Gateford Hill 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. At our last assessment we rated this key question Inadequate. At this assessment the rating has changed to 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 had been learnt since the last assessment. The provider acknowledged and acted upon all our findings and used the last assessment as a learning opportunity to improve the safety of the care provided at Gateford Hill. Staff listened to concerns about safety and the management team responded to these concerns in a timely manner to promote safety. The provider utilised their internal specialists to support the team to make the required improvements. Incidents were analysed by the management team and discussed at team meetings. This reduced the risk of reoccurring incidents which promoted safety to people.

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. Staff told us people were assessed prior to admission and care plans had improved. A relative we spoke with told us they were invited to speak with the nursing team to discuss their loved one’s needs and wishes. Care plans and risk assessments were in place for people and detailed individual risks. For example, a person who required support with their nutritional needs had a detailed risk assessment and care plan in place. This meant staff had accurate information in order to support people safely. We also found where people needed specialist support referrals were made in a timely manner. For example, we found a referral had been made to the specialist dementia team when a person’s needs changed without delay. This meant people received support in a timely manner.

The provider had systems and processes in place to safeguard people from abuse and neglect. Staff understood their role in safeguarding and knew how to report concerns including reporting to external agencies such as the local authority safeguarding team. Staff had undertaken further training since our last assessment to ensure they recognised all safeguarding concerns. We found staff reported safeguarding incidents without delay and the management team investigated and reported appropriately to ensure people were protected from abuse and neglect. People told us they felt safe living at Gateford Hill. A relative of a person we spoke with said, “I have never had any queries about their safety. I know they are well looked after.” Staff were supported by ongoing training and a detailed safeguarding policy. This protected people from the risk of abuse and neglect.

Staff worked with people to understand and manage any associated risks. Staff supported people safely which was in line with their assessed needs and wishes. The provider’s senior management team discussed with us in detail the training they had implemented since our last assessment to ensure staff carried out their duties safely. We found staff now had clear guidance in place to support people safely. For example, we reviewed records for a person living with a wound. We found a clear repositioning plan was in place to inform staff how to meet the person’s needs. This protected people from the risk of harm. Reviews of people’s needs had taken place to ensure information held within people’s care records was accurate. Staff knew how to access care records and demonstrated they knew people and their needs well. For example, we observed a staff member supporting a person with their nutritional needs, they provided care in line with their care plan using a kind and calming manner. This approach ensured the persons nutritional needs were met which promoted their well-being. We found where people required equipment to keep them safe such as bed rails and walking frames, these were used safely with risk assessments in place. This protected people from the risk of harm.

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 provider had carried out extensive works since our last assessment to ensure environmental risks were addressed. The provider had completed a full review and rectified all the issues we identified at our last assessment. This included fixing large items of furniture to walls to prevent tipping, and the fitting of alarms on external doors to alert staff of people living the building. The manager and deputy manager completed walk rounds of the service daily to ensure any issues were identified and acted upon without delay. Parts of the home that could cause harm to people, such as cupboards storing cleaning equipment, the sluice and medicines room were locked and secure. This helped to keep people safe.

Staff were recruited safely and there were enough staff deployed to meet people’s needs. People received care from kind and experienced staff who knew them well. All of the people we spoke with, and their relatives told us staffing had improved since our last assessment. A person we spoke with said, “I don’t have to wait long at all anymore, there is always someone around” and a relative we spoke with said, “Staff seem more relaxed with more staff around. Staff have more time to speak with you now.” Some people said, newer staff did not know them as well as other established staff, but they said experienced staff were inducting them which made them feel safe. Staffing levels were determined using a dependency tool based on people’s needs whilst also considering the layout of the building. Records we reviewed demonstrated there were enough staff on duty to support people safely. Recruitment processes were followed to ensure only suitable staff were appointed. Checks including, interviews, references and Disclosure and Barring Service (DBS) checks were conducted before staff started working at the service. 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 service 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 had undergone maintenance work to ensure all areas and equipment could be cleaned effectively. We observed the home to be clean and tidy. People we spoke with told us the home was clean and without odours. For example, a relative we spoke with said, “The home is always clean, and the bedroom is always tidy.” Regular infection prevention and control audits ensured any issues were addressed and rectified without delay; this protected people from the risk of harm.

Medicines were managed safely. The provider had instructed one of their specialist nurses to support the service to improve the management and safety of medicines. New systems had been implemented; nursing staff we spoke with told us this had increased their confidence to administer medicines safely. We found all medicines were stored safely and where required dated upon opening to ensure staff knew they were safe to administer. A person we spoke with said, staff supported them to take their medicines and waited until they had taken them all before leaving, they told us this made them feel safe. We observed staff administering medicines throughout the day to people, they followed guidance and used a caring approach. Not all people living at Gateford Hill were able to tell staff if they were in pain, to ensure all people had their pain assessed staff utilised a tool which assessed people’s pain using other indicators such as body language. Records we reviewed evidenced this was consistently used for those unable to communicate pain. This protected people from the risk of unnecessary pain.