Blandford Grange 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 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.

There was an inclusive and positive culture of continuous learning and improvement. Staff told us, “Registered manager and deputy always listen and give us advice. We raise any concerns on a day-to-day basis, and they will solve the issue or guide us to solveit. There is an on-call facilityavailableat the weekends or evenings for management support and advice if needed.”

Staff gave us examples of how accidents and incidents were used as opportunities for learning and discussed at team meetings. Staff said, “Any accidents or incidents involving residents are communicated to us at handover at the start of ourshift. If they happen during our shift, then it is documented factually for the manager and the next shift.This meant risks were identified and managed to reduce risk to people”.

Referrals, such as to Occupational Therapy had been made as necessary, including notifying CQC of specific events as required.

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.

There was clear management structure with heads of departments meeting daily. Leadership was visible and demonstrated effective oversight over people's current needs and risks to their health and safety. The deputy manager explained the assessment process that included meeting the person and obtaining as much information from relatives and other health and social care professionals as possible.

Well established links had been made with external professionals.to ensure joined up care. A healthcare professional told us, “I think there have been notable improvements since the arrival of the deputy manager. Communication has been easier, questions and referrals are more open, and monitoring is better.”
The registered manager and staff involved people, relatives, and health and social care professionals when people were referred to the service. Pre-admission assessments were completed to ensure the service could meet people’s needs and manage any associated risks. People were encouraged to visit the service prior to admission to check it was suitable for them.

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 were protected from the risk of harm and abuse; safeguarding processes were clear and robust. There was a safeguarding reporting system in place that staff expressed full confidence in using. Staff told us, “I know the signs of abuse and who to report to inside and outside of my work. I am confident in reporting concerns.”

The provider shared concerns openly and in a timely way with external stakeholders such as the local authority. Staff were trained to identify and manage any situations where people’s safety or human rights may be compromised. Where people’s liberty had been restricted, the provider had ensured this was done lawfully using Deprivation of Liberty Safeguards (DoLS).

Everyone we spoke with told us they, or their loved ones felt safe, and that staff knew people well. Comments made included, “I’m happy she’s [loved one] 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.
Care plans were detailed and provided sufficient guidance to staff to keep people safe.

People had clear and detailed risk assessments in place and the equipment and support they needed to reduce the risk of accidents or incidents occurring. Risk assessments were person-centred, proportionate, and regularly reviewed.

The call bell system was working effectively and records showed it was regularly checked and monitored.

People had personal emergency evacuation plans (PEEPs) which were fit for purpose, well-organised, and easy to locate.

Accidents and incidents were logged and trends identified. Risks had been identified and mitigated.

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

The premises were well-maintained. The head of maintenance followed an audit schedule to check the premises were safe for people, staff, and visitors. Equipment, including slings, hoists, and wheelchairs, was regularly inspected and maintained. Weekly fire alarm tests and routine fire drills were conducted, and fire wardens and first aiders were always onsite.

A healthcare professional told us, “I have seen appropriate techniques and equipment in use.”

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision, annual appraisals and development. They worked together well to provide safe care that met people’s individual needs.

People and their relatives felt there were enough well-trained staff to provide the support people needed and wanted. Work rotas showed enough staff were deployed to meet people’s needs

Systems were in place to ensure staff were recruited safely and were suitable to work with people living at Blandford Grange Care Home. Recruitment processes included a Disclosure and Barring Service (DBS) check, identity check and previous employment 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.

Staff undertook a programme of induction and on-going training to ensure they maintained the knowledge and skills necessary to support people in the right way. A member of staff said, “The induction was very good, and I felt the online trainer explained things very well. The company provides on-going training and options for further qualifications.” Staff told us they were trained well and encouraged to keep up with training, as well as suggest any training they think may help.

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.

Infection prevention and control measures were in place. Staff had access to and wore appropriate personal protective equipment (PPE).

During our site visits we observed staff using handwashing facilities and PPE correctly. The housekeeping team followed cleaning schedules to ensure the cleanliness of the premises was continually maintained. The provider’s head housekeeper told us they were well-supported by management and had the resources and equipment they needed to keep the premises clean and infection-free. Everyone we received feedback from felt the service was clean and ‘homely’.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

Some improvements to current medicines procedures were needed. When medicines patches were applied, they were recorded on patch charts, and the application site rotated appropriately. However, regular checks that the patches were still in place were not recorded, which was not in line with the home’s medicines management policy.

Medicines care plans contained information on some higher risk medicines such as anticoagulant blood thinners, to show that people’s individual risks had been considered. However, they were not available for flammable paraffin-containing topical preparations. We were told these would be put in place.

When medicated external preparations were applied these were recorded individually on people’s medicines charts. However, when non-medicated preparations were applied, they were recorded by care staff on an electronic system. This did not always include the name of each preparation applied. The provider was considering how best to record this in future.

Regular audits took place which identified actions for improvement. However, they did not pick up the areas for improvement that we found.

When medicines were prescribed ‘when required’ there was information to guide staff on when it would be appropriate to give a dose, in protocols and in people’s care plans. Staff received updated training and competency checks to make sure they gave medicines safely. There were suitable systems for reporting and investigating any errors or incidents.

We observed people received their medicines safely, as prescribed for them. There were suitable arrangements in place for ordering, storing, recording and disposal of medicines, including those needing extra security and cold storage.