Frognal House 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

The last rating for this key question was good. At this assessment the rating has remained good.

This meant people using the service were protected from abuse and 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 when required ensuring safety events were appropriately reported and managed. Lessons were learnt to continually identify and embed good practice.

There were clear policies and procedures in place for responding to incidents, accidents and complaints and staff were knowledgeable about these. Daily staff meetings were held providing effective communication and which provided staff with information regarding any service improvements and lessons learnt. Records showed that following events and investigations, changes were made where required and changes were reviewed to ensure they were embedded.

The provider worked with people and health and social care 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.

Assessments of people’s needs, risks and wishes were completed upon admission to the service and continually reviewed to ensure they were reflective of people’s needs. People and their relatives told us if they required support from a health or social care professional, this was arranged promptly by staff. A person told us, “Staff are very quick to call if you need anything. The [health care professional] was here the other day to reassess.” Care plans were developed and shared with health and social care professionals when required to ensure individuals continued well-being.

Staff worked effectively with health and social care professionals to ensure people received appropriate support when meeting their physical and mental health needs. We spoke with a visiting health care professional who commended staff for their good work. They told us staff made referrals to their service in good time and chased up referrals until they attended.

Staff worked with people and health and social care professional to understand what being safe meant to them and the best way to achieve that. Staff focused on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect.

Staff shared concerns quickly and appropriately ensuring people’s safety and well-being. People told us they felt safe, and staff were available when required. Comments included, “I’m perfectly safe, I trust them [staff] implicitly”, “I have to get to know everyone yet, but I feel that I am safe in their hands”, “They [staff] are a 110% there when you want or need them” and “I have never felt safer.”

There were safeguarding policies and procedures in place and staff were trained to recognise and respond to concerns, potential abuse and harm. Staff told us they felt confident any concerns would be managed appropriately. A staff member told us, “I would report safeguarding concerns to the deputy or registered manager. I am sure they would refer this to the local authority safeguarding team and CQC.”

There was good oversight of all safeguarding concerns and accidents and incidents. The home manager showed us tools used to manage these, and which supported staff to learn when things went wrong. Records showed that appropriate actions were taken by staff where required and there were good working partnerships in place to minimise the risk of reoccurrence.

Where people needed to be deprived of their liberty to keep them safe, the provider ensured a deprivation of liberty safeguard (DoLS) authorisation was applied for through the relevant local authority and we saw that any conditions within them were met.

Staff worked well with people to fully understand and manage identified risks by thinking holistically. Staff provided care that met people’s needs and was safe, supportive and enabled them to do the things that mattered to them. 

People told us they were involved in planning and managing identified risks. A person said, “They [staff] really listen to you here, not like other places.” Another person commented, “The staff talk to me a lot.”

Comprehensive risk assessments were completed with people to ensure they were safe, and staff took action to mitigate any identified risks. Care plans were developed following assessments to support, manage and review identified risks. For example, risk of falls, skin integrity and nutrition and hydration. Staff supported people safely and appropriate equipment was available if people needed assistance. A staff member told us where people were assessed as at risk of falls, they were closely monitored by staff, to make sure they used their walking aids.

A visiting professional to the service told us staff were efficient in their work and provided safe care. They told us staff recognised deterioration quickly in people and raised concerns and made referrals to professionals when required according to their area of need and risk.

The provider was fully aware of all potential risks in the care environment and controlled them well. They made sure equipment, facilities and technology supported the delivery of safe care. Equipment was regularly serviced to maintain safety.

The design of the premises was safe and met people's needs. People and their relatives told us they liked the home environment. One person commented, “It is really lovely, and they are refurbishing.” The registered manager told us the service was in the process of renovation. Works were taking place to convert some double rooms into apartments. This would reduce the number of people the provider is registered to provide care for by the CQC.

The service was spacious, well-furnished and decorated with wide corridors with appealing artworks on display. There were separate dining and lounge areas on the ground floor, and activity rooms on each of the other floors. People's en-suite bedrooms were personalised to their individual preference. There were adapted bathrooms, dining rooms, and quiet areas with suitable furniture to support people with limited mobility. We saw dementia friendly signage located around the home including memory boxes, photographs, and different coloured bedroom doors to aid people’s orientation. We saw signage to the lounges, dining areas, terrace and people’s bedrooms were also provided in Braille making it easier for people who were sight impaired to find their way around the service, (Braille is a tactile writing system that allows blind and partially sighted individuals to read and write using raised dots). People had access to an expansive very well-maintained garden to the rear of the service. We observed some people sitting in the garden enjoying the view and chatting with staff. There was a well-furnished secure garden at the rear of the property which allowed safe access for people living with dementia to use when they wished.

The maintenance person told us they assessed and maintained the environment and equipment used. We saw servicing records for the fire alarm system, gas safety and legionella and portable appliance testing. Checks and audits were also carried out on hoisting equipment, water temperatures, baths, the call bell system and regular fire drills were conducted. The fire alarm system was tested on a weekly basis.

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.

People and their relatives told us they felt there was enough staff to meet their needs in a timely manner. Comments included, “I always see a lot of staff”, “I can look after myself but if someone calls, they [staff] are pretty quick”, “If we do need someone, they [staff] are very quick”, and “I listen, and it seems quite quick to me.” However, a few people told us that on occasions they do have to wait until staff are available to assist. We discussed this with the home manager who told us they regularly monitored call bell response times and were working to ensure that all calls were responded to within 3 minutes. Records we saw confirmed this.

We observed there were enough staff deployed throughout the service to meet people’s needs. Staff told us staffing levels were very good. One staff member said, “We have very good staffing levels. I have worked in care for 30 years and this is the highest I have ever seen.” Another staff member said, “The ratio of staff to residents is good, we have enough staff.”

Robust recruitment procedures were in place. Recruitment records included proof of identification, application forms with employment histories, employment references, health and right to work in the UK checks. We saw evidence that Disclosure and Barring Service (DBS) checks had been carried out. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

Staff completed training in areas relevant to peoples care and support needs. The providers training matrix showed that staff had received training on dementia awareness, diabetes, oral health, learning disability, fire safety, health and safety, basic life support, moving and assisting people, safeguarding adults, the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). A staff member told us, “The training we receive is good. The training on dementia awareness was helpful, it helped me understand the people I support, for example the signs to look for when people are in pain or when they need additional help. I feel well supported by my managers.” Another staff member commented, “I am doing my induction with lots of training. I am also shadowing experienced staff. I feel that I am well supported, I enjoy working here.” A third staff member said, “We receive good training and regular supervision from managers.”

There were systems in place to help prevent and control infections. We observed the service looked clean throughout. We spoke with the head of housekeeping. They told us the service employed 23 housekeepers; they worked to a cleaning schedule to make sure people lived in a clean environment. There was a resident of the day initiative where the resident in question received extra attention in relation to cleaning, maintenance, catering and care. The housekeeper’s part in the initiative was to make sure the persons bedroom received a deep clean.

The head of housekeeping told us they were responsible for making sure staff followed safe infection prevention procedures. They carried regular infection control checks and observed staff practice in relation to infection control. They also oversaw the laundry. They told us where they had suggested an area for improvement to the manager, action had been taken. Laundry staff previously distributed people’s laundry to them using high trollies, which staff could not see over the top of the trollies and this place people using the service at risk. They suggested to the manager that lower trollies would make distributing laundry around the service safer. The manager agreed and supplied the laundry team with lower trollies.

The head of housekeeping told us staff were provided with personal protective equipment (PPE) when needed. We saw staff wore this appropriately. Training records confirmed that all staff had received training on infection control.

Staff ensured medicines and treatments were safe and met people’s needs, capacities and preferences. People told us they received their medicines safely and as prescribed. Comments included, “They [staff] administer them with no problems”, “5 times a day and always at the same time”, and “They [staff] always give my tablets on time.”

Staff received up to date medicines management training and their skills and competencies were assessed and reviewed on a regular basis to ensure continued safe practice. We observed medicines being administered and staff demonstrated a good understanding of medicines management principles and practice. Records of medicines management were well-maintained and followed national guidance.

Medicines administration records were kept on an electronic medicines management system which staff updated on a regular basis. Medicines audits were conducted on a regular basis to ensure good safe oversight. Medicines were stored safely and securely, with no excess medicines observed. Stock control measures were in place to prevent the accumulation of expired or unwanted medicines.