Updated 10 September 2019
Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.
At the last inspection this key question was rated as requires improvement. At this inspection this key question has now improved to good. This meant people were safe and protected from avoidable harm.
Using medicines safely
• At our previous inspection we identified people were not always supported with their medicines safely. At this inspection, medicines were managed safely, and people received their medicines as prescribed. Only those staff appropriately trained, administered medicines to people. One relative said, “There used to be a problem with [family member] being given (time specific medicine) on time, but better now.”
• We observed a senior staff member administering lunchtime medicines. They checked the medicine administration records (MAR), the medicines packet and reconciled the medicines. The senior approached people in a quiet, dignified way informing them of their medicine. They asked if they wanted water or cordial to drink.
• The senior staff member was knowledgeable about medication and the importance of the correct procedures.
Assessing risk, safety monitoring and management
• Risks to people were assessed and action taken to address them. However, the service had started the process of transferring care plans onto a new format. Whilst the risks were assessed in the new format, some information was conflicting, and it was not clear if action had been taken. For example, one person’s risk assessment stated, “Consider a referral to the speech and language team (SALT).” However, the person’s eating and drinking care plan stated, “No swallowing issues.” The care plan did not identify if the guidance had been followed or why the choking assessment had scored medium. The registered manager had organised a care plan audit to check the new formats contained accurate information. The registered manager sent an update with actions taken clearly recorded.
• Risks to people's safety and well-being were understood by staff. The premises and equipment were risk assessed and safely maintained.
• People and relatives said the service kept people safe. One person told us, “It is very safe here. Always someone when I need them.”
Systems and processes to safeguard people from the risk of abuse
• Staff had received training on how to safeguard people from the risk of abuse. Staff understood how to recognise the signs of abuse and the ways to report this. One staff member said, “I would be confident to whistle-blow and could go to the manager.”
• The provider had policies and systems in place to safeguard people from abuse and they followed the local safeguarding protocols.
Staffing and recruitment
• People continued to be supported by staff who had been safely recruited. A full employment history and references were obtained. Disclosure and Barring Service (DBS) criminal record checks were completed. The DBS helps employers make safer recruitment decisions.
• During the inspection we observed staff were available to people, responding promptly to requests for support. In communal areas, people had consistent staff supervision and there was good interaction throughout the day. One person told us, “There is always someone around, occasionally have to wait a bit but not long.” A relative said, “There seems to be enough staff around.”
• Staff we spoke to felt there were enough staff on duty. One staff member told us, “There is enough staff here and the seniors will help when we are pushed.”
Preventing and controlling infection
• Staff had access to personal protective equipment (PPE) such as gloves and aprons, to enable them to reduce the risks of cross infection. These were readily available.
• The service was clean throughout, we spoke with the head housekeeper about two rooms where we had detected an odour and they told us they would check these. When we returned later, both rooms had been cleaned and no odour remaine