April Court

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 means 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.

People and relatives felt able to approach senior staff and managers if they had any queries or concerns. Relatives confirmed staff informed them of anything significant that had happened to their family member.

Staff prioritised the safety of people living at April Court. They knew how to speak up about concerns. Information about speaking up within the organisation was displayed on a poster in the staff locker room. They said they would feel confident to do so, should the need arise.

Lessons were learned from safety events, such as accidents and incidents. Staff knew how to report these and reported concerns without delay. The management team investigated, ensuring any necessary actions were completed for people's safety. The registered manager escalated concerns as needed with the provider. The registered manager and provider analysed and reviewed safety events to identify any developing themes that might indicate the need for further changes in practice.

The provider had a dedicated process and contact details for staff to speak up. There was also a clear, widely understood process for reporting, investigating, reviewing and learning from safety events.

People told us how staff planned their care and support with them. Relatives had the level of involvement they and their family member wanted.

Key workers (named support workers) planned and organised care in collaboration with people and their relatives. This included involving people meaningfully in managing any risks that affected them.

The registered manager and staff took seriously the transition process for people getting to know the service and considering whether they wanted to live there. Likewise, they supported people who were considering moving on from the service to live in an alternative setting.

The registered manager and staff worked closely with people's health and social care professionals to ensure they received the care and support they needed, including health care.

People had up to date hospital care passports written in an easy-to-read format. These set out clearly what was important to people, and what hospital staff needed to know to care for them safely and effectively.

People told us staff were kind and that they liked them. Relatives also spoke of trustworthy, kind staff.

Staff knew how to identify and report signs of abuse. They were confident the registered manager would take concerns seriously and follow them up appropriately.

The registered manager understood their role in identifying and reporting abuse, and in gathering information for a safeguarding enquiry.

People looked happy and comfortable in the company of staff.

Safeguarding processes and practices upheld people's human rights, protecting them from discrimination and abuse. Staff including managers had initial and refresher update training about their responsibilities for safeguarding people. The management team acted promptly on safeguarding concerns, reporting these to the appropriate authority and working in consultation with them to pursue enquiries.

Staff followed clear processes for supporting people with their money and finances, including bank cards, where people needed this. This included recording each transaction and ensuring there was a receipt to support it.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act 2005 (MCA). In care homes this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We reviewed whether appropriate legal authorisations were in place when needed to deprive a person of their liberty.

The registered manager understood the operation of DoLS. She and the staff had identified people who were deprived of their liberty and had applied to the relevant local authority to authorise this. There was a system for identifying when fresh DoLS applications were required because existing authorisations were expiring.

Staff and managers had training about the operation of DoLS.

People were happy with their care and support. Staff involved them in planning care and managing risks.

Staff knew people well and understood the support they needed to manage risks.

Staff understood how care and support could be restrictive in some circumstances. They followed good practice requirements in relation to restrictions, only using them if they were in people's best interests and were the least restrictive option at the time.

Staff followed people's care and support plans in relation to managing risk.

Staff provided effective, prompt support to people who showed signs of becoming distressed.

People's individual risk assessments reflected their individual needs and preferences. They were proportionate, up to date, and regularly reviewed.

People's care and support plans were consistent with their risk assessments.

People liked their rooms and found them comfortable. They had access to specialist equipment if they needed it. They smiled and looked comfortable when staff assisted them using this equipment.

Staff knew how to use any specialist equipment that people needed, for example, to assist them to stand or move.

The registered manager had already recognised that some redecoration was needed and had submitted a proposal to the provider for consideration.

Décor in some communal areas was scuffed and faded. This included patches of torn wallpaper and worn paintwork on the handrails in the corridor.

The building was kept at a comfortable temperature.

Equipment was in working order and staff used it correctly.

The service had current safety certification for gas, electricity and fire.

There were regular health and safety checks. These included water safety checks and flushing of infrequently used outlets, to reduce the risk from legionella. Legionellae are bacteria that live in water systems and can cause serious illness.

Fire safety checks took place at the expected frequency. There were regular, timed fire drills involving people and staff. The management team took action to address any shortfalls identified.

Each person had a personal emergency evacuation plan. They were kept in an easily accessible file near the front door, so they could be provided readily to emergency services personnel.

People told us they knew and liked the staff. They often called them by name.

Relatives viewed staff as highly competent. Comments included, “The staff are brilliant” and “They’re fantastic.”

The registered manager maintained an overview of training to ensure staff were up to date with required learning. Staff confirmed she prompted them when training was due, to complete the relevant face-to-face training or computerised learning module.

Enough staff were on duty to provide safe and effective care. This included staff at night to ensure people's safety in an emergency. Recruitment was under way for staff vacancies, which were covered in the meantime by overtime, bank staff or agency staff. Usually, agency staff worked regularly at April Court and knew the people living there.

Staff worked in an organised, calm way.

Recruitment of staff took place safely, with checks completed before staff started working at the service. This included obtaining enhanced criminal records clearance from the Disclosure and Barring Service, with checks the candidate was not barred from working with adults receiving care. There were also interviews and reference checks.

The registered manager ensured similar checks had been completed for agency staff.

Staffing was adjusted according to the level of care people needed. The registered manager kept this under review.

New staff induction and probation reflected the requirements of the Care Certificate. The Care Certificate is an agreed set of standards that define the knowledge, skills and behaviours needed for care work. The provider expected staff new to care to obtain the Care Certificate.

Staff received additional training relevant to their roles and the needs of people living at April Court. The provider supported staff to obtain nationally recognised qualifications, such as level 2 and 3 qualifications in health and social care. The provider required staff to undertake training about learning disability and autism. Most staff had completed this training.

There was periodic refresher training, which was compulsory for staff following induction. Training records reflected that staff were up to date with their learning.

People were proud of their bedrooms. They valued the assistance they had from staff to keep them clean.

Staff had access to the personal protective equipment (PPE) they needed.

A member of staff was designated 'infection control champion'. They undertook monthly infection control audits, which the registered manager oversaw. The management team visited all parts of the building multiple times a day, informally checking if cleanliness was up to standard.

The registered manager had managed infection control during the COVID19 pandemic. They ensured the service was prepared to manage any outbreaks of infection.

The premises were clean. Regular housekeeping staff were working during the inspection.

There were safe arrangements for the disposal of waste. This included the use of bins that did not need to be touched by hand, with designated bins for clinical waste.

Staff used PPE appropriately. There were facilities for hand cleansing around the building.

Staff received training about infection prevention and control, including hand hygiene and using PPE. Staff involved in preparing, serving and assisting with food also had training about food hygiene. This formed part of their initial and regular refresher training.

Infection control was discussed at regular staff meetings.

Housekeeping staff followed cleaning rotas to ensure all parts of the building were cleaned regularly.

People received pneumonia vaccinations and flu and COVID-19 boosters, if they wanted them.

People were as involved as they wished to be in decisions about their medicines.

A senior member of staff had the role of ‘champion’ for medicines management. They ensured staff had the skills and knowledge they needed to store and handle medicines safely, through competence assessments at least annually. They checked medicines storage, supplies and records regularly, to make sure staff had been following safe practice. They oversaw the ordering of medicines and setting up of monthly medicines records. They were also involved, with medicines champions in the provider's other services, in reviewing the provider's medicines policy.

The medicines champion and registered manager were conscious of the NHS programme for stopping over medication of people with a learning disability and autistic people (STOMP). They had liaised with medical professionals to review and reduce the medicines someone was prescribed, resulting in an improved quality of life for that person.

Staff ensured people's GPs reviewed their medicines annually, unless health changes in the meantime meant the person needed their medicines changed.

If people lacked the capacity to consent to taking medicines, these were administered only where they had been assessed as being in the person's best interests, in line with the Mental Capacity Act 2005.

Where people were prescribed 'as required' (known as PRN) medicines, there were clear guidelines for staff as to how and when to administer these. If someone was prescribed PRN medicines to help them calm when they were becoming upset or angry, these were not used routinely and were only given as a last resort.

Medicines were stored safely and securely, including medicines that required additional security. Medicines that required cool storage were refrigerated. Staff checked at least daily that the temperature of the medicines room and of the medicines refrigerator remained within safe ranges. Medicines were ordered in good time, with staff ensuring stocks were sufficient. There were procedures for disposing of medicines that people had declined or that were no longer needed.

Staff handling medicines had been trained to do so and their competency assessed.

The management team, including the medicines champion, took the necessary action in respect of any medicines errors reported by staff or discovered during audits.