Spion Kop 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 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 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 provider had systems in place to identify learning opportunities and improve the quality of care delivery. For example, staff meetings and one to one supervision was held on a regular basis, where staff and leaders discussed any concerns and identified opportunities for improvement.

The registered manager demonstrated changes they had made to policies and procedures in response to people’s changing needs. This showed leaders were proactive in learning lessons and altering their approach to keep people safe.

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.

People received regular visits from professionals and partner organisations who were involved in their care such as social workers, nurses and GPs. Staff recorded visits from professionals and any communication between the provider and the visitor. This meant that any changes in people’s care and support could be communicated to all staff.

When the provider was assessing people for potentially coming to live at the home, there was a robust process in place to ensure their needs were identified. If it was agreed that a person would come to live at the home care plans were put in place before their arrival. Handover information from the person, their relatives, professionals involved in their care, and previous providers were all recorded and used to inform decision-making. This meant people were supported effectively from the moment they arrived and gave their move the best chance of success.

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.

Staff and leaders knew how to identify safeguarding concerns and report them appropriately to the local authority and CQC. Any safeguarding concerns were recorded as incidents and analysed to identify any actions that could be taken to protect people. We reviewed recorded safeguarding incidents and observed the registered manager had made detailed observations and created an action plan to safeguard people and ensure incidents were not repeated.

All staff received mandatory training in safeguarding, with regular refreshers to keep them up to date with current practice.

One relative told us, “My relative is very safe - I do ask them when I call and they always tell me they feel safe.”

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’s care plans contained detailed information about risks. These were written in the first person and used positive, non-judgemental language.

The provider involved people in managing risks by spending time talking with them and using easy-read documents to aid their understanding.

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

Environmental checks were carried out on a regular basis so the building, garden and equipment were all safe to use. A comprehensive system of audits ensured all areas of environmental safety were covered.

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 were knowledgeable, skilled and approachable. They demonstrated knowledge of the provider’s policies and procedures and the people they were working with.

All of the staff were permanent, with no agency or bank staff used. Leaders told us that any staff leave was covered within the group of permanent staff members. This demonstrated continuity and experience within the staff group, and people and staff had got to know each other over a period of time.

Staff received comprehensive mandatory training which supported them to carry out their roles, and all staff were required to work towards completing their care certificate as a condition of employment. This meant that the provider had systems in place to ensure staff were trained and competent in their roles.

One relative told us, “My relative always says how comfortable they are and that the carers are very chatty and welcoming”.

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.

Support staff carried out regular cleaning tasks which were set out in checklists and ticked off when completed. This meant all areas of the provider were clean and tidy. The cleaning checklists were audited by leaders, who also carried out a separate audit in which they inspected the levels of cleanliness themselves. This meant leaders did not just rely on what staff had documented and checked the level of hygiene themselves as well.

One relative told us, “The place is very clean and it is the best place they have ever stayed at”.

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.

All staff were trained in administering medication and demonstrated knowledge of how to administer and store medication safely. Leaders completed regular medication audits, with processes in place to identify and investigate medication errors should they occur.

The medication cupboard was clean and organised. Medication was labelled appropriately with the name of the person the medication was prescribed for and the date that it had been opened. Medication Administration Record (MAR) sheets were clear to follow and understand and were up to date. Staff completed spot check counts of medication which were all correct, this showed the systems in place to monitor medication levels were effective. People were treated as individuals with regards to the administration of their medication . Those who were able to take their medication independently were encouraged to do so, and those who required support were asked for their consent for staff to help them, which was recorded in their care plan.

One person told us, “I take my own medication but staff help me if I need this”. A relative told us, “The provider makes sure my relative’s medication is safe”.