Euxton Park 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. This is the first assessment for this service. This key question has been rated requires improvement.

This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The service was in breach of legal regulation in relation to people’s safe care and treatment.

This service scored 62 (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.

Lessons were always learnt to continually identify and embed good practice. Staff did not always however identify risk and report promptly.

The provider demonstrated a positive learning culture and was able to show how learning from incidents, audits and reviews was shared and used to improve practice across the service and wider organisation. Leaders described how lessons learned were communicated between different locations to promote continuous improvement and reduce the risk of similar issues occurring elsewhere.

The provider shared examples of organisational learning relating to diabetic care and the management and prevention of falls. Following incidents and reviews, learning was disseminated across services and actions were taken to strengthen care delivery. For example, leaders explained that learning identified in relation to diabetic care resulted in all people with diabetes having their care plans reviewed to ensure they reflected current needs and risks.

Staff were supported to learn from incidents and safety concerns. Lessons learned and key messages were discussed at regular staff meetings, providing opportunities for staff to reflect on practice and understand how improvements could be made. This helped to promote consistency of care and ensured staff remained informed about learning from within the service and across the wider organisation.

Staff understood how to record incidents, and they felt able to raise safety concerns with managers. They described a culture where concerns could be discussed openly and where managers were approachable and receptive to feedback. This supported the identification and sharing of learning opportunities.

However, we found staff did not always consistently identify risks or escalate concerns promptly. This meant some risks to people's safety were not always recognised at the earliest opportunity, leaving people at potential risk of harm. While leaders demonstrated that learning took place when issues were identified, more consistent recognition and reporting of risks by staff would further strengthen the provider's learning culture.

Overall, the provider had systems in place to capture, share and act on learning from incidents and events. Learning was embedded through communication, staff meetings and improvements to care planning, contributing to better outcomes for people using the service.

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.

People experienced safe and coordinated care when moving between services, and accessing support from external healthcare professionals. The provider worked collaboratively with people, relatives and healthcare partners to help ensure continuity of care and maintain people's safety. The provider worked in partnership with the local hospice.

There were effective systems in place to support admissions to the service. A pre-admission assessment process was used to gather information about people's health conditions, support needs, preferences and risks before they moved into the service. This enabled staff to understand people's needs in advance and ensured appropriate care and support could be planned from the point of admission. A person said, “Before I moved here, I was asked questions and they wrote it down.”

Information about people's care and support needs was available to staff prior to people moving into the service. This helped to ensure people experienced a smooth transition and reduced the risk of important information being lost during transfers of care. Hospital passports were in place and contained key information about people's communication needs, health conditions and support requirements. These documents supported healthcare professionals to provide safe and personalised care when people attended hospital or other healthcare settings.

The provider demonstrated effective partnership working with healthcare professionals. Referrals were generally made appropriately when people required specialist advice or intervention, helping to ensure people's health needs were assessed and managed. Staff understood when additional support was required and worked with external professionals to promote positive outcomes for people.

During the assessment, we identified one person who would have benefited from a referral to the Speech and Language Therapy (SALT) team; however, this referral had not been made. The provider responded promptly to our findings and completed the referral without delay. We reviewed the circumstances and found there was no evidence the person had experienced harm. The provider's immediate action demonstrated a willingness to address issues when identified.

Regular information-sharing meetings were held with the nominated GP practice. These meetings provided opportunities to discuss people's health needs, review concerns and ensure actions were followed up appropriately. This collaborative approach supported continuity of care and helped to ensure people received coordinated support from different services.

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 were happy and felt safe in the company of staff. Most people and relatives were confident if they raised concerns with management, appropriate action would be taken. A relative said, “We do trust that [relative] is safe as can be. They [staff] watch him all the time.”

Staff completed safeguarding training and compliance rates were high. Staff knew how to report any safeguarding concerns and there was information about what to do available in staff areas. There was an appropriate and up to date policy. Management collated safeguarding issues and worked alongside the local authority to make sure safeguarding concerns were investigated, and any recommendations were implemented.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked if the service was working within the principles of the MCA and how they managed DoLS within the service. We found that DoLS were being applied for and these were being reviewed.

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 generally involved in decisions about risks relating to their care and support. Most risk assessments included information about how risks should be managed while supporting people to remain as independent as possible.

Relatives involved in discussions about risks and how these should be managed. One relative said, "They look at all the potential risks and how to deal with them." This showed relatives were consulted and kept informed about measures to keep people safe.

However, we found one example where a person with capacity wanted to access the grounds independently. They were prevented from doing this as staff were concerned about their safety. As the person had capacity to make this decision, this restriction was not in line with supporting people's choice and independence. The provider acted on this following the assessment feedback and the person has now a plan in place to access the grounds, safely with a risk assessment in place. This showed that the provider was responsive to feedback.

The provider did not always detect and control potential risks in the care environment. They did not make sure that equipment, facilities and technology supported the delivery of safe care.

The provider had not consistently ensured that environmental risks to people's health, safety and welfare were assessed, monitored and mitigated effectively. We found examples where risk assessments had not been reviewed following incidents or changes in people's circumstances to ensure appropriate measures were in place to reduce the risk of harm.

For example, one person had regularly been observed placing their legs over bed rails, which placed them at risk of falls. Records showed this had occurred on multiple occasions; however, the associated risk assessment had not been reviewed, and no additional control measures had been considered or implemented. This meant the provider had not taken sufficient action to reduce the risk of the person falling from bed or to minimise the potential impact of injury should a fall occur.

We also found that existing risk control measures were not always reviewed and updated to reflect people's changing needs. As a result, the provider could not demonstrate that risks were. appropriately managed. This increased the likelihood that people could be exposed to avoidable harm.

Systems for monitoring the safety of equipment were not always effective. Bed maintenance and safety checks were being undertaken; however, these checks were not consistently documented. The lack of records meant there was no clear audit trail to demonstrate checks had occurred, and management did not have effective oversight of the safety and maintenance of all the equipment. Other equipment had been serviced in line with regulations, and these checks were recorded.

We identified that an electric wheelchair was being charged overnight in a person's bedroom. The provider had not completed a risk assessment to consider any associated fire or environmental risks. Following our feedback, the provider responded promptly by completing a risk assessment and discussing the arrangements with the person to ensure risks were appropriately considered.

Some aspects of environmental safety were managed appropriately. Fire drills were carried out to help ensure people and staff understood evacuation procedures in the event of an emergency. People had up to date Personal Emergency Evacuation Plans (PEEPs) in place and adaptive equipment was available to support those who required it.

Despite these positive findings, the provider's approach to risk management was not consistently effective. The failure to review risk assessments following incidents, the lack of documented equipment safety checks, and insufficient oversight of environmental risks meant people were not always protected from avoidable harm. These issues demonstrated a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Safe Care and Treatment.

The provider did not always make sure there were enough qualified, skilled and experienced staff. They did not always work together well to provide safe care that met people’s individual needs.

There were enough staff to support people safely. People and their families were mostly positive about the care staff provided.

A relative said, "They are very attentive, they are sometimes in a bit of a rush, I have no complaints about the staff.” This showed staff were caring and responsive to people's needs. Another person said, “I think they could do with one or two more staff, they just have enough time to do what they have to, but they don't take into account any problems that may occur." This showed some people felt there was little flexibility when unexpected situations arose. A person said, “They need more staff here, I have to wait till they are ready to get me up, that can take until dinner time” Another person said, “I have to wait sometimes up to 20 mins for staff to answer my call bell because there is not enough staff”. We observed call bells being answered promptly on inspection.

Staff shared similar views. One member of staff said, "I would like to spend more time with residents." Another said, "We need more staff, we cannot manage sometimes." This feedback showed staff were committed to providing good care but felt additional staffing would allow them to spend more time supporting people.

Training compliance was high, and staff completed a wide range of training to help them carry out their roles safely. New staff completed a comprehensive induction before working independently. Staff also received regular one-to-one supervision and annual appraisals to support their development.

People said staff appeared well trained and knowledgeable. Staff knew people well and responded to their needs appropriately. We did not find evidence that people’s needs were not being met due to staffing levels.

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 home was clean, tidy and well maintained. There were dedicated cleaning and laundry staff who completed cleaning schedules and checklists to help make sure cleaning tasks were carried out regularly.

People and their relatives were positive about the cleanliness of the home. Relatives said the home was "clean and tidy." A person said, "My room is kept clean and tidy."

Staff understood how to reduce the risk of infection and followed good infection control practices. During our assessment, we saw staff wearing gloves and aprons when providing personal care and disposing of these safely in the correct waste bins after use.

Personal protective equipment (PPE), including gloves and aprons, was readily available throughout the home. This meant staff had easy access to the equipment they needed to help prevent the spread of infection.

Laundry was managed safely. Colour-coded laundry trolleys were used in line with infection prevention and control guidance, helping to reduce the risk of cross-contamination.

Overall, there were effective systems in place to prevent and control infection. The home was clean, staff followed good infection control procedures, and people were happy with the standards of cleanliness.

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.

Staff signed to say that they had administered people’s medicines as prescribed. Individual guidance was available on medicines that had been prescribed to be given ‘when necessary’. Staff recorded the effectiveness of the medicine given. This helped to monitor outcomes for people. Medicines were stored securely and according to guidance. Staff recorded dates of opening medicines. People received time sensitive medicine on time, and this was well managed. Staff were observed administering medicines following best practice. People were not rushed and their medicine was explained to them. A person said, “I haven’t had any concerns around medicines”. Another person said, “I am doing ok with medication; I get it every day at the right time.” People received regular reviews of their medicines by health professionals, and this was clearly recorded.

The service had a nominated pharmacy. Audits to monitor medicine administration, recording and disposal are completed monthly. Stock counts were completed and medicine entering the home was checked and signed by two members of staff. This ensured that medicines were stored and given safely. Spot checks on medicine administration was taking place, and any concerns were investigated and acted upon immediately.