Safe Harbour Dementia 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. At our last inspection 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 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 concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The registered manager reviewed accidents and incidents through daily huddles, weekly staff debriefs and monthly analysis. We saw examples where falls had been analysed and linked to underlying health issues, resulting in referrals to health professionals and a reduction in incidents. The provider completed extensive audits across the service and used findings to drive improvements. The provider had also established a care academy and participated in professional networks to promote learning and improve care outcomes.
 

Staff 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.

Care records demonstrated involvement from a range of healthcare professionals, including GPs, district nurses, speech and language therapists, physiotherapists, falls teams and diabetic nurses. We saw evidence that referrals were made appropriately when risks were identified and recommendations from professionals were incorporated into care planning. Records showed people experiencing deterioration were supported through recognised pathways, with healthcare professionals involved to support decision-making and treatment.
People, relatives and professionals consistently told us they felt people were safe living at the service. A professional described the home as personalised and stated they would recommend it to others. Another person told us, "Yes, I feel safe here."
 

Staff worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect.
Staff demonstrated a good understanding of safeguarding responsibilities and were able to explain how they would recognise, report and escalate concerns. Policies reflected current safeguarding requirements and promoted a culture where people could raise concerns safely. Records showed safeguarding concerns were reported appropriately and there were no active safeguarding investigations at the time of our assessment. The management team monitored safeguarding activity through governance systems and used learning to improve practice where necessary.
Staff understood when Deprivation of Liberty Safeguards (DoLS) authorisations would need to be sought, the impact of the recent Supreme Court judgement and what to do if there were conditions imposed.

Staff worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.
Risk assessments and care plans identified individual risks relating to mobility, nutrition, skin integrity, medicines and health conditions. Care planning included information about people's preferences and how risks should be managed in a way that respected their wishes. We saw examples where people were supported to make informed decisions about their care. Staff understood people's individual risks and could describe actions required to keep them safe. Although records were detailed and person-centred, some information was repeated across documents, and key risk information could be more clearly summarised to support accessibility for staff. We raised this with the registered manager at the time of our inspection who has since taken this on board.
 

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.
During our inspection we found communal areas, bedrooms, bathrooms, kitchen areas and outdoor spaces were clean, tidy and free from unpleasant odours. Environmental checks, fire safety monitoring, equipment servicing and health and safety audits were completed regularly. We saw evidence of checks relating to water temperatures, window restrictors, fire safety systems, pressure-relieving equipment, slings and hoists. Bedrooms were personalised and adapted to meet people's needs. Personal protective equipment was readily available throughout the service, and staff followed good infection prevention and control practices. Where inspectors identified minor environmental issues, including damaged edges and radiator cover concerns, the provider responded promptly and took action to reduce associated risks. This demonstrated an ongoing commitment to maintaining a safe environment for people living at the service.
 

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.
Staff said there was enough staff available to provide safe care and support. A member of staff told us they would be happy for a relative to live at the service because people were safe and well cared for. Staff feedback. Recruitment records demonstrated appropriate pre-employment checks had been completed, including identity verification, references and Disclosure and Barring Service checks. Mandatory training compliance was reported as 100%, and staff completed additional training in dementia care, equality and diversity, nutrition and hydration, communication and sensory impairment. Staff told us they felt supported by managers and had access to ongoing development opportunities. The provider monitored staffing, training and competency through governance systems. We observed staff were visible within communal areas, responded appropriately to people's needs and worked effectively as a team throughout the assessment.
 

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 was visibly clean and well maintained, and we observed good standards of cleanliness throughout the service. Personal protective equipment was readily available at the point of care, and staff followed infection prevention and control practices during the inspection. Regular infection prevention and control audits were completed and monitored by leaders. Environmental checks covered areas such as cleaning schedules, laundry processes, waste disposal, hand hygiene facilities and equipment cleanliness. The housekeeping team completed audits to monitor standards, and the management team maintained oversight of actions identified. Care plans considered infection risks where relevant, and people had access to healthcare support when concerns about infections arose. There were clear systems for monitoring cleanliness and reducing risks of infection for people living at the service.
 

Staff 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.

We reviewed medicines administration records and found these were generally completed correctly. Staff demonstrated a good understanding of higher-risk medicines and systems were in place to support the safe administration of time-critical medicines, including medicines used to manage Parkinson's disease. Protocols were available to guide the use of medicines prescribed on an as-required basis, and staff were encouraged to use non-pharmacological interventions before administering some medicines. Regular medicines audits were completed, and the service worked proactively with healthcare professionals to reduce unnecessary medicines and minimise waste. We identified 1 minor recording issue relating to a handwritten medicines administration record, which leaders addressed immediately.