Portsdown View

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 did not provide a rating for the service. At this assessment, this key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 66 (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.

Staff reported accidents and incidents appropriately and, overall, these were thoroughly investigated with measures implemented to reduce the likelihood of reoccurrence. This resulted in good outcomes for people. For example, there had been a reduction of falls for some people following the introduction of preventative measures.

However, records used to identify and monitor people's distressed emotions were not always fully completed. This increased the risk that staff may not have sufficient information to provide consistent, person-centred support. We raised this with the provider during the inspection, and they took prompt and robust action to improve recording processes. Despite this, staff knew people well and how to support any distressed emotions. In addition, the provider shared case studies that demonstrated how work undertaken to better understand people's emotional needs had led to improved wellbeing and quality of life for some 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.

The service worked proactively with external health and social care professionals to promote safe, seamless transitions between services. A hospital discharge coordinator praised the home for going above and beyond to facilitate a person's admission, demonstrating a strong commitment to collaborative working and positive outcomes.

People and their relatives spoke very positively about their experience of moving into Portsdown View. They described the transition as well planned and reassuring, with staff taking time to help them settle in. Numerous people and relatives told us people had planned to stay for respite care but chose to make Portsdown View their permanent home due to their positive experience.

Robust arrangements supported people when they required admission to hospital, including a comprehensive electronic transfer record containing key information about each person's care needs to support safe, coordinated care and continuity. Staff accompanied people until a family member could attend or, where this was not possible, remained with them until they had been safely admitted to a ward. This reassured people and their relatives their needs would continue to be met.

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.

People and relatives told us people were safe living at the service. For example, a relative said, “I know [Person’s name] feels very secure there, she calls it her luxury hotel. She’s very happy and safe.”

The provider demonstrated a proactive approach to promoting people's understanding of safeguarding and personal safety. For example, they had delivered safeguarding workshops for people using the service and their relatives, alongside a separate cyber safety workshop. These sessions were designed to increase people’s awareness of potential risks, helping them recognise when something was wrong, and ensuring they understood how and where to seek support if they felt unsafe.

Staff received safeguarding training and demonstrated a sound understanding of their responsibilities. Records demonstrated concerns were reported without delay, and safeguarding referrals to the local authority were timely, appropriate and well documented.

Where people needed to be deprived of their liberty to keep them safe, the service ensured a deprivation of liberty safeguard (DoLS) was applied for through the relevant local authority.

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. However, risk assessment records needed improvement.

Risk assessments were in place to guide staff in managing people's risks. However, some required further detail to ensure they provided clear, personalised guidance for staff. Where people had multiple or complex health conditions or needs, records did not always demonstrate how these were related or the associated risks. We also identified some inconsistencies between records, including conflicting information about people's mobility, oral care and nutritional risks. This meant records did not always provide staff with clear, accurate and person-centred guidance to support safe and consistent care. The nominated individual told us of their plans to improve these.

Despite this, staff understood people’s risks well and knew how to reduce risks for people. People were supported to take positive risks where appropriate, with decisions made collaboratively and centred on their individual preferences and rights. For example, 1 person wished to continue to eat a diet that did not align with a health professional’s advice and the provider worked collaboratively to support this in the safest way possible.

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 premises was secure, well maintained and safe. Safety equipment such as window restrictors were in place throughout. Safety checks had been completed as required in relation to fire, gas, electrical, water and equipment safety. Staff told us there were processes to report environmental concerns which were acted upon promptly.

The home was decorated to a high standard, had a variety of areas for people to enjoy and was suitable for the people who lived there. The environment promoted safety. For example, corridors were wide with handrails and lighting in bathrooms was automatic, which helped minimise the risk of people falling. Consideration had been given to people who lived with dementia. For example, there were themed areas to help people orientate around the home.

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.

Staffing levels were planned and monitored using a dependency tool. We observed there were enough staff available to meet people’s needs in a timely way. However, people's experiences of response to call bell times varied. The provider monitored call bell response times. Records showed that, overall, call bells were responded to in a timely manner. The nominated individual told us they aimed to improve response times further and would continue to monitor performance to support this.

People and relatives consistently told us staff were well trained and had the skills to meet their needs safely. Staff received a comprehensive induction, training and competency assessments relevant to their roles. Training was positively evaluated by staff. For example, 97% of staff reported they had gained new knowledge from training undertaken.

Staff were supported through regular supervision and annual appraisal which focused on staff wellbeing, day-to-day practice, learning, personal development, and future goals. Staff also participated in additional reflective practice sessions to support continuous learning and improvement.

Staff were recruited safely and required pre-employment checks had been completed.

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 was clean. Staff followed infection prevention and control procedures in line with current guidance and their training which included the correct use of personal protective equipment and hand hygiene practices.

People and their relatives spoke positively about the cleanliness of the home. For example, 1 person said, “The rooms always look so clean, and you never see them being cleaned.” Another said, “It’s absolutely spotless and always smells fresh.”

Effective systems and competent staff ensured people received medicines and treatments safely, according to their needs and preferences. However, shortfalls were identified with records.

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Records relating to PRN (as required) protocols, variable doses and escalation plans needed further detail to ensure staff had sufficient guidance. We discussed our concerns with leaders who told us of their plans to make the necessary improvements. Although staff demonstrated a good understanding of how to meet people’s needs, the lack of personalised records meant there was a risk of inconsistent practice and inappropriate or delayed administration, particularly if unfamiliar staff were required to administer these.

Topical medicines were not stored securely, creating a potential risk that people living with cognitive impairment could access them or that the medicines could become less effective. Leaders responded immediately and began taking action during the inspection to ensure medicines were stored safely.

Medicines were otherwise stored securely and administered only by staff who had received appropriate training and had been assessed as competent. Effective systems were also in place for the safe receipt, storage and return of medicines.