Astell Care Centre

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.

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.

Processes were followed to ensure all accidents, incidents, safeguarding concerns, and complaints were appropriately investigated and actioned. Details about actions taken and referrals to other agencies were recorded. Information was shared with staff via staff meetings and supervision sessions to prevent re-occurrence and support learning.

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.

Professionals we spoke with thought the service was generally safe. There had been a recent increase in the number of concerns raised about the service. We discussed these with the registered manager, and we were advised the management team were working well with other healthcare professionals to improve the service.

Professionals told us staff worked well with them, and they had a good working relationship.
Processes were in place to ensure safe systems were followed. This included an admission policy which was followed to ensure a safe transition to the service. A pre-admissions assessment was completed prior to people moving to the service to ensure people’s needs could 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.

Staff took safeguarding people seriously. One staff member said, "I have had safeguarding training. I would definitely report if I saw anything. I know it would be dealt with properly."

Processes were in place to safeguard people. This included policies and procedures for staff to follow and staff training. Records demonstrated that safeguarding incidents were referred to the local authority and Care Quality Commission appropriately. We observed staff supporting people safely. Staff understood people’s needs and demonstrated their understanding of people’s rights to make their own decisions.
 

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.

Assessments had been carried out to identify any risks involved in people’s care. Where risks had been identified, information was provided for staff about how to mitigate these. We observed during our visits that staff had an understanding of care planning for special diets and were aware of people who required particular dietary needs.
 

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 employed maintenance staff, who people told us responded quickly to any issues they reported. Observations confirmed maintenance checks of the building were undertaken regularly. Maintenance staff also carried out and kept records of health and safety checks on the building and utilities. We noted emergency pull cords were accessible and correctly sited which was an improvement from the last inspection. A refurbishment and redecoration plan was in place to replace carpets and other flooring and refurbish 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.

We received mixed feedback from people and relatives about whether there were sufficient staff deployed to meet people’s needs. As evidenced by the staff rota and our onsite observations staffing levels across the home were safe. Each unit had a nurse scheduled on duty, along with sufficient numbers of care staff. Staff generally worked on the same unit, which helped ensure continuity of care, as they were familiar with people’s needs and the individuals knew and trusted the staff supporting them.

Safe recruitment practices were in place; a dependency tool was used to assess staffing levels to help ensure sufficient staff were deployed. The provider promoted a learning culture and ensured staff had access to a wide range of training. Staff had received training which the provider deemed mandatory and specific to meet the needs of people who lived at the home. Staff appraisal sessions were completed in line with the provider's policy.
 

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.

Staff assessed and managed the risk of infection. They controlled the risk of it spreading and understood their responsibility to share concerns with appropriate agencies if necessary.

Staff attended training in infection prevention and control (IPC) and understood how to protect people from the risk of infection. Housekeeping staff carried out regular cleaning, and there were checklists in place to ensure good hygiene was maintained in all areas of the home. We observed that all areas of the home were clean and hygienic during our visits.
 

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.

The management team had taken action to address the shortfalls found at the last inspection, including the management of time sensitive medicine. The clinical lead told us, "We have made so many improvements, we’ve took feedback on board and worked really hard to get these meds right." The clinical room was clean and tidy, and temperatures monitored and controlled medicines were managed effectively.

Staff made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff worked closely with the GP and pharmacist to make sure medicines were managed appropriately. The process and recording around the use of ‘thickeners’ (medicine used to thicken food or fluids for people with swallowing difficulties) had been reviewed and improved since the last inspection and staff had received further training.

A review was completed that ensured topical (creams/ointments) medicines were available for administration. Care plans and risk assessments had also been updated to provide detailed information especially for those with complex conditions.