Palmerston 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.

At our last assessment we rated this key question Requires Improvement. At this assessment the rating has changed to Good.

This meant people were safe and protected from avoidable harm.

The provider was previously in breach of the legal regulation in relation to safe care and treatment. Improvements were found at this inspection, and the provider was no longer in breach of this regulation.

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.

There were systems in place to learn from safety incidents and events, one example was a multipurpose tracker that the registered manager utilised. This covered incidents, near misses, safeguarding’s, complaints etc. The registered manager was then able to investigate, action any outcomes and learn lessons from these events. This was then disseminated through the team through a variety of ways.

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.

An example of this was when a person who uses the service was admitted to hospital for treatment. When they were ready to be discharged the registered manager ensured that an updated assessment was carried out. This meant the service could still meet the persons needs safely and effectively.

A social worker who works with the service told us, “I have had people that I have placed at the service and there has always been good feedback, partnership working and joint review”.

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.

There were proactive systems put in place to safeguard people. For example, when one person who uses the service had a fall the service identified that changes in medicines could be a cause. They engaged with clinicians and put in temporary measures such as additional 1-1 support.

A professional told us, “People are clean, wearing clean clothes and well presented, the food, everything, it’s just a nice home. From my perspective, if I had a relative that needed a care home, I would want them here.”

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 discussions about their care, and their needs, wishes and preferences were considered.

People told us they felt involved in their care. However, feedback from relatives was mixed. While some felt they were involved, others said they had not been included since their relative moved into the service.

The registered manager acknowledged this and demonstrated plans to improve engagement with relatives, including introducing remote care reviews to increase involvement and communication.

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

Since the last inspection there have been marked improvements to the home. There had been a recent renovation to bathrooms and these were in the final stages of being completed. There was improvements made to storage facilities so that equipment was stored safely as well as electronics being safely secured in appropriate cabinets.

There was good evidence of proactive steps being taken by the provider, for example there was a new air conditioning unit supplied and installed. This ensured that residents were kept cool and safe during the heatwaves experienced in the week of the inspection.

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 provider had multiple systems in place to ensure safe and effective care was delivered by staff. Training was provided to staff in a variety of ways, through e-learning and face to face delivery. This was followed up by comprehensive competencies carried out by management to ensure that skills were embedded into practice.

When we asked staff about training one staff member told us, “I am always getting trained.”

The service had also improved significantly in recruitment practices since the last inspection, ensuring audits were in place to meet safe recruitment practices. There were enough staff to safely care for peoples needs.

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 service had good practices and resources in place to maintain high levels of cleanliness and reduce the risk of infection. Recent improvements included hiring an extra housekeeper and instituting a new app for kitchen staff, this assisted kitchen staff with cleaning audits, temperature records and a comprehensive information library.

In describing the home one person told us, “Its lovely isn’t it”. Multiple relatives described the home as clean and stated that this had improved in recent months.

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.

Medicine administration was done in line with best practice and was respectful and was safe. Regular audits were conducted and our own checks showed that there were no discrepancies or concerns.
PRN (As required) protocols are documents that detail how staff should administer nonregular medicines safely, they also detail in what circumstances to give medicine and the desired outcome. We reviewed a sample of these protocols for people and found them to be very detailed and developed in line with best practice.