Featherton House

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 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. However, lessons were not always learnt to continually identify and embed good practice.

Incidents, accidents and safeguarding concerns were reported, and a monthly analysis was completed by management. However, following the review, actions and lessons learnt were not always identified. For example, a monthly falls analysis recorded the same lessons learned across four separate analyses. As a result, lessons learned were not consistently identified or reviewed, reducing the opportunity to prevent similar incidents from recurring.

However, records showed that incidents were managed appropriately. Staff told us they knew how to report concerns and were knowledgeable about the processes for reporting incidents and accidents.

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.

Prior to moving into the home, people’s needs were assessed. Where possible, this was completed face to face to ensure the provider could meet the persons’ assessed needs. Care plans provided guidance to staff on how best to support the person. Staff followed instructions safely and effectively, working closely with external professionals, such as the mental health team, occupational therapists, pharmacists, district nurses and the GP to ensure people received safe care and treatment.

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 the risk of abuse and avoidable harm. All staff received regular safeguarding training. Safeguarding was regularly discussed in supervisions and team meetings and staff had a clear understanding of their responsibility to report any safeguarding concerns. One staff member we spoke with told us, “I would report anything I see or deem as a risk to [person’s] health and welfare. I would report this to a higher position of power to myself, such as a senior on shift or a manager. If I felt as though these concerns were not taken seriously, I would whistle blow or go to the regional manager. I would verbally tell or explain the situation that was being reported, then document it on the appropriate paperwork.”

People and their relatives told us they felt safe living in the home. One relative we spoke with told us, “The care here is very safe, staff are always around. I can tell [person] feels safe here.”

The registered manager had reported safeguarding concerns to the relevant local authority and had notified the Care Quality Commission by submitting the required statutory notifications.

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.

Risk assessments were in place, and most risk assessments provided guidance for staff on how to manage identified risks. For example, where people were at risk of choking, detailed guidance was available on how to support them safely with eating and drinking, as well as what actions to take if they choked. However, some risk assessments contained standard wording which was not specific to the person. This meant further work was required to strengthen some risk assessments to ensure all appropriate risk mitigation was in place.

People’s wishes were considered when completing risk assessments, ensuring decisions reflected what mattered most to them. For example, being as independent as possible with personal care was important to 1 person. This was written within their risk assessments and care plan, and staff were aware of the level of support that was required.

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.

People were at an increased risk of harm as multiple staircases within the building were freely accessible, which posed a risk of falls. Although the provider had introduced some mitigation measures, such as installing sensor mats in the bedrooms of certain individuals on the first floor, they could not be confident that staff would always respond promptly to alerts, particularly when attending to others in the home. This was raised with the registered manager, who took action by arranging for adapted safety gates to be installed on all staircases. The registered manager completed a risk assessment outlining potential control measures; however, the provider could not be fully assured these measures were sufficient to fully mitigate the risk and ensure people’s ongoing safety.

However, the provider had appropriate checks in place to maintain the environment and equipment used, such as, fire alarm system, portable appliances and water temperature checks. Action had been taken where concerns were identified during the checks.

Staff received effective training around fire safety and fire drills were carried out regularly by day and night staff. People had up to date personal evacuation plans to ensure staff evacuated them safely in an 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.

People and their relatives told us there were enough staff available to meet their needs. One person we spoke with told us, “I think there’s enough staff. If I want something they come.” Another person told us, “They’ve always got time for you to sit and chat, they are never too busy for you.”

Staff told us there were enough staff to meet people’s needs. One staff member told us, “Staffing has generally been sufficient to meet people’s needs safely. Naturally, there can be busier periods during the night when several people require assistance at the same time, but withseniors on duty we usually work well together to manage this.” Another staff member told us, “The current staffing levels are very adequate. We have enough staff to cover people’s needs on a day-to-day basis. As with any care home, there will be a day that happens to be busier than others and we may struggle a little, but we all work together as a team to ensure people’s needs are being met, and that the shift runs as smoothly as possible.”

Recruitment checks were carried out by the provider to ensure staff were safe to work with people. Pre-employment checks included a job application form, an interview, and references. All staff were required to complete an enhanced Disclosure and Barring Service (DBS) check before starting employment. A DBS check provides information about any convictions and cautions held by police.

The provider had a training matrix which was reviewed regularly to ensure staff were up to date with their training. One person we spoke with told us, “I feel quite safe with [staff], they seem well trained.” Staff received regular supervisions, 1 staff member we spoke with told us, “Supervisions take place regularly and I find them useful because they give me the chance to talk about my progress and any training or guidance I need.”

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 home appeared clean and free from odour. Systems were in place to maintain good infection control practices and staff had completed infection prevention and control training. Staff wore personal protective equipment (PPE) when supporting people. A person told us, “They usually wear gloves and aprons when they help me wash.”

Cleaning schedules and audits were in place to ensure all areas of the home were cleaned regularly.

An infection booklet was used for people who developed an infection, which clearly recorded the date the infection was identified, if it was transmissible, whether treatment was required, and the overall outcome. The management team completed a monthly infection analysis to identify any themes or trends with infections in the home. This supported good oversight, timely intervention, and helped to reduce the risk of recurrence.

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 well managed. Checks were carried out daily on stock checks and temperatures and people had guidance in place on how they would like to take their medicines.

People received their medicines from staff who had completed training in the safe handling and administration of medicines. Staff were subject to regular competency checks to ensure they continued to manage medicines safely.

Medicine records showed that each person had an individual medicines risk assessment in place. The management team carried out regular medicine audits, and policies and procedures were available to guide staff on the safe management of medicines. People had as prescribed (PRN) medicines with PRN protocols in place. These contained clear guidance for staff on when the PRN medicines were to be administered. When PRN medicines had been administered, staff checked the effectiveness of the medicine. For example, where a person had requested a PRN pain relief, staff assessed their pain level before administering the medicine, and after they had taken the pain relief. This meant staff were able to monitor the effectiveness of the medicine and if it had the desired outcome.