Gresley House Residential 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. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

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 understood their responsibilities to report any concerns. The management team and provider had systems in place to ensure accidents and incidents were regularly analysed to identify any emerging themes or patterns to improve the care provided. Learning from events had been cascaded through the staff team.

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 assessed people’s needs prior to them using the service to ensure their needs could be safely met. Information was sought from the person, their relatives and external professionals involved in their care. People had care plans and risk assessments which were based on the assessments completed and these were reviewed and updated when needed.

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.

People were protected from abuse and avoidable harm. People told us they felt happy and safe using the service, we observed people to be familiar and comfortable with the staff supporting them. Staff had received training in safeguarding and knew how to recognise signs of abuse and how to safeguard people if they had any concerns. Deprivation of liberty safeguards (DoLS) were used to ensure people’s safety, together with best interest decisions. The service had made appropriate DoLS applications.

Some people living on the first floor told us sometimes other people would enter their rooms. The provider advised us they would look into this to ensure everyone felt safe in their own room.

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.

People were safely supported to live their day to day lives in line with their choices and preferences. Staff demonstrated a good understanding of people’s needs and how to support them with known risks. Staff were kept informed about any risks and changes to people’s care and support needs through handover meetings. People’s relatives confirmed they were involved in reviews of people’s care.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

There were arrangements to monitor the safety of the premises through regular safety checks, which included fire safety, maintenance and equipment checks. The provider was responsive to areas for improvement we identified during the inspection. For example, additional call bell monitoring was facilitated to improve the systems already in place.

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.

We received mixed feedback on staffing levels from people and staff. Some people told us they thought more staff were needed. One person told us, “I don’t think they have enough (staff), but those they’ve got are so good.” Some staff felt more were needed due people’s variable needs.

We observed occasions when call bells were not responded to by staff. The provider took action to understand what had gone wrong and reduce the risk of this happening again. Communication was sent to staff to remind them of the expectations of responding to call bells and the call system was set up to generate reports of response times. We observed times when people were not supervised by staff in communal areas and one occasion where we had to prompt staff to provide support for a person. The management team were responsive to the feedback shared during inspection. The provider utilised tools to identify the number of staff required to meet people’s needs safely. These figures were reviewed weekly. The nominated individual undertook a review of the staffing requirements of the home and the system for staff allocation. This confirmed sufficient staff were available to support people safely. The management team were committed to supporting staff to work effectively to meet people’s needs.

Staff were recruited safely and completed training relevant to their role. The provider implemented systems to check on staff practice and competence. The provider has a current ongoing recruitment drive to employ a more consistent staff team.

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.

People were protected from the risk of infection. The provider had systems and processes to assess and manage the risk of infection. People were happy with the cleanliness of the home. One person told us, “They [staff] keep the whole place clean.” On the day of our visit, the home was clean. We observed staff wearing personal protective equipment in-line with good practice, which helped reduce the risk of infection. Good food hygiene practices were observed.

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.

Medicines were administered and stored safely. People were happy with the support they received to manage their medicines. One person told us, “I take a few tablets. They [staff] wait while I take mine safely”.

The management team responded immediately to feedback on the day of the site visit to improve the system for the prompt return of medicines which were no longer required to the pharmacy. The GP for the service was invited by the manager of the location to work with them to improve protocols for as required medicines to ensure best outcomes for people.