Churchview 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.

This is the first assessment for this newly registered service. This key question has been rated good.

This meant people were safe and protected from avoidable harm.

This service scored 72 (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.

People told us they were happy living at the home and felt safe and well cared for. Their comments included, “I’m quite safe, I have no worries” and “No problem, I love them all, they are good to me.”

Staff knew how to report and document any incidents or accidents. Lessons were learned when things went wrong. The provider analysed all incidents and accidents that occurred at the service to find out what went wrong and how to prevent re-occurrence. Following the last 3 incidents, we saw the provider had created a poster for staff to refer to, stating the incident, what may have caused it and how to prevent this from happening again.

The provider had introduced a ‘lessons learned and good practice’ WhatsApp group for staff, so they could share key learning updates and examples of good practices across the home. For example, where it had been identified through falls data that there had been an increase in falls at weekends, we saw the provider had introduced the R.A.G (red, amber, green) falls risk system. This was to help staff quickly identify people who were at risk of falls, so they could put in place appropriate safety measures.

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 told us the staff were always available if they needed support. One person said, “You can call them any time and they will come, nighttime, daytime, any time.” Relatives stated they were informed and involved when their family members required support or treatment from different services.

The staff team and registered manager told us they worked well with other professionals to ensure continuity of care, including when people moved between different services or required temporary stays in hospital. Records we viewed indicated working relationships and communication with external professionals were effective. The registered manager told us, “When someone goes to hospital, the nurses will get the clinical lead involved so [they] have an oversight. ReSPECTforms [Recommended Summary Plan for Emergency Care and Treatment] and hospital passports go with the person.” ReSPECT forms record a person's preferences and clinical recommendations for their care during an emergency when they cannot make or express decisions for themselves.

External healthcare professionals involved in the service provided a range of training sessions to enhance the staff’s skills and knowledge.These included training in end-of-life care, syringe driver, dysphagia and covert medication guidance. Dysphagia is the medical term for swallowing difficulties. Staff were then equipped to put this learning into practice, reinforcing a collaborative culture of learning.

The service had up to date policies and procedures in place. Staff were required to read and sign these to evidence they understood and agreed to follow these.

The registered manager understood their responsibilities in relation to Duty of Candour. They told us, “I oversee all notifications. Last year we had to dismiss someone for poor moving and handling. The staff lied in their statement. We had to use the Duty of candour. We have had some safeguarding whereby we were open and honest. We have a lessons learned folder whereby we record any incidents and what is learned from these.”

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 who were able to tell us said they felt safe from harm and abuse. One person told us, “I have no worries like that, that’s the best thing about it” and another said, “I certainly do feel safe.” A relative added, “They look after [family member] and turn [them] over. They always try to get [them] to eat. They work with me on things.”

Staff were aware of their responsibility to safeguard people and who to contact in the event of any safeguarding concerns. One staff member told us, “I have completed safeguarding adults training. If I had a concern, I would ensure the resident is safe, report it immediately to the nurse in charge or manager, complete a safeguarding report, document factual information and follow the home’s safeguarding policy.”

There was a safeguarding policy and procedures, and the staff were aware of these. Staff received safeguarding training and knew how to report any concerns.

There was a positive culture within the home. We found the staff to be responsive to people’s needs and to be kind and considerate when supporting them. People told us the staff were kind and nice and looked after them well.

The provider was proactive in raising safeguarding concerns with the local authority and CQC. They worked with the relevant professionals to investigate concerns when incidents occurred. We saw evidence of this in the documents we viewed during our visit.

The provider understood their responsibilities under the Mental Capacity Act 2005 in ensuring Deprivation of Liberty safeguards (DoLS) applications were submitted as required.

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 said staff knew their needs and met these safely. They said staff were responsive and answered their call bells promptly. Records indicated staff responded quickly to all calls. Processes to help ensure risks to people were assessed and mitigated were effective. We observed safe care being delivered to people.

There were effective systems in place to identify, manage and reduce risks to people’s health and safety. For example, a person was at high risk of falls. We saw a sensor mat had been put in place, so the staff would be alerted if the person got out of bed. This had reduced the risk of the person falling. Regular checks were undertaken to ensure the sensor mat was switched on and in good working order.

When people could become distressed, they received support to manage this appropriately. For example, one person tended to display aggression when agitated and upset. The staff displayed a calm and reassuring attitude towards the person, encouraging them to take part in activities and directing them to quiet areas to keep them calm. These measures deflected situations and prevented escalation. There was clear guidance to inform staff how to de-escalate situations and reduce people’s anxiety. The staff received PBS (Positive behaviour support) training to equip them with the skills to support people appropriately.

There were effective systems to review care plans and risk assessments and ensure they were sufficiently detailed and contained key information and guidance for staff.

Personal emergency evacuation plans were in place for each person. These contained detailed information about each person and the support they required to safely evacuate the building in the event of a fire or other emergency.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. However, in 5 out of 6 dining rooms, we found unlocked cupboards containing rinse aids, dishwasher tablets and washing up liquid. One lock was said to be faulty and the maintenance person confirmed they had been informed and were going to repair this. Others were just left unlocked. We discussed this with the registered manager who acknowledged the current locks were difficult for staff to use. By the end of the inspection, they showed us more suitable locks which they were planning to put in place without delay. Meanwhile we saw evidence the cupboards had been locked and the staff informed they must keep all products in locked cupboards at all times.

People were supported in a safe and well-maintained environment that met their needs. People and relatives told us they liked the home and felt it was homely and well decorated.

There were effective systems in place to monitor and regularly check the safety and upkeep of the premises. The management team and staff worked together to help ensure any potential risks were identified and addressed promptly such as faulty equipment or trip hazards. There were daily and weekly checks completed of all areas of the home to ensure safe systems were in place. These included water temperatures, fire safety checks and kitchen equipment. The maintenance person responded promptly to any reports from the staff where repairs were required.

Equipment used to support people was suitable, well maintained and stored securely. The provider had an up-to-date plan in place to help ensure people were supported in the event of an emergency.

The kitchen was clean and well organised. Staff wore appropriate uniform and protective wear. Fridges were clean and food items stored correctly. All checks were carried out regularly.

The home was clean and well-maintained with good quality fixtures and furnishings. Communal areas were light and airy which allowed people to mobilise easily. People’s bedrooms were personalised with photographs and items belonging to them.

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 who could tell us thought there were enough staff available to meet their needs. Their comments included, “I think there’s enough, I never have to wait”, “There are plenty. They are quite pleasant.” A relative agreed and said, “I said to one of them, are you short staffed? and she said no, we’re not, it’s just the long hours… they do it with a smile though, that’s what I like about them.”

People thought the staff were skilled and well trained. They told us, “Very well trained, they’re good” and “I have never looked into it but they do their jobs, we don’t have any problems. They do their jobs properly.” A relative agreed and said, "They are competent. There are so many people that can't get out of their beds, so they are always busy."

The training matrix indicated the staff received training the provider considered mandatory, such as health and safety, first aid, infection prevention and control and safeguarding. They also received training specific to the needs of people who lived at the service. This included dementia care, end of life care, diabetes and epilepsy. The staff had their competencies assessed regularly to help ensure they maintained their skills and knowledge.

Staff told us they were happy working at the home, felt supported and listened to. They said they received training that equipped them to do their job well and care for people who used the service.

The provider used a dependency tool to calculate the staffing levels based on people’s individual needs. The staff rota indicated the staffing levels recommended were consistent, including for staff working at night.

The provider carried out checks on the suitability of staff before they started working at the service. Systems in place included checks on new staff’s identity, eligibility to work in the United Kingdom, Disclosure and Barring Service (DBS) checks. DBS checks provide information including details about convictions and cautions held on the Police National Computer. This information helps employers make safer recruitment decisions.

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.

People told us they felt safe from the risk of infection because premises and equipment were kept clean and hygienic, and relatives confirmed they did not have any issues with cleanliness of the service.

The home was clean, hygienic and well-maintained. We observed a domestic team ensured the service was kept to a high standard. Cleaning staff followed a cleaning schedule and used appropriate personal protective equipment (PPE). The laundry was well organised, and staff followed correct infection control procedures.

The staff received training in infection control and followed safe guidelines. Care staff had access to and wore appropriate PPE when supporting people to help protect them from cross infection when supported people with their meals.

Appropriate systems were in place in relation to infection control. The provider ensured staff were trained in the use and disposal of PPE. The provider’s infection prevention and control policy was up to date. Information about the risk of infection was shared appropriately with people using the service and visitors. The management team carried out audits to ensure standards of cleanliness were maintained.

Although overall, the provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences, we found some minor shortfalls in the management of medicines.

Staff supported people who required covert medicines appropriately. Covert administration is whenmedicines are administered in a disguised format. Medicines could be hidden in food, drink or given through a feeding tube. They held best interests meetings and maintained authorisations to support this practice. However, we identified one record where a recent change to a medicine had not been reflected within the covert administration authorisation.This meant the approval did not match the medicine being given, which could affect safe use and compliance with legal requirements.

We were not fully assured that all medicines requiring refrigeration were stored in line with product guidance. Although staff monitored fridge temperatures, they had not consistently escalated when temperatures fell outside the recommended range. This meant there was a risk that some medicines may not have been stored appropriately,increasing the chance that they may not have remained effective.

Following feedback, the provider took prompt action to address the shortfalls we identified. However, overall, staff generally managed medicines safely and people received their medicines as prescribed. Staff followed clear processes for ordering, receiving and storing medicines. Two members of staff completed medicines reconciliation checks and acted promptly to follow up any discrepancies with the GP or pharmacist.

The service kept all medicines secure and restricted access to authorised staff only. They carried out regular stock checks of controlled drugs.

Care plans generally contained clear and up-to-date information about people’s medicines, including those deemed high risk. For example, records for people living with diabetes included detailed guidance on insulin administration and monitoring. Staff, including junior staff, demonstrated a strong understanding of diabetes management and people’s individual needs.

Staff received regular medicines training, including in-house refresher sessions. Leaders provided ongoing supervision and competency checks to ensure staff remained safe to administer medicines. The service also accessed external training to further develop staff skills in meeting people’s needs.

Staff kept medicines storage areas clean, organised and well maintained. The service used homely remedies appropriately to support people with minor ailments. Staff consulted with GPs to ensure these remedies were suitable and safe for each person.

The service demonstrated good oversight of people receiving high-risk medicines. Staff maintained logs to track review dates and key information for medicines such as antipsychotics, anticoagulants and diabetes treatments. A pharmacist from the local GP practice regularly reviewed people’s medicines. The service worked closely with the GP and pharmacy team, who provided weekly visits and additional support for urgent concerns.