Chorlton Place Nursing 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 requires improvement. At this assessment the rating has changed to 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.

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 provider encouraged staff to report incidents, accidents, near misses and concerns. Staff understood their responsibilities for recognising risks, reporting concerns and keeping people safe. Staff told us learning was shared through handovers, meetings, supervision and governance processes.

The provider investigated significant incidents and used learning to improve practice. For example, learning from an oxygen-related incident resulted in changes to training, risk management and clinical oversight arrangements. Incidents, safeguarding concerns and clinical risks were reviewed through governance processes, with actions monitored and improvements made to areas including medicines management, staff training and clinical monitoring.

Staff were able to describe changes introduced following previous incidents and understood how lessons learned influenced day-to-day practice. This demonstrated the service used information from incidents and reviews to support learning and improve the quality and safety of care.

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 received coordinated care from staff who worked with a range of healthcare professionals, including GPs, district nurses, specialist nurses and hospital teams. Professional advice and follow-up actions were recorded and reflected in people's care and support plans.

People's needs were assessed and reviewed through care planning, clinical monitoring and risk management systems. Staff worked with external professionals when people's needs changed and could explain how concerns were escalated to healthcare services or emergency responders when required.

Records demonstrated changes in people's health and wellbeing were monitored and acted upon. Governance and clinical monitoring systems provided oversight of areas such as deterioration, diabetes management, weight loss and infections, helping to ensure risks were identified and managed appropriately.

People experienced continuity of care because systems for communication, review and escalation were embedded in practice and supported effective partnership working across services.

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

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's risks were assessed and reviewed through care plans, risk assessments and clinical monitoring systems. Records showed that risks relating to areas such as falls, diabetes, choking, skin integrity and clinical deterioration were identified and managed through planned support and regular review.

People and, where appropriate, their relatives were involved in discussions about care and support. Staff worked with healthcare professionals when people's needs changed and updated care plans and risk assessments to reflect changing risks and support needs.

Staff demonstrated a good understanding of the risks associated with people's care. They were able to explain how they monitored people, recognised deterioration, managed identified risks and escalated concerns when required. Governance records and clinical monitoring systems showed that managers maintained oversight of risks and reviewed actions where concerns were identified.

People received care from staff who understood their risks and the support required to help keep them safe while promoting their wellbeing and independence.

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 lived in an environment where risks were identified and managed. Records showed the provider completed routine checks of the premises, equipment and safety systems, and acted when concerns were identified.

Maintenance records and audits demonstrated regular monitoring of areas including fire safety equipment, call bell systems, moving and handling equipment and medicines storage arrangements. Staff understood their responsibilities for identifying and reporting environmental risks, and managers maintained oversight through audits and governance processes.

The provider had strengthened oversight of environmental risks associated with oxygen therapy and medicines storage. Records showed these areas were monitored through routine checks and governance processes, with learning incorporated into policies, procedures and staff training.

Staff were able to describe the actions they would take if environmental concerns were identified. This provided assurance environmental risks were recognised, escalated and addressed in a timely way.

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.

Staff received training, supervision and support relevant to their roles. Records showed staff completed training in areas including medicines management, diabetes care, recognising deterioration and oxygen therapy, with managers monitoring compliance through governance processes.

The provider maintained oversight of staff competence through competency assessments, training records and management review. We reviewed current medicines competency assessments, and leaders described arrangements for retraining and reassessment where concerns were identified.

Staff demonstrated a good understanding of people's needs and risks. They were able to explain how they monitored for deterioration, managed risks, followed medicines procedures and escalated concerns when required.

People's care needs informed staffing arrangements and we observed staff responding to people in a timely way. Records, observations and staff feedback provided assurance that staffing arrangements supported the safe delivery of care.

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 were protected by systems and processes designed to prevent and control the spread of infection. The provider monitored infection prevention and control through audits, routine checks and governance oversight. Staff understood their responsibilities and were able to describe the measures they followed to reduce infection risks.

Records showed the provider had addressed previous concerns relating to environmental cleanliness and pest control. Infection risks and trends were reviewed through governance processes and action taken where concerns were identified. Arrangements relating to oxygen equipment management and cleaning had also been strengthened and incorporated into staff training and monitoring systems.

Staff were able to explain how infection control concerns would be identified, reported and managed. Audits, monitoring records and governance reviews provided assurance infection prevention and control arrangements were maintained and regularly reviewed.

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.

The provider had systems in place to support the safe ordering, storage, administration and monitoring of medicines. Medicines incidents, audits, stock control and insulin management were reviewed through governance processes, and actions were taken where concerns were identified.

We observed medicines being administered safely and in accordance with prescribed guidance. Staff demonstrated a good understanding of medicines management procedures, including diabetes care, blood glucose monitoring and the escalation of concerns. Records also showed that medicines prescribed on an as-required basis (PRN) were subject to review and monitoring.

Leaders maintained oversight of medicines through audits, routine monitoring and review of information from electronic medicines systems. Staff competencies, training and medicines-related risks were monitored to help ensure safe practice. Staff were able to explain how medicines incidents and concerns were reported, reviewed and acted upon.