Pear Tree House

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 newly registered service. This key question has been rated 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.

Lessons were learnt to continually identify and embed good practice.

The registered manager spoke confidently about the learning culture of the home. They gave us examples of how incidents, accidents and safeguarding concerns were reviewed to ensure lessons were learnt. For example, they shared with us how a medical appointment had taken place in the home. They showed us a lessons learnt document that related to this. It included detail on what the situation was, what happened during this and how a reflective discussion took place within the team to review this. There was also a lessons learnt analysis and a future actions and outcome section which related to the person.

Staff told us they were involved with this process and they confirmed information was shared with them from the registered manager. They felt involved with all aspects of learning within the home. There were systems in place to ensure lessons were learnt to ensure good practice was continued.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored.

There were systems in place to ensure the person’s needs were assessed before they started using the service. This involved detailed and robust transition periods and plans for the person as reported upon under assessing needs. Staff had supported the person in their previous environment before moving, to help get to know them. The person had care plans and risk assessments which they had developed. These were based on their assessed needs that were continually reviewed and updated when required.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that.

The person and their relatives raised no concerns about safety.

There were systems in place to ensure safeguarding concerns were identified, reviewed and investigated when needed.

Staff told us they had received training in this area and records we viewed confirmed this. They were aware what action they should take if there were concerns. One staff member said, “We know [person] well, we look for any changes to behaviours, any changes in interactions or anything different. Of course, we are aware of abuse people may face such as financial or physical, however we try and make it individual to the people we support.”

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In [care homes/hospitals], 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 whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that when needed, DoLS were in place.

Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Relatives were happy with how risks were managed. A relative described how their relation had presented in a previous setting and how they were much more settled now.

We saw detailed, person-centred care plans and risk assessments were in place for the person. They were robust, clear and gave staff the necessary information to safely support people. They considered the diet the person required, how they mobilised, how they may present if emotionally distressed, and any known risks they had.

The registered manager told us they worked with the person and those important to them to ensure care plans and risk assessments were in place, were individual and specific to the person’s needs and regularly reviewed and updated.

There was a system in place to ensure the person had care plans and risk assessments in place that were reflective of their current needs. These were reviewed regularly or when changes had occurred.

The provider detected and controlled potential risks in the care environment.

The person looked comfortable in their environment which had been adapted and assessed to meet their needs. A relative spoke positively about the environment the person lived in. They told us, “I couldn’t ask for a better home.”

There were processes in place to ensure any potential concerns or risks were identified and reported so that appropriate action could be taken. There was a planned process for this to ensure any work that was undertaken was not disruptive to the person and their routines.

The provider had systems in place to ensure there were enough staff available to support people.

We saw there were enough staff available to support the person. Staff were allocated to the person based on their levels of individual assessed need. The provider worked closely with the local authority who funded these hours to ensure they were continually reviewed and appropriate for the person they supported.

Staff told us and records confirmed staff had received training. This included mandatory training and training that was specific to the person’s individual needs. One staff member told us how they had worked closely with the Speech and Language Team (SaLT) to develop an eating and drinking plan for the person. The SaLT team had then developed and implemented training for staff that only related to this person. Records we viewed confirmed staff training was up to date.

Staff had received the relevant pre-employment checks before they could start working in the home to ensure they were safe to do so.

The provider assessed and managed the risk of infection.

We saw the home was clean and the person was protected from the risk of cross infection. Staff told us they had received training and there was enough Personal Protective Equipment (PPE) available for them to use. There were processes in place to ensure concerns with IPC were identified so that appropriate action could be taken.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

No concerns were raised with how medicines were managed. One relative said, “Staff do all the medicines very well, I have never heard of any issues.”

Records we viewed confirmed the person received their medicines as prescribed. When the person had ‘as required’ medicines, there was detailed guidance in place for staff to follow to ensure people had these at the correct time and only when needed.

We saw medicines were stored securely to ensure any risks associated were considered. Daily checks were completed on medicines to ensure stock levels were correct and accurate. Audits of medicines were also completed.

Staff administering medicines had received training and their competency was checked to ensure they were safe to administer these to the person.

The provider was planning to change from paper records to an electronic system, the registered managed had developed a 4 weekly plan which looked at how this could be done safely and with the least disruption. The plan included key areas such as staff training and development.