Apple Blossom Court

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 66 (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. Systems were in place to record and monitor accidents and incidents. Staff understood the process for reporting and recording events which occurred. Events were reviewed on a regular basis by the registered manager. This enabled them to analyse trends, identify any lessons learnt and work with people to identify why events had happened, and how to avoid situations in the future.

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. A healthcare professional told us, “I really like it here. I can’t fault it and there is great communication. Staff are very responsive to any issues. You can tell there is a lot of love and care for the residents. [Staff] are very good at responding to concerns and good at listening to advice.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Systems were in place to protect people from the risk of abuse. Staff received training and understood the actions they must take if they felt someone was being harmed or abused. One staff member told us, “I am fully aware my manager would be behind me to support me. If [the registered manager] wasn’t dealing with my concerns, I would take it higher if I witnessed anything.” Referrals had been made to the local authority safeguarding team when abuse had been suspected, and investigations had been completed. People told us they felt safe; family members told us they would approach staff with any concerns. One family member said, “Anything I am worried about I can raise. I feel comfortable approaching the staff.” Information explaining how people could raise concerns if they felt someone was being abused was clearly displayed.

The provider worked with people to understand and manage risks. Risk assessments had been completed, and personalised care plans had been developed to minimise any risk to people’s health and wellbeing. Staff told us these plans were clear to follow. One staff member commented, “To familiarise myself with a person I always refer to peoples care plans. This gives me a good understanding of each person.” Staff provided care to meet people’s needs which was safe, supportive and enabled people to do the things that mattered to them. A family member commented, “I am happy with the care [Name] receives and they are very happy and settled there.”Throughout our assessment, we observed safe working practices, such as moving and handling of people.

The provider detected and controlled potential risks in the care environment. Routine checks on the environment and equipment were up to date and certificates were in place to demonstrate this. However, some aspects of the environment were not well maintained. For example, repair was needed to some fire doors as the recent replacement of flooring had left some gaps, some furniture in bedrooms was damaged, some kitchen doors needed repairing and some flooring to bedrooms and landings had small rips. We raised our concerns about the fire doors with the local fire service who visited the service and provided us with assurance about people’s safety. We discussed our findings with the registered manager. Immediate action was taken to address the issues we identified, and we were provided with evidence of ongoing refurbishments plans for the home. We received positive feedback from staff and family members about environmental improvements which had been made to the service since our last inspection. Staff comments included, “[The registered manager] is always going out of their way to make improvements at the home even down to activity equipment, new furniture. Always improving all the time” and “The building could do with a new kitchen but to be honest the home has been improving over last few years. I have seen big improvements.” Family members commented, “Staff have really improved the welcoming feel of the place. It is nice, better than it was. It feels like the provider is maintaining it better” and “It’s a bit scruffy but the care is what is important. It’s as clean and tidy as it can be.”

Staff were suitably qualified, skilled and experienced. Staff were safely recruited and inducted; appropriate checks had been made before applicants were offered employment. Staff received training to effectively support people with a learning disability and autistic people. Staffing levels were safe, and we observed there were enough staff on duty to support people to access a variety of activities both within the service and out within their local community. Family members spoke positively about the staff team and the care people received. Comments included, “Staff are very kind, caring and hardworking people. They have a lot of challenges, but they are so caring” and “In the past there has been a huge staff turnover. I feel it is more stable now.”

Systems were in place to assess and manage the risk of infection, however, systems had not always effectively detected aspects of poor cleanliness within the service. Although the home was generally clean and tidy, some aspects of the environment, for example, tiling and shower areas needed a deep clean. One shower chair needed to be replaced, and a small amount of furniture had been left outside waiting for disposal. This was unsightly and needed to be promptly disposed of. We discussed our findings with the registered manager and saw evidence many of the issues we identified about cleanliness, and the environment generally had already been raised previously with the provider who had not always acted in a prompt manner. Immediate action was taken to address all the shortfalls we raised, and improvements were demonstrated by the last day of our assessment.

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. However, some systems needed to be more robust to ensure changes in prescribed medicines, including those medicines which were prescribed on an ‘as required’ basis were appropriately documented. For example, one person’s medicines had recently changed but the documentation for staff to follow had not been fully updated to be clear which was an ‘as required’ medicine, and which was a regular dose. Another person required a medicine to be taken once a month, however, the medication administration record (MAR) provided by the pharmacy did not accurately reflect this and needed to be updated. There was no evidence anyone had not received their prescribed medicines, and they were administered by appropriately trained staff who knew people well. The registered manager told us they would complete a review of these records. Medicines were stored securely, and people were encouraged to be as independent as possible in the management and administration of their medicines. We observed one person being supported to take their own medicines. Regular reviews took place to monitor the frequency of administration of any medicines prescribed to support people through periods of anxiety or distress. This reduced the risk of overmedicating people and ensuring such medicines were only administered in line with agreed plans of care.