The Old School House 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 re registered 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 regulations in relation to the maintenance of the premises and equipment in the home.

This service scored 59 (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 did not always have a proactive and positive culture of safety based on openness and honesty. Staff did not always listen to concerns about safety and did not always investigate and report safety events. Lessons were not always learnt to continually identify and embed good practice.

There had been a number of concerns raised over previous months passed on to the provider and investigated. However, these investigations had not led to a significant improvement in the quality of 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.

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

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.

The service’s safeguarding policy contained the procedures to take for all kinds of potential safeguarding issues. For example, if a person was admitted to the service and had bruising that had occurred previously. Most staff had received safeguarding training and only the newest staff were yet to have this training, although planned. Staff we spoke with were confident they could recognise and raise any potential safeguarding issues.

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.

The service was working with people to understand and manage their risk. Risk assessments relating to the health, safety and welfare of people using the service were completed. Equipment to help people manage risks safely was being used, including bedrails and pressure sensor mats.

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

The fixtures, fittings and furnishings in most communal rooms and bedrooms in the home were reasonably maintained. However, on our first visit to the home, we found it was dirty in places and there was a strong urine odour throughout the home. When we returned 8 days later, we found the cleanliness of the home had improved considerably. However there remained an incontinence odour in places in the home.

On our first visit the garden was cluttered with black bags of old clothes and old items of furniture and furnishings. These had been removed by the time of our second visit and the garden was once again safe and tidy, for people to use.

We identified numerous poorly maintained fixtures and fittings on our first visit. Some of these issues were improved by our second visit. However, many issues remained. For example, a main lounge remained without window coverings of any kind, and in ensuite toilets there were broken toilets, extractor fans, and lights.

On our second visit we found the kitchen was cluttered and in need of thorough cleaning particularly under and around equipment.

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

On our first visit there were not enough, or appropriately deployed, care staff present in the home at certain times, to quickly meet the needs of people living in the home. From 21 April 25 a new staffing level is to be introduced with an increase of 1 care staff to both the morning and late afternoon / evening staffing numbers. Also, the care staff were to be allocated more flexibly around the home to meet peoples’ needs more effectively.

The provider did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading or share concerns with appropriate agencies promptly.

During our assessment, we identified numerous places where sealants had failed, or surfaces had broken down, preventing surfaces from being effectively cleaned to prevent the potential spread of infection. The cleanliness of the home had improved by our second visit, but there continued to be improvements needed in this area. For example, sealant around the base of toilets, sealant around washable surfaces in ensuite toilets, and a shower seat surface had all broken down and come away.

On our first visit, the laundry room did not have a safe process or space to manage the processing of heavily soiled items, to help prevent the spread of infection. Between our first and second visits, the provider removed a large amount of material and clutter from the laundry room, enabling a safer space to be created to manage soiled laundry effectively.

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.

Between our first, and second day visits, the service implemented a second medicines room on the top floor of the building, so medicines were more accessible to people living on the top floor. There was 1 occasion when guidelines in place for staff to administer an ‘as required’ medicine were unclear. However as soon as this issue was identified, the service addressed the issue immediately.