Codnor Park 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

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. Find out what we look at when we assess this area and How we calculate these scores.

Staff told us they felt supported by leaders, and this meant they felt safe and supported to report incidents and reflect upon them.

Incidents and accidents were recorded by staff at the time they occurred and audited on a monthly basis by leaders. Audits included a section for reflective practice and action planning to avoid a recurrence of any concerning issues. Mechanisms were in place to support staff to be involved in reflective practice – regular supervisions, team meetings and handovers were used to communicate and reflect about any incidents.

The provider had access to a dedicated training manager who designed training for staff, as well as booking training from external providers when trainers with specific skills and experience were required. Leaders told us that having the training manager helped to ensure training was specifically designed to meet the needs of the staff and the people that they were caring for.

The provider was in regular contact with their local GP practice, district nursing team and community mental health teams. Weekly ward round meetings and Multi-Disciplinary Team Meetings ( MDT) were held. The provider arranged weekly visits from the advanced nurse practitioner (ANP), who were in the process of reviewing medication and RESPECT (Recommended Summary Plan for Emergency Care and Treatment) forms for people.

We looked at the care plan for the person who had most recently come to live with the provider. Their care plan contained the necessary detail and there was evidence the provider had communicated with the person, their relatives and medical professionals involved in the person’s care before they moved into the service. The provider had a dedicated Media and community relations manager who works for the parent provider – their role is to triage referrals and ensure that all necessary information is provided to support the provider to care for new admissions before they move in.

Carer shifts had a 15-minute overlap where staff from the current and previous shift would be on shift together for a handover period. This ensured that handovers were not rushed and that important information was handed over.

The provider was located on the same site as a nursing home owned by the parent provider. Leaders told us that previously some people with declining health needs had moved from the provider to the nursing home – the similar building layout, décor, furnishings, and systems had helped to make this transition comfortable for people.

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 whilst protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately with the local authority and CQC.

Staff and leaders demonstrated knowledge of what safeguarding meant and how they would make a safeguarding referral to the local authority if they needed to do so. Leaders demonstrated knowledge of the incidents they needed to notify us about.

The provider had a fall reporting tool as part of their electronic care planning system. Accidents, incidents and falls were reviewed on a monthly basis by leaders. Leaders advised us staff will made referrals to the NHS falls team if they were concerned that a person is at risk. They advised us that if a person fell 3 times regardless of the apparent cause, they would be referred to the NHS Falls Team. This system meant that people had their falls monitored and that they were referred for support in a timely way.

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.

People were supported to manage their own medical needs with support from staff where needed. Care plans described people’s health needs and which aspects each person was able to manage for themselves, whilst also outlining staff’s responsibilities in supporting them to do this. If a person lacked the mental capacity to manage an aspect of their own care, a mental capacity assessment had been completed and documented, with a record of any decisions that had been taken in a person’s best interests.

One person said, “I have my walker here. I have everything I need. I feel safe.” Most people we spoke with told us they had seen their care plan and that staff involved them in making decisions about their care. We observed staff speaking with people with compassion and offering support to people without doing things for them. For example, when one person got up from their chair, a staff member stood near to them and told them they were there for them if they needed help.

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 care home was clean and tidy. It was well-furnished and recently decorated. We observed that wet floor signs were in place where areas were being cleaned. There were fans in the corridors and around communal areas of the home to help keep people cool during the hot weather.

The provider had recently renovated areas of the care home, with a newly decorated room which was intended to look like a café for people who may be unable to go out but wanted to feel like they were in a comfortable café environment. The garden area had recently been redesigned, with raised beds full of various plants at a height that would be visible and accessible for people with limited mobility who may enjoy gardening. Paved areas provided stable flooring for wheelchairs or people who may be at risk of falling when mobilising.

The provider had specialist equipment in place to minimise further injury to people who had fallen. For example, the provider had CAMEL (Complete Air Moving Elevating Lift) devices available on both floors of the care home. Staff were trained in the use of this equipment, which is designed to avoid manual handling when helping people who have fallen on the floor to get back up – reducing the risk of further injury to people and staff.

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.

The staff we spoke with told us they felt supported in their roles. Staff said they were given mandatory training and were supported to undertake additional training if the need arose. Staff felt part of a team and confirmed leaders were approachable and willing to lead by example and support them.

We reviewed staff rotas for the previous 4 weeks. The majority of shifts were covered by permanent staff, with some shifts covered by agency staff. Leaders advised us that wherever possible they used one specific agency so there was consistency in the staff who provided support. Leaders told us that as part of their monthly audits of accidents, incidents and falls, they looked at the dependency tool calculations for each shift where an incident occurred. If there appeared to be a link between the incident and the number of staff on shift, they considered adjusting the staffing levels accordingly.

One relative told us, “Staff talk openly and honestly when I ask questions about the service. I have no complaints at all. My relative is comfortable and although they were worried about coming here, they have actually settled very well”.

The provider had systems in place to ensure cleaning was conducted on a regular basis. Domestic staff were knowledgeable about infection control, the equipment and processes used to maintain a hygienic service. They had received training in control of substances hazardous to health (COSSH) and infection prevention and control (IPC). Cleaning rotas were completed and showed evidence of regular hygiene checks in all areas of the building.

We saw evidence that bins had been emptied in a timely way, with yellow bins provided for the disposal of clinical waste. PPE, soap and alcohol hand gel was available throughout the home in locations where needed. Kitchens and eating areas were clean and tidy and cleaning audits for food preparation areas were up to date.

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning their own care, including when changes happened.

The clinic room was clean and organised, with a clear system in place to identify where medications needed to be stored. Medication was ordered via the electronic medication system, which the provider’s pharmacy also has access to. Upon delivery medications were booked in by staff using QR codes on the packaging of each medication which can be scanned in order to add it to the electronic system. Booked in medication was also approved by the pharmacy using the electronic system.

Care plans contained information about people’s health needs and these were linked to their medication care plans. MCA and best interest decisions around medication were recorded in people’s individual care plans as required.

The provider worked in partnership with the GP and district nurses to regularly review medication. District nurses visited the care home on a weekly basis to make observations on the health of people who required monitoring. Nurses administered insulin to people who required it, and advised care staff on alterations that they could make to the diets of people who had diabetes and needed their blood sugar levels to be lowered or raised.

The provider used an electronic medication system to order, stock and administer medications. The system contained health and medication information for each person, and an electronic medication administration record (MAR). The system had checks in place to ensure medication was administered correctly to each person. For example, a warning notice would appear on the system if a medication was marked as having already been administered to a person, to minimise the risk of double-dosing. Any recorded medication errors or discrepancies in stock counts would automatically send an alert to leaders, so that they could then have oversight of the issue.

Leaders told us that when people were upset or agitated, they used as and when (PRN) medication as a last resort, and showed us processes that were in place to analyse the triggers which may have led people to display distressed behaviour. For example, for one person who was becoming upset and agitated, the leaders and staff spent time with that person, supporting them to access the calmer environment in the garden of the care home. They then contacted their relatives and the community psychiatric nurse for feedback about what might be upsetting the person, before resorting to medication.