Hillcroft Nursing Home Morecambe

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

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. Lessons were learnt to continually identify and embed good practice.

There was a robust system in place for recording any accidents or incidents and where lessons had been learned. Appropriate referrals were made to other agencies including the local authority safeguarding team and relevant health professionals. Families and relevant others were informed of accidents and incidents, and duty of candour was followed. Learning from accidents and incidents was shared in several ways including the information being visible for visitors to the home.

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, such as on admission to hospital.

Preadmission assessments were completed and transitions into the service were well planned. The planning usually included family and professionals who were already involved in the care and treatment of people. We spoke with a visiting professional who was supporting a person in transitioning who had been previously cared for by them. They told us, “I visit [person] every weekday for one hour, I was their carer for 2 and half years. I have been made very welcome in the home.”

People and their relatives told us they had been involved in informing and developing their initial care plans. A relative said, “I was involved with [Relative] care plan. We filled in a ‘Get to know me’ booklet with all their needs.” Processes were also in place to help ease transition to other services if needed such as detailed emergency hospital admission information.

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 and their relatives told us they felt the service was safe. Incidents of safeguarding had been identified and shared with the local authority.

Staff had received training in recognising abuse and on Deprivation of Liberties Safeguarding (DoLS). Consents had been obtained and DoLS applied for in line with the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and found consents had been appropriately obtained and where relevant DoLS authorisations applied for.

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.

Risks associated with people’s care and treatment had been recognised and recorded. Records were detailed, accurate and current. The management team had systems for the oversight of accidents and incidents. They considered trends and themes and took action to minimise reoccurence. People’s needs were regularly being reviewed and were reflective of any changing needs. A relative told us, “[Relative] tripped over one time when they were unsteady on their feet. Staff reported it straight away and called us.”

Staff told us they could access people’s records easily to follow risk management plans. We observed very positive interactions by staff with people who could not easily express their needs or became easily distressed.

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

Regular environment and equipment safety checks were in place. However, on our walkaround of the building we saw some issues that could pose a risk to people. These included wardrobes that were not secured, unlocked doors to rooms and cupboards that contained items of risk and some medicines that were not stored safely. The provider and deputy manager took immediate action to address these issues. There was an ongoing programme of refurbishment and decoration. Regular servicing of equipment was in place. Staff were adequately trained in fire and evacuation and the use of equipment.

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.

A dependency scoring tool was used to determine the ideal number of staff required. We observed staff were able to give support to people as and when they needed to. People and staff told us they felt there were sufficient staff. A relative said, “I think there is plenty of staff and there is always a nurse on hand when you want one.” A staff member told us, “There are sufficient staff but sometimes it does get busy.”

The provider completed a variety of checks of suitability on staff being employed, to ensure they were fit and proper to work with people. We saw induction training checklists had been consistently completed. Staff told us they felt they had received more than sufficient training to care for people safely. Staff also told us they were fully supported by the provider to enhance their qualifications and progress in their careers.

People and relatives, we spoke with thought staff were appropriately trained. One person said, “Staff swap around so they all get to know what they are doing, they are excellent.” Staff told us they felt very supported by the management team and had regular supervisions and appraisals.

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. Staff and leaders worked to minimise the risk of any infection transmission.

The home was clean and regular checks of the cleanliness and infection prevention were being completed. Personal Protective Equipment (PPE) and hand sanitiser was readily available and was seen to be used effectively. People were very happy with the quality of cleanliness in the home. Food handling and food hygiene was in line with best practice.

The provider did not always make sure that some medicines were safely stored. People did receive their medicines safely as they had been prescribed.

We found prescribed thickening agent was left unsecure in communal areas however no one using the service was able to access it due to their current mobility. We also found some prescribed topical medicines kept in people bathrooms were accessible to people. No monitoring of room temperatures was in place. This was immediately addressed by the provider and management team.

Medicines were generally stored securely and areas used to store medicines had the temperature monitored. Medicines administration records were completed accurately. The records were clear and concise in detailing peoples’ preferences for the administration of their medicines. Regular reviews of medications took place with the local GP surgery.

Medicines were managed by staff who had been trained and had their competency assessed. Audit processes used for medicines management had not picked up on some of the issues we found during the inspection. The issues identified were acted on by the provider and management team and changes made to the auditing processes to ensure these areas would be captured.