Cayton View 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 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.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to feedback, any doubts about safety were reported and investigated in timely manner. Management reviewed records for themes and patterns to enable them to implement any required actions that helped to keep people safe. Staff understood and followed up to date policies and procedures. They understood when to report any concerns including incidents and accidents. Prompt action was taken where needed, including referrals to health care agencies. Outcomes were used to implement reflective actions as part of a process of lessons learnt, helping to keep people safe from similar events.

The provider completed an initial pre-assessment with people to ensure the service was suitable for them. This assessment was held on an individual electronic care planning system and used as a point of reference for staff to fully and safely support the person. Where required the provider worked with other healthcare partners to set up and support safe systems of care. This included continuity of care for people, including when people moved between different services. For example, when accessing hospital or GP services. Records showed people were referred to other healthcare professionals when needed. People received help from regular visits from district nurses, the local GP practice and other health professionals. A health professional told us the service was always supportive of their visits, responding to their feedback and amending records to ensure the information for care staff was reflective of people’s individual needs. This helped to reduce unnecessary hospital admissions and GP appointments keeping people safe. Staff told us they worked well with health and social care professionals and had developed good working relationships. There were clear processes to ensure people’s current information was safely shared and we saw records of this during the inspection.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to avoid known risks. 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 and their relatives spoke positively about their experience living at the service. They confirmed they felt safe and protected from the risks of abuse. Relatives told us they felt confident their loved ones were safe and had routinely seen staff checking in on people’s wellbeing. One person said, “I think it’s great here, I do feel safe, there’s always someone around. I have a button I can press, and they [staff] are there.” Staff had received up to date training in safeguarding adults from abuse which resulted in a clear appreciation of the associated safeguarding policy which was used to understand and raise any concerns. Staff told us if they saw poor practice by colleagues or other health professionals, they would follow the whistleblowing policy to share this information anonymously, protecting people from the risks of abuse. A staff member said, “We routinely share any concerns, the [registered] manager is approachable and will quickly investigate anything of concern.” It was clear from safeguarding records that management took all allegations seriously. Clear processes were used to review, escalate, and act to protect people from any allegation of abuse including harm.

The provider collaborated 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. Care plans included information which showed levels of known risk for people with information for staff to respond with to provide people with safe activities of care and support. The provider completed detailed risk assessments to help staff manage potential risks that may be posed. For example, risk from falls and skin damage. Staff had access to detailed information to support people to manage and mitigate known risks associated with their diverse needs. Regular management oversight ensured where people had been assessed as being at risk of malnutrition or dehydration, that care plans included weekly weight checks. This process enabled focused action to be taken to support those identified as ‘at risk’ with referrals completed to health professionals. For example, dieticians. Where people had individual dietary needs, this was recorded and information shared with the cook. Where people were assessed as ‘at risk from choking’, input from the speech and language therapy (SALT) team was recorded to support textured diets; ensuring meals were prepared to make them easier and safer to swallow.

The provider identified and controlled potential risks in the care home environment. They madesure equipment, facilities, and technology supported the delivery of safe care.The service had robust processes in place to manage and maintain the environment,equipment, and ensure measures for health and safety were completed with regular frequency.Legally required scheduled checks were completed, for example, equipment and utilities werecertified and dated as completed by relevant professionals. Any identified concerns wereactioned without unnecessary delay.A fire risk assessment was in place, and actions found had been completed. Ongoing fire drills,evacuations and equipment checks were completed and certified. Readily accessible individualpersonal emergency evacuation plans were in place along with an emergency grab bag tosupport safe evacuation in any emergency.

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. Checks were completed to ensure staff were safe and suitable for their roles. People and staff told us there was enough competent staff on duty to meet people’s individual needs. One person said, “They could always do with more staff, look how busy they are, but they still have time to listen to you.” The registered manager completed an evaluation of people’s changing needs to decide and adjust staffing numbers without any reliance on agency staff. Staff we spoke with told us they enjoyed working at the home. One staff member said, “It’s a great place to work, we’re a great team, it’s quite a new service but there’s good staff retention which provides people with familiarity and consistency of care.” Staff received induction, ongoing probation, with supervision and appraisals completed to support them in their roles. Observations of staff practice were used in conjunction with training to ensure staff remained competent and delivered safe care following best practice guidance. For example, to support people to take their medicines and to mobilise around the home. Training compliance rates were high with refresher training in areas considered mandatory and other areas to meet people’s individual needs planned. The provider had recently introduced mandatory training to improve staff understanding in support of people with a Learning Disability was in progress and allocated to all staff regardless of their role or responsibility. We saw staff were attentive to people’s needs throughout our inspection. Staff were available to support with activities, to spend time chatting to people and support them with personal cares and at mealtimes. Call bells were responded to quickly and checks were completed to ensure people were not kept unnecessarily waiting in their rooms. People and their relatives told us staff appeared well trained. One person said, “It’s wonderful [here] they [staff] are amazing, everybody is amazing. I can’t look after myself but here I’m well looked after. I am confident the staff know what they are doing.”

The provider assessed and managed the risk of infection. Policies ensured processes were in place to detect infection and control the risk of it spreading, promptly sharing any concerns with appropriate agencies. The home was clean and free from any unpleasant/lingering odours. Staff had been trained in infection prevention and control and told us there was enough personal protective equipment available such as gloves and aprons. Staff clearly understood how and when to use PPE and how to dispose of it safely. Ongoing schedules for cleaning and maintenance were signed as completed with audits in place to oversee the cleanliness and safety of the environment. Deep cleaning of both communal areas and individual rooms was completed with management oversight to address any concerns.

The provider made sure that medicines and treatments were safe and met people’s needs, abilities and preferences. Staff involved people in planning, including when changes happened. People received their medicines safely as prescribed from suitably trained and competent staff. Medicines were administered and recorded using an electronic medicines management system which provided a clear audit trail including any refusals. People received a first assessment of their needs to decide if they had the ability to self-administer. Where they needed support, associated risk assessments were in place to ensure medicines were administered as prescribed. This included information to ensure any time constrained medicines and medicines after food were scheduled and administered as prescribed. People received reviews of their medicines to ensure they remained relevant and effective. One person told us, “I receive my medication on time, I do my own blood pressure medication, and staff do the rest.” Staff followed best practice wearing Personal Protective Equipment (PPE), they approached people with drinks and discussed the medicine, recording the administration only after they observed the person had taken it. Protocols were in place to support the safe administration of medicines taken as needed (PRN)For example, pain relief. All medicines, including controlled drugs were stored securely and safely. The clinical lead completed audits and checks and processes ensured any errors or omissions were investigated with resulting actions taken where needed.