Appleby

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 69 (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. A relative told us, “The home seems very proactive in dealing with issues, particularly around safety.”

The registered manager monitored and analysed accidents and incidents, complaints, and safeguarding concerns to identify any lessons learned. These were then shared with staff to promote continuous improvement and maintain a safe environment.

During our assessment, the provider showed a commitment to learning and strengthening their procedures, taking immediate action to address issues identified.

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 provider’s electronic care planning system generated a report covering the person’s needs if they needed to go to hospital or another care service, to ensure accurate and timely information was transferred.

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. Staff shared concerns quickly and appropriately. They told us they had no concerns about staff practices and said there was an emphasis on raising any issues promptly to maintain safe, high‑quality care.

Risks were assessed and monitored to help ensure people’s safety and wellbeing. Staff used the electronic risk assessment system effectively and they were knowledgeable about people’s individual needs and associated risks.

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 home was undergoing redecoration and refurbishment. A significant amount of work had already been completed, and further improvements were planned. The upstairs floor which consisted of Laurel Suite (male only suite) and Armstrong Suite had been reconfigured as part of the refurbishment works. Staff identified further opportunities to promote people’s comfort and dignity, including the addition of a bath and kitchenette for Laurel Suite. A professional also highlighted that providing additional walking space could benefit people who were more restless. This feedback was shared with the registered manager and provider for consideration.

A robust system was not fully in place to verify the professional registration of staff and role suitability. Following our feedback, the provider took prompt action to address this issue and strengthened their verification processes.

One staff member had transferred from another of the provider’s services, which operated under a different legal entity. Recruitment records did not clearly demonstrate all the checks which had been completed, including a full employment history. While repeating all recruitment checks was not required, there should have been sufficient evidence to confirm compliance with best practice.

There were enough staff deployed to meet people’s needs. Staff had access to training relevant to their roles and were supported through regular supervision and appraisal to deliver person-centred care. One professional told us, “The manager is good at keeping in touch with the department and has hosted training sessions for other care homes for the department in the past. They also send staff along to current training I offer.”

During our observations, we noted that not all moving and handling manoeuvres followed best practice. Following our feedback, the registered manager carried out checks on staff practices and told us that moving and handling leads were also in place to ensure safe procedures were consistently followed.

Overall, the home was clean and well maintained. We noted that some hard-to-reach areas, such as the underside of bath and shower equipment, required additional attention to ensure consistent hygiene standards. Staff took immediate action and cleaned these areas during our visit.

Records did not always evidence that an effective system was in place to ensure medicines were safely managed.

Guidance for ‘as required’ and variable dose medicines lacked person-centred detail, and records did not always show why medicines were given or their effectiveness. Records were not in place for all prescribed creams and medicine patch rotation documentation was incomplete. A running balance system was in place for assurance with only a few discrepancies identified. Medicines were stored securely, but fridge temperature checks had not been correctly completed. We did not identify any impact of these shortfalls on people’s health and wellbeing. The registered manager had started to take action to address the issues we identified.