Claremont

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 changed to Good.

This meant people were safe and protected from avoidable harm.

This service scored 69 (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. Staff completed accident and incident records, which were then reviewed by the registered manager to identify any responsive action required to prevent similar incidents potentially occurring again. The registered manager also analysed when, where and how any falls occurred, to identify any patterns or learning points. Any lessons learned from incidents were shared with the staff team.

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. For instance, if people needed to go into hospital the provider had a system to ensure relevant key information was shared. A visiting healthcare professional told us how they worked with the home, and said, “I know they follow the advice I give.”

The provider worked with people 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 told us there had been no recent safeguarding referrals or incidents, but there were systems in place to ensure any safeguarding issues were appropriately reported and investigated. The provider had a safeguarding policy and staff completed regular safeguarding training. Staff were aware of the signs of potential abuse and what action to take if they had any concerns.

Applications had been submitted to lawfully deprive people of their liberty where this was required. Staff adhered to any conditions on people’s Deprivation of Liberty Safeguards authorisations. This ensured any actions were the least restrictive and in people’s best interests.

The provider had made improvements in the management of risk. Staff demonstrated good understanding about potential risks relating to each person, such as health, nutrition and falls risks. We saw staff intervened appropriately to support people, to monitor their safety, and to respond to incidents.

Risk assessments had been completed and were regularly reviewed. They covered a range of relevant areas. Support was provided in line with these individual risk assessments. The provider reviewed their fire risk assessment and night staffing levels after our assessment, in response to a change in people’s needs.

People confirmed they felt safe and they appeared comfortable within the home. One person told us they would speak to the manager or staff if there was anything they were concerned about.

The provider identified and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Environment and equipment checks were completed regularly, and relevant safety certificates were in place. We noted some maintenance issues identified in audits earlier in the year, such as patches of damp on the ceilings of the kitchen and living room, had not been rectified promptly. However, a contractor had recently been appointed, and the repair work was due to commence imminently.

The provider made sure there were enough qualified, skilled and experienced staff to ensure people’s safety, but the staffing levels did not always allow sufficient flexibility to enable each person to be supported individually in the community when they wished to go out. Not everyone was funded for individual support hours, which resulted in some inequity of opportunity. The provider was aware of this and told us they arranged the rota to try and ensure everyone had opportunity to go out and pursue their interests. They told us they were also gathering evidence in relation to people’s changing needs, in order to support with reviewing people’s social care needs assessments and funding arrangements.

Staff were safely recruited and received effective support, supervision and development. They worked together to provide safe care. Staff were satisfied with the training they received and the registered manager monitored training compliance closely. Staff had received training in supporting people with a learning disability and autism, but the registered manager was in the process of sourcing more advanced training in this area, in line with the new mandatory learning disability training requirements.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and had systems in place to share concerns with appropriate agencies promptly.

The environment was generally clean and there was a schedule in place for cleaning. Relevant infection prevention and control policies and procedures were in place and staff completed training and competence checks in this area. The provider also completed handwashing audits. Staff had access to personal protective equipment (PPE) and knew when to use this.

The provider made sure that medicines were safe and met people’s needs, capacities and preferences. The provider had medicines policies and procedures in place, and staff received training and regular competence checks. Staff generally completed medicine administration records (MARs) appropriately, however we noted some anomalies which had not been picked up in audits completed by the provider. For instance, there was an inaccurate handwritten amendment to a MAR. The handwritten entry had not been countersigned by a second staff member in line with best practice, and could potentially have resulted in a medicines error. There were some anomalies with records relating to creams administration and one person’s ‘when required’ constipation medicine was administered routinely. The registered manager confirmed this was needed routinely, so they contacted the GP following our site visit to request a change to the prescriptions. There had been no harm to people as a result of these issues.