Strawberry Fields 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 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 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. Accidents and incidents were reviewed and outcomes shared with the staff team. The oversight of accidents and incidents had improved following visits by local commissioners. The provider told us they used their visits to improve the service and acted upon feedback. Staff told us, they completed workshops to strengthen their knowledge in specific areas to improve the safety and quality of the care they provided. Incidents were analysed by the management team and discussed at team meetings and during individual supervisions. This reduced the risk of reoccurring incidents which promoted safety 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. People were fully assessed prior to moving into Strawberry Fields. The provider explained they had recently introduced nursing care at the service, and each person was holistically assessed to ensure staff could meet their needs safely. People and relatives told us they were fully involved in developing care plans. A relative we spoke with said, “They discuss everything with [relative] and us too.” Staff gave us examples of working with other health and social care professionals to ensure all people were supported to move into Strawberry Fields safely, this included visiting people in hospital and in other care homes to complete an assessment of needs. A professional we spoke with told us, staff knew people exceptionally well, which meant they provided clear information about peoples needs to ensure they received the right support from external professionals.

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 which meant people were protected from the risk of abuse and neglect. Staff completed training in safeguarding, they knew how to recognise, and report safeguarding concerns in a timely manner. All the people and relatives we spoke with told us they felt safe at Strawberry Fields. One person said, “I like it here, the staff make me feel safe” and a relative said, “My [relative] is 100% safe, 24-hour care, they are absolutely brilliant with them.” The management team were aware of their responsibility to report safeguarding concerns to the local authority and CQC, we found concerns were reported without delay. Some people at the service were subject to a Deprivation of Liberty Safeguard (DoLs), this is where a person cannot make decisions about their care and treatment. Restrictive care arrangements were legally authorised in the person’s best interest. Staff had knowledge of DoLs and how this impacts people. Applications were made to ensure any restrictions were lawful. This protected people’s human rights.

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 had clear guidance in place to support people safely. For example, we reviewed records for a person who was at a high risk of falls, there was a detailed falls care plan in place. We found any risk reduction measures required such as a falls sensor were in place. This protected people from the risk of harm. Reviews of people’s needs were completed regularly to ensure information held within people’s care records was accurate. People and where needed their families and/or representative were involved in reviews. Staff knew how to access care records and demonstrated they knew people and their needs well. For example, we observed a person to start shouting at another person, staff quickly supported them in a kind and caring manner and prevented an incident. This approach ensured the person and all those around them avoided any unnecessary distress.

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 provider was undertaking extensive environmental work during our visit including a new roof and new windows and had appointed competent external professionals to undertake this work. Internal works such as decoration and maintenance of skirting boards to ensure these could be cleaned effectively was also being completed. These works ensured the building and environment remained safe for people using the service. Furniture and equipment were monitored and where needed replaced. Safety checks such as annual checks of electrical equipment were completed by a trained professional. The home was safe in the event of a fire, all people had personal emergency evacuation plans in place in the event of an emergency. Staff completed regular fire drills to ensure they could safely support people to evacuate the building, should the situation arise.

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 told us there were enough staff and without exception staff were kind, caring and knew people and their needs well. A person we spoke with said, “They are my angels, all of them” and a relative we spoke with said, “There does seem to be enough staff. They know [relative] and are attentive to their needs.” Another relative we spoke with said, “My [relative] is definitely safe, the staff are caring.” Staffing levels were determined using a dependency tool based on people’s needs. Records we reviewed demonstrated there were enough staff on duty to support people safely. Recruitment processes were followed to ensure only suitable staff were appointed. Checks including, interviews, references and Disclosure and Barring Service (DBS) checks were conducted before staff started working at the service. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

The provider did not always assess or manage the risk of infection. We found infection control audits had not always been completed, the registered manager acknowledged this and advised they had made changes and had plans in place to ensure these were completed regularly. The service had recently had an external infection control audit and the provider responded to the actions required. We found due to extensive environmental works being completed some areas of the home had areas of dust, we observed housekeeping staff to be working hard to manage this as much as reasonably possible. We observed housekeeping and care staff resolved any spillages quickly to ensure people were kept safe from slipping. People we spoke with praised the home and staff; they said the home was clean and welcoming. A relative we spoke with said, “I see them cleaning all the time. The cleanliness is excellent,” and a person we spoke with said, “The staff keep my bedroom clean and tidy, just how I like it.” We observed staff to wear personal protective equipment (PPE) appropriately. The correct use of PPE minimises the risk of transmitting infections which protects people from the risk of harm.

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 found the fridge which stored medicines was slightly out of the acceptable temperature range, staff had found this but not escalated to the management team. We fed this back to the provider who ordered a new fridge immediately. Staff received training in medicines and had their competency assessed. People told us they received their medicines safely. For example, a relative said, “My [relative] takes a lot of medication, and they are really on it.” A relative also explained staff supported their loved one when they had an adverse reaction to a medicine, they explained staff quickly sought medical attention and prevented the person from being admitted to hospital. Some people required their prescribed medicines to be given covertly to prevent any adverse health reactions. Covert medicine administration means giving a person who lacks capacity medicines without their knowledge often in food or drink. Where people had this assessed need, staff administered this in line with best practice guidance and with full involvement from the persons representative and healthcare team. We observed staff administering medicines throughout the day to people, they followed guidance and used a caring approach.