Shottermill House

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 69 (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. The registered manager ensured incidents and accidents were followed up and analysed to identify and implement any lessons learned. For example, when people fell, actions were taken to mitigate ongoing risks and review their care to make it safer. A relative commented how staff ensured a person’s care was reviewed and made safer following an accident, “I was impressed at how quickly this all happened.”

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 and their relatives told us their experience of moving into the home was positive and their care was continuously reviewed and well-coordinated. A healthcare professional commented, “Staff at Shottermill House appear to have a really good relationship with their residents and they know their residents well. Because of this, the care home staff are able to identify when their residents become unwell or if their needs change. Shottermill House staff contact our team for help or advice via email or telephone, depending on the urgency of their complaint.” People’s care records included information on how the home worked together with other health and social care professionals to ensure people had good experience of joined-up care.

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. People and their relatives told us they felt safe in the home. One person said, “I feel safe and looked after here, they are really lovely staff.” Staff knew how to recognise and report any safeguarding concerns and received appropriate training in safeguarding. The management team took appropriate actions to report and investigate any safeguarding concerns and to protect people. However, some records of how safeguarding issues related to events of distressed behaviours were reviewed and actioned were not always fully robust and streamlined within people’s care documentation. The registered manager provided evidence of actions taken in those instances and assurances on how they protected people.

The provider overall 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. However, some people’s individual care plans and daily care records we reviewed did not always robustly and consistently reflect some of their care needs and how they were met, for example around monitoring of their hydration levels, specifics of their dietary requirements or how staff supported them when they got distressed. People were not impacted or at risk due to those shortfalls in recording, as staff who provided care knew them and their individual needs well and the management team ensured appropriate care was in place when people’s needs had changed. People’s care plans overall included information around their individual needs and risks. For example, in relation to their health, personal care, risk of falls and mobility support needs or skin care. People and their relatives told us staff provided them with good and safe care. A relative said, “They (staff) understand the risk”, and explained staff were always around, ready to help, as their loved one was at risk of falls. Other relatives commented, “[Staff] have done a really amazing job in a very difficult situation, handled (all needs of the person) very sensitively”, and “[The care] is very good, [person] is looked after extremely well and has been from day one.” Staff told us they felt the information they were provided about people’s needs was robust and supporting them to provide safe care to people.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People and their relatives told us the home was always clean, comfortable and well-maintained. People were encouraged to personalise their bedrooms and supported to use the facilities safely. The home was accessible to people with physical disabilities. We observed the environment was clean, tidy and generally well laid out to meet people’s needs. The provider ensured maintenance and regular environmental and equipment safety checks were completed.

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 and their relatives told us they thought there were enough staff on duty. People told us they all had access to personal call bells and staff would attend quickly when called to assist. One person said, “I have a little red button, and if I need them in the night, they come quick, but I don’t often (need support).” A relative told us, “There certainly seems to be enough staff, even to worry about small details.” There was a calm atmosphere throughout the home with no one appearing rushed or needing to wait for their care. Staff told us there were enough of them to provide care safely and in a timely way. Staff received an induction appropriate for their role and ongoing training and support, including supervisions with more senior staff members. Staff told us they felt supported by the management. New staff were recruited safely.

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. People and their relatives were complimentary about the level of cleanliness and hygiene practices in the home. People told us, “It’s all very clean, and I like that”, and “The laundry is very busy and it’s a great service.” A relative said, echoing voices of other relatives, “The place always seems to be spotlessly clean.” The home was clean and tidy. Staff had access to personal protective equipment and handwashing and sanitising facilities. We observed staff followed good infection prevention and control practice when supporting people. However, we raised with the registered manager that some parts of mobility equipment were not appropriately cleaned on the day of our visit. The registered manager took appropriate action to remedy that. New shelving for cleaning and airing equipment pieces and more robust cleaning system were put in place. The management team ensured regular audits of infection prevention and control practices in the home were completed and staff received appropriate training.

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. People and their relatives told us they were involved in medicines reviews with healthcare professionals and supported to take their medicines safely and on time. One person said, “I definitely have my medicines regularly, [staff] come round like clockwork.” A relative commented, “All done very safely (with medicines) and (staff) go round at the right time, religiously.” Although people received safe support with their medicines and most systems were aligned with the national best practice guidance on medicines management in care homes, some elements of recording were not fully consistent and robust enough. For example, people’s ‘when required’ (PRN) medicines guidance was not always providing all details staff required to ensure these medicines were appropriately offered, administered and monitored for their effectiveness. The medicines stock monitoring records were not always fully consistent and streamlined. Any risks to people were mitigated as staff who supported them with their medicines knew them very well. PRN medicines were appropriately administered at the right times. The home worked closely with their local pharmacy support. We observed people received safe and personalised support with their medicines. Staff were trained and competency assessed in safe management of medicines.