Appletree Court 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 75 (out of 100) for this area.

This service scored 75 (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 strong and positive culture of safety, based on openness and complete honesty. Staff actively listened to concerns about safety and thoroughly investigated and reported safety events. Lessons were always learnt to continually identify and embed good practice. Action was taken to understand why an incident occurred and what could be changed to prevent further occurrences. Learning from incidents was a theme running through the governance systems and the management team were keen to identify any problems and improve the service and outcomes for people. Discussions between staff and people took place to ensure practice was reviewed and changes made to improve the service. Staff told us they felt feel supported and valued. The provider consulted with other healthcare professionals when needed, to monitor and learn from incidents. The staff team also discussed any incidents and when interventions had worked well or had not worked. They shared their experiences so these could be learnt from, and this ensured a consistent and person-centred approach to supporting people

People and their relatives told us the provider worked closely with other agencies and health professionals to meet people's specific needs. Comments from people included “my mother is safe from harm here” and “I feel that there are always plenty of good staff.

Systems were in place to ensure people received a full assessment of their needs prior to and upon admission. The provider involved people and their families in assessments. There were protocols in place which guided staff when to make referrals or escalate concerns.

People and relatives told us they received safe care. People said staff were very good and did their job well. Comments included, “I feel safe because there are many carers and other staff all the time around where we sit and that is something what make me feel safe.” “My relative is here for around 4 years. She is safe and very well looked after.”

Staff had a good understanding of safeguarding. Staff could explain several types of abuse and what signs and symptoms to look out for. Staff told us if they suspected or saw any form of abuse, they would report it to the nurse in charge or the manager. A staff member told us “"If I saw anything concerning, I would report it straight away. Our manager takes these things very seriously - we have had training on exactly what to look for and who to tell."

We observed staff treat people with care and respect. Information about safeguarding and speaking up were displayed on notice boards in communal areas.

The provider had a clear process in place to safeguard people against abuse. There was leadership presence 7 days a week which ensured there was oversight and support, and they commenced investigations as required. Staff received training in safeguarding, this meant they were able to identify any concerns and report them to their managers. There were safeguarding and whistleblowing procedures in place. This meant staff had guidance to use if needed.

People told us they felt supported by staff who knew them well and were aware of their medical, health and social needs. People were encouraged and supported to be independent with daily tasks and activities but without compromising their safety. Comprehensive risk assessments were completed, and care plans were regularly updated to mitigate identified risks, particularly regarding falls and challenging behaviours. These were regularly reviewed and updated according to changing needs.

The care team maintained a continuous assessment and adaptation of support strategies to ensure the highest standard of person-centred care while managing all identified risks.

Staff told us they had access to care plans and risk assessments. Staff knew people’s needs well and demonstrated knowledge in how to support people safely. For example, a staff member spoke about how they supported people who were at risk of malnutrition and dehydration. They spoke confidently about how they ensured people consumed the right amount of fluids and how they were trained on thickening drinks. Staff told us how they monitored people’s weight and reported any concerns to senior staff, who then made the appropriate referrals to health care professionals. The risk assessments were reviewed monthly or sooner.

We checked the airflow mattress of several people which were set at the correct setting as per their care plan. We checked some equipment, such as slings, hoists, and found they were in good working order. We observed maintenance checks in place for the equipment being used.

Risk assessments were person-centred, and outcome focused which contained clear instructions on how to support people safely. These assessments were incorporated into people’s care plans. The risk assessments covered preventing falls, moving, and handling, nutrition, skin integrity.

and weight assessments. People who were at risk of weight loss were weighed regularly and concerns were escalated to health care professionals. From records seen, we could see the provider had processes in place which enabled staff to work closely with other agencies. These included, the tissue viability nurses, speech and language therapists, GP, dieticians and podiatry services.

N/A

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The care environment was well maintained, and regular checks were conducted to monitor the safety of domestic systems and fire safety

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. The registered manager completed a dependency assessment to ensure staffing levels were safe to provide care for people. People told us staff were there when they needed them including to spend quality time whilst doing activities and their favourite pastimes. A relative told us, “Staff are exceedingly kind and caring all the time and they treat [family member] with respect, and they like the carers, they talk to [family member] and joke. “A person said, “I really can’t fault staff. One word, they are excellent. They offer me choices. The speak kindly and they are just always there if I need anything. I think we are truly lucky to have them here.” Staff told us they felt supported by the management team. Supervisions were carried out and staff told us they could access support at any time. Staff were recruited safely. Procedures were in place to ensure the required checks were carried out on staff before they commenced their employment. Staff learning and development was in place to ensure staff were properly inducted into the service and their knowledge developed. The provider had oversight of training within the service

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. The home was clean, tidy, and well maintained. There were stores of personal protective equipment (PPE) throughout the home and staff knew how to use PPE appropriately. The domestic staff ensured that touch surfaces were cleaned frequently undertook deep cleaning and used appropriate cleaning products to prevent the spread of infections.

Medicines were consistently and safely managed in accordance with national guidelines. We observed staff demonstrating patience and kindness during the administration of medications. Individuals received their medications safely as prescribed, including those that should be taken before eating.

Medicines were managed by staff who had received the relevant training and who underwent annual assessments of their competency. Appropriate systems were in place to ensure medicines were managed safely. Medicines were kept securely in locked trolleys. Medicine Administration Records (MAR) contained sufficient information such as photographs and allergies of each person to ensure safe administration of their medicines. MAR sheets were completed accurately and stock checks tallied with the balances recorded. There were checks of medicines and audits to identify any concerns and address any shortfalls. Staff followed the guidance in place on managing 'when required' medicines for each person and documented the reasons why they had administered the medicines.