that Vine house older persons residence was not able to meet their changing needs. We were shown examples of sharing information between relevant partners to facilitate continuity of care.

People were not always safeguarded to ensure that they understood their rights and protected against discrimination under the Mental Capacity Act 2005. The provider did not always undertake decision specific mental capacity assessments to determine people’s capacity to make specific decisions about their care.

The MCA promotes safeguarding decisions making by empowering people to make decisions for themselves wherever possible, and by protecting people who lack capacity by providing a flexible framework that places them at the heart of the decision-making process. We have detailed this within the Effective key question.

Staff had the training and knowledge to ensure they could recognise when people may be unsafe and to identify potential signs of abuse. Staff understood processes for reporting these concerns.

People told us they felt safe and would know who to talk to if they were worried.

The provider ensured that statutory notifications had been submitted to CQC, and the local authority were alerted to any potential safeguarding incidents. Statutory notifications are events and incidents that providers are required to inform us of.

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 were involved in managing risks and had their views and choices considered allowing them to continue to do the things they liked in daily life. One person told us they were involved in developing a risk assessment about the use of bed rails.

During discussions, leaders recognised some risk assessments should be updated for some people as they hadn’t always kept up with the pace of change. These new risk assessments were put in place during the inspection. Staff had received appropriate training to meet people's needs safely.

A staff member told us how they develop risk assessments. “I can write the risk assessment using our system. I take computer to the person, so they are involved in it, then goes to the care plan. Carers can access the information. We cover any new assessments in handover, and all staff must read them. Managers check the assessment is ok.”

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

There had been some issues raised in relation to fire safety, the provider had responded to recommendations and had undertaken work to mitigate risks.

Regular maintenance checks of the environment were completed, while equipment was homed and monitored.

The layout of the home supported people who required support from staff and equipment to mobilise around safely. Areas were accessible and free of clutter. People had access to a lift and clear handrails to help them navigate where they wished safely.

The provider did not always make sure there were enough qualified, skilled and experienced staff. They did not always make sure staff received effective support, supervision and development.

We found gaps in the recruitment processes, for example, a staff member only had one reference on record, and another was started without a full DBS or a risk assessment to mitigate any risk. This was discussed with the provider and both issues were resolved the following day. Other recruitment records sampled were complete as required.

Staff had access to a range of training, both online and face to face. However, there were gaps in attendance on some courses for some staff, these were being addressed.

Staff supervision and team meetings had taken place and covered a range of topics; there was a plan to improve the frequency. This was discussed with the provider who had put an action plan in place. Staff told us they enjoyed being part of the team and felt they worked in a home which put the people who live there first.

People told us they liked the staff and found them kind and helpful. One person said, “They know what they are doing.”

One staff said, “We have a great team here. Our residents really deserve the best.”

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.

We found the building was clean and well maintained. Consideration was given to all areas of the building. People and staff told us rooms were cleaned regularly.

The kitchen was clean, and food stored was well-organised. Food safety checks were carried out and recorded. Staff carrying out food related tasks had appropriate food hygiene training.

The provider made sure that medicines were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Medicines were administered by staff trained to do so. People’s medicines were managed, administered and stored safely. Medication Administration Records (MAR) showed that people received their medicines as prescribed, and these records were completed accurately. PRN protocols were in place for most medicines which were prescribed on a ‘when required’ basis. However, we did find 2 medicines lacked appropriate PRN protocols. This was discussed and clearer protocols were in place by the following day. No person came to harm as staff were very clear about the steps they needed to take and the things to consider before giving the medicines.

One person told us, “They put it on my bedside table with my drink, and they wait for me to take the tablets and swallow them which is exactly what you're supposed to do so yes they are very good with medication.”

Leaders had oversight of medicine administration and completed regular audits and competency assessments to ensure they were administered safely.