Mile Oak Rest 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

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’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 72 (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 demonstrated a good understanding of their responsibilities to raise concerns about safety and incidents. They felt confident to raise their concerns to management.
Incidents reported to the management were scrutinised and reviewed to identify themes and trends. Appropriate actions were taken to prevent recurrence, thereby helping to keep people safe. Staff confirmed safety events and the actions taken were shared during handovers, team meetings and supervisions to support learning and prevent recurrence.

People and relatives confirmed they were confident to raise concerns and felt they would be listened to and actions would be taken. A relative told us, “I have raised a few concerns with [Manager], and they have always responded immediately in a caring and helpful manner”.
 

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.

Before people moved into Mile Oak Rest Home, a pre-admission assessment was carried out to ensure their needs could be met.

A hospital passport was available if the person went into hospital or moved to another service providing information about their health conditions, care needs, family contacts and personal preferences. These were kept centrally in a file and were reviewed monthly.

A health and social care professional told us, “Communication between staff and visiting professionals, including myself, has been effective. Relevant information is shared appropriately, and staff are cooperative in supporting safe care practices, particularly when coordinating care for residents who may be accessing multiple 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.

There were clear processes to manage safeguarding events and the manager worked collaboratively with the local authority to support people safely. Staff told us they knew how to raise concerns and had completed safeguarding training specific to their role. One staff member told us, “I am aware of how to identify abuse or harm. I would report to the senior carer on duty, who I feel would act accordingly. If in doubt, I’d go straight to the duty Manager”.

People reported they felt safe around staff, one person told us, “It’s lovely here and the staff are lovely too, 100%”. Relatives felt able to raise concerns. One relative told us, “I have raised a few concerns with [Manager], and they have always responded immediately in a caring and helpful manner”.

Where people were deprived of their liberty for care or treatment purposes, legal authorisations had been sought through the Deprivation of Liberty Safeguards (DoLS). The management team, maintained oversight of all applications, authorisations, and associated conditions, ensuring that all documentation remained accurate and up to date.
 

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.

Risks to people were identified, assessed and reviewed regularly. However, of the care records we reviewed, we found one person did not have a risk assessment completed in relation to self-administration of certain medication. This was discussed with the manager during the inspection, who took immediate action. Care plans reflected people’s individual needs and preferences.

Staff understood their responsibilities and escalated concerns appropriately when a person’s well-being was at risk. One staff member told us, “I believe people are well cared for and safe. Staff are attentive and aware of individuals’ needs and risks, and they follow care plans to support people appropriately. For example, staff monitor individuals closely where needed and respond quickly to any concerns, helping to maintain a safe environment”.

Key risk areas, such as fire safety, falls, skin integrity, and nutrition and hydration, were monitored closely. Staff told us they were kept informed about changes in people’s needs through effective communication , for example in handovers and staff meetings.
 

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 environment was safe and well-maintained. Regular checks of the environment and the maintenance of equipment were consistently carried out; however, it was unclear if required actions from the last legionella risk assessment, obtained by the previous provider, had been completed. We discussed this with the manager who immediately arranged for a new risk assessment to be carried out. The new risk assessment highlighted minor actions which were rectified straight away.

People had access to a call bell system, enabling them to request help in both emergency and non-emergency situations. We observed staff responding promptly to call bells.

Staff had undertaken training in health and safety and fire safety, giving them a good understanding of how to maintain safety within the service.

People spoken with felt safe with one relative commenting, “The staff have ensured that [person] is safe and have helped [person] find their way in this new environment which at first they found a bit confusing”.
 

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 was safe and effective. Staff received regular supervision, spot checks and competency assessments to assess their knowledge. Training was up to date, with a mixture of online training and practical sessions tailored to staff needs.

Recruitment records showed staff were recruited safely. Other checks included an enhanced Disclosure and Barring Service (DBS) checks for adults. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. References from previous employments had been sought. However, the provider did not always follow their own recruitment policy and procedures. We raised this with the manager during the inspection, and they took immediate action to address.

Staff felt supported and valued. Comments from staff included, “I feel like a valued member of staff” and “The manager is very understanding and supports the staff by making them feel valued for the work they do”.
 

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 provider had an infection prevention and control (IPC) policy in line with current good practice standards. Staff practice was observed by leaders during regular daily walk arounds.

Staff completed training in IPC and had access to personal protective equipment (PPE) such as gloves. We observed staff using PPE appropriately. For example, when delivering personal care.
We observed the premises were well maintained, appeared clean and there were no malodours.
 

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

Medications were not always managed safely, for example, we found some medication prescribed did not have either a medication administration record (MAR) chart or specific instruction from the prescriber to guide staff on safe administration.
Although we found consistent recordings of high temperatures in the medication room, the manager confirmed this had been raised with the provider. Currently a portable fan being used to manage the high temperatures was ineffective. The provider did not always follow their own medication policy regarding frequency of audits. We addressed these shortfalls with the manager who took immediate actions to address them. Shortly after our inspection, the manager confirmed action had been taken to install a permanent air-cooling system within the medication room.

The home operated an effective process for ordering and delivering medicines, ensuring that people had a continuous supply. Medicines, including controlled drugs, were securely stored, with access strictly limited to authorised staff members.

The home worked well with their local pharmacist who told us, “My role is to conduct Medication Reviews on/with the Residents, I am also involved in altering medication to allow safe swallow and Covert (after MCA assessment has been conducted). We provide a holistic approach and summarise all relevant information in the GP Journal to aid medication reduction”.

Staff had regular training, and their practice checked to ensure they administered medicines safely. Any errors or incidents were investigated and reported, so that systems could be put in place to prevent them recurring. Feedback from relatives suggested people received their medicines safely when they needed them.