Thurlaston Meadows Care Home Ltd

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 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 now 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 understood the importance of learning from incidents and knew how to record and escalate any incidents. Processes were now in place to ensure any learning was communicated to staff through regular meetings, or immediately if this was required. One staff member said, “News will be told around the staff in morning meeting. We are informed of any changes [needed], definitely.” Another staff member told us, “We have lots of meetings. Anything new or which needs to be brought up or changed is discussed. You get to hear everything on [shift] handover.” The registered manager now reviewed all incidents at the home, and considered if there were any patterns emerging, which required changes in how people were cared for. For example, if people wanted specialist input from health care professionals or equipment purchased, to help them.

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. Relatives gave examples showing how their family member’s and their views about the care to be provided were considered. For example, before people moved into the home and when they wanted support to obtain GP advice. One relative told us staff had worked with their family member’s social worker, when they were due to be discharged after a stay in hospital. This helped to ensure their family member had the care they needed when they returned to the home. Other health and social care professionals were positive about the way staff supported transitions safely and effectively, by following any advice they had provided. Processes were in place to communicate essential information about people’s needs to other health and social care professionals. This helped to ensure people’s need were communicated and helped to ensure they would continue to receive the care they wanted, safely.

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 comfortable with the staff caring for them, and were positive about how they were treated. People told us there was no reason for them not to feel safe with the staff caring for them. Relatives were confident in the actions taken by staff to ensure their family members safeguarding was promoted. For example, one relative said, “Staff were very attentive” to their family member, and knew what action to take to ensure they were not neglected, because of their complex needs. Staff were confident leadership at the home would support people, if this was required. A staff member told us, “It’s about making sure the residents are safe. You report any injury, such as a bruise. You need to report it to stop it.” The registered manager and staff understood their responsibility to share concerns quickly and appropriately, should they occur.

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. Staff now worked with people to identify people's risks and to put measures in place to mitigate these. People told us staff knew how to help them to manage their safety. One person explained they had a pendant alarm, in case they needed support from staff, for example, if they experienced a fall. This helped to reassure the person. Other people told us staff regularly checked they were well. One person told us, “I wasn’t safe living at home. They [staff] try hard to look after me that is why I feel safe here.” Another person told us, “Someone always check on me at night, so I feel safe.” Some people wanted help to move around the home. One person said staff worked at their pace, and told us, “I never feel rushed, [staff] know my capability.” Staff now understood people's individual risks and how to respond to these. People's care plans provided staff with the guidance they needed to mitigate people's risks. For example, in relation to sudden and significant decline in their health, risks arising from prescribed medicines, poor skin health, choking, falls, and people becoming anxious. However, we found people’s safety would be further promoted by improving some staff’s practice when assisting people to move around the home. The registered manager took immediate action to address this.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People told us they enjoyed the comfort provided in their rooms and the facilities at the home. One person said, “It’s a lovely place”, another person told us, “I have a nice room.” Premises and safety checks were now regularly undertaken, to ensure the home provided a safe and welcoming environment for people, staff and visitors. These now included checks on equipment, services, ambient temperatures and to reduce the likelihood and impact of fire. Fire safety leaflets had given to people living at the home. These had also been made available in the reception, to help inform relatives and visitors of the fire procedures. Staff knew what action to take to promote people’s safety in the event of a fire. Staff also ensured they communicated any premises improvements required, and these were now promptly actioned. This helped to mitigate these risks. We found the storage of a person’s thickener could be further improved. The registered manager took immediate action to make this secure.

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. There were enough staff to care for people. People told us they did not have to wait very long if they wanted support from staff. One person said, “There are enough staff to meet our needs.” Another person told us, “There is enough staff but at night they take a little longer to come, but I’m satisfied it’s not too late.” Relatives were positive about staffing levels. One relative said, “[The home] always seem well staffed.” People told us they were supported by a consistent staff team across shifts. A relative said there had been some staff changes, but, “Staff are really good. The ones they take on are really good and recruitment seems good. I have no concerns with the staff.” Staff told us there had been some changes to their shift patterns, recently, but said there were enough staff to meet people’s safety and care needs. Staff had been supported to provide good care through induction and training. Most people told us staff had the skills an experience to look after them. One person told us, “I think that the staff are well trained to look after me and they cope well." Another person said, “I have decent quality staff and enough staff on at night, so I do feel safe.” However, some people felt there were variations in staff skills and knowledge. One person told us, “Sometimes the staff seems very trained, but some need more training.” People told us if they requested staff with more experience or training their wishes were respected. Relatives were positive about staff skills and knowledge Systems were in place to check the suitability of staff before they commenced employment. These included obtaining references and Disclosure and Barring Service (DBS) checks. DBS checks provide information including details about convictions and cautions held on the Police National Computer. Staff were supported to provide good care to people through access to senior staff and on-going supervisions.

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 were complimentary about the cleanliness of the home. One person said, “The cleaners do a good job, there’s no faults.” Another person told us they could rely on staff to ensure their room and bathroom was consistently clean. Staff made sure they and visitors wore appropriate PPE in key areas of the home. Guidance for staff and visitors was in place to promote good infection control practices. For example, in relation to handwashing. Some people required equipment to assist them to move around the home. Systems were in place to deep clean areas of the home when appropriate. We found one piece of equipment had not been labelled with the person’s name. It is important some equipment is used just by one person, to reduce the likelihood of the spread of infection. The registered manager arranged for the item to be labelled. Senior staff undertook checks on staff’s infection prevention practice, so they could be assured people received safe care.

There had been improvements in the way people’s medicines were managed. The provider now made sure that medicines and treatments were safer and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. Some further guidance and monitoring was required to ensure people consistently received their medicines as prescribed. People told us they could rely on staff supporting them to have the medicines they wanted. One person said, “I have my medication on time, and they have recently reviewed my medication and I have it 1 hour before food.” People told us staff talked with them about their medicines. One person said, “They used to let me administer my own meds but now they give and watch me take them. They never forget to give me my medication.” Systems introduced now supported the safe administration of medicinal patches, which were now rotated in accordance with manufacturer’s instructions. There had been improvements in the guidance given to staff for ‘as and when’ required medicines. However, we found one instance where further information was required to guide staff which dose to give a person and to inform staff what action to take, should another person have an allergic reaction to their medicines. Staff had recognised ‘as and when required’ medication protocols needed to be reviewed and were in the process of completing them at the time of the inspection. People’s prescribed creams were not always recorded when administered. There was no evidence of harm to people as a result of this. The registered manager provided assurances they would address this without delay. Some people living at the home managed some elements of their own medicines. Where people were self-administrating their medication a risk assessment had been put in place which detailed what they could do for themselves and where staff support was required. Staff were not allowed to administer medicines until they had been trained to do this, and their competency was regularly checked. Staff understood what action to take, should an error occur when they administered people’s medicines. Senior staff undertook robust investigations in the event of an error or near miss involving people’s medicines, with appropriate actions put in place to reduce the likelihood of further errors. People’s medicines were securely stored. However, we asked the registered manager to review how some controlled drugs were disposed of, to ensure there was a consistent approach to this by staff. The registered manager introduced additional systems to support this during our inspection. Senior staff undertook checks on the administration and storage of people’s medicines, so they could be sure they had received these as prescribed. The registered manager had recognised the importance of the safe administration of medicines, and had introduced a ‘medication technician role’, to ensure there was enough staff resource to do this.