Edward House

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 requires improvement. At this assessment, the rating has remained requires improvement. This meant people were not consistently kept safe and protected from avoidable harm.

The provider remained in breach of Regulation 12 Safe care and treatment at this inspection.

 

This service scored 59 (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 did not always have a proactive and positive culture of safety based on openness and honesty. Staff did listen to concerns about safety but lessons were not always learnt to continually identify and embed good practice.

There were no processes or systems in place when incidents had occurred to review what had happened and prevent re-occurrence. For example, the data for incidents and accidents was collated but there was no analysis to identify themes and trends to put measures in place to avoid incidents recurring and reduce the risk of harm to people.

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. We saw evidence of communication with external professionals and spoke with 3 visiting professionals during the assessment process. One told us how the team worked with them, “They [staff] will always ask if they want us to look at anyone urgently, they are on the ball.”

However, we did note there were 2 people observed during the assessment who were in need of input from external healthcare professionals and referrals had not been made to get this support for people. We discussed this with the management team who took action to ensure these people received the required external support and measures were introduced to improve their care.

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 we spoke with felt they were protected from avoidable harm. One relative shared their experience of their parents’ care and said, “[Relative] had cellulitis in their leg and they [staff] called the doctor who came straight away. The district nurse comes now to do dressings.”

We spoke with staff who had received training on safeguarding and understood signs to be observant for that could indicate a person was being abused. Staff were clear about reporting any concerns to the management team but were not always clear about how to report any concerns to external agencies, for example, the local authority safeguarding team. We discussed this with the registered manager who said they would discuss this with staff at a team meeting.

The provider did not always have a proactive and positive culture of safety based on openness and honesty. Staff did listen to concerns about safety but lessons were not always learnt to continually identify and embed good practice.

There were no processes or systems in place when incidents had occurred to review what had happened and prevent re-occurrence. For example, the data for incidents and accidents was collated but there was no analysis to identify themes and trends to put measures in place to avoid incidents recurring and reduce the risk of harm to people.

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

We identified safety concerns in the home including wardrobes not secured to walls to avoid the risk of them falling and injuring someone, a damaged loft hatch, poor positioning of evacuation equipment, and a lack of window restrictors to reduce the risk of a person falling from a window or leaving the home without support. In addition, we found 3 people living on the upper floor with significant mobility issues which would put them at risk in the event of a fire as they would all require support from 2 staff to evacuate from the building. The registered manager and provider were very responsive and addressed the environmental concerns, including the part of the building people had their bedrooms on, during the process of the assessment to reduce the potential risk of harm to people.

We saw equipment was routinely checked including the nurse call system and sensor mats used to alert staff when a person needed assistance.

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.

Most people felt there were enough staff, but some people told us they did not always feel there were enough staff available. We did not observe evidence of this during our assessment and did not observe anyone having to wait for staff to ensure they received safe care. The provider used a dependency tool to calculate the number of staff required to ensure people’s needs were met safely and the rota reflected these staffing levels.

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.

We observed 3 domestic staff engaged in cleaning tasks during the assessment. The home appeared clean and there was no malodour. People were happy with the cleanliness of the home. One relative said, “It’s lovely and clean. They are always cleaning the carpets.”

People told us they received support with their personal hygiene, but this was not always clearly documented by staff. One person said, “I have a shower 2-3 times a week. They [staff] always ask me if I want one.”

We did note that there was a sharps box that had been overfilled which presented a risk of infection and was not in line with the provider’s infection prevention and control policy. However, this was kept in an area that was not accessible to people so presented a low risk of harm. We spoke with the registered manager about this issue and they advised they would address this.

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.

We saw medication administration records were completed consistently; medicines were stored and disposed of appropriately including controlled drugs. We did note an audit on the controlled drugs had been missed and there was conflicting information on 2 documents. However, there had not been an error in the administration of medicines and the missed audit was highlighted to the deputy manager and measures to avoid a recurrence were discussed.

People were happy with the support they received with medicines including ‘as required’ medicine. We saw examples of where people’s medicines had been changed to better meet people’s needs. One relative said, “[Relative] wasn’t taking their medication so they [staff] got it changed and now [relative] has liquid medication so it’s easier for them to take.”