Canterbury 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.

Staff provided safe and effective care. Regular staff handovers and meetings were embedded into practice, ensuring that important information, learning, and experiences were communicated clearly and consistently across the team. This supported continuity of care and helped to maintain up‑to‑date knowledge of each person’s needs.

Any incidents and accidents were reviewed, and where learning was identified this was shared with the wider team, promoting a culture of openness and continuous improvement. This systematic approach ensured that lessons were not only identified but also embedded into practice to reduce the risk of recurrence. As a result, people using the service benefited from consistent, well-informed care delivered by staff who were supported to learn and improve.

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.

The staff team worked collaboratively with people and a range of healthcare professionals to ensure safe and well-coordinated transitions between services and systems of care. They communicated effectively with relevant professionals, sharing important information and updates to support people’s ongoing needs. This joint approach helped to ensure that care was planned and delivered consistently, particularly during periods of change such as hospital admissions, discharges, or reviews of 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 told us they felt safe living at Canterbury House. One person said, “Staff are gentle – I like it here.” Another person commented, “I feel safe here – everyone is so nice.”

The manager understood their responsibility to report any safeguarding concerns to the local authority and to CQC. Records demonstrated information had been shared appropriately to investigate and address any safeguarding referrals raised.

Staff showed a good understanding of their duty to protect people from abuse, harm, and discrimination. They were clear on how to report any concerns to managers and senior staff and stated they would escalate issues further if they felt they had not been properly addressed.

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 told us they felt comfortable and secure living at the service. One person’s relative said, “They keep me informed when I visit most days – [family member] has had no falls, no concerns.” Another relative commented, “[I visit regularly] and they tell me things about [family member] every day. When I am away, they ring me if necessary.”

Risk assessments for people were reviewed and updated and there was guidance written for staff about how to manage risks that had been identified. We reviewed care planning documents and saw recognised tools such as a pressure ulcer risk assessment and nutrition screening tool were used. These helped assess the level of care need for people and were used as planned to help mitigate against any risks.

The provider did not always detect and controlled potential risks in the care environment. They did not always and consistently make sure equipment, facilities and technology supported the delivery of safe care. We identified some hot water pipes that needed covering to protect people from the risk of burns, the provider took immediate action to rectify this.

The provider ensured that required safety checks were completed, including those relating to fire, water, Legionella, and equipment safety. There was evidence that regular maintenance checks were carried out on site, with a dedicated maintenance person having oversight of work that required completion. Where appropriate, safety checks were undertaken by external contractors to help ensure the environment remained safe.

Staff were able to explain the actions they would take in the event of a fire and had received fire safety training with fire drills conducted to reinforce this training.

Leaders told us there was a refurbishment plan in place, with redecoration having taken place recently. Further plans included replacing soft furnishings throughout the service within the coming year. A relative told us, “We have seen an improvement in the environment recently with new furniture and decoration. Staff decorate the home at festival times of the year.” This meant people lived in a well‑maintained and safe environment, with risks identified and managed appropriately and staff prepared to respond effectively in the event of an emergency.

The provider did not always make sure there were enough qualified, skilled and experienced staff deployed to meet people’s needs. They did not always make sure staff received effective support, supervision and development.

We received mixed feedback regarding staffing levels from people using the service, their relatives, and staff with the majority telling us there were not enough staff available to meet people’s needs. Others expressed concerns that staffing levels were not always consistent, particularly during busier periods, staff absences, or unplanned events. Relatives and staff described times when the service felt stretched, which impacted the ability of staff to provide timely support and more personalised interactions, and that activities were often the first to be cancelled if there were staffing challenges. In response to these concerns the provider was proactive and took immediate action to increase staffing levels and offered assurances that they would continue to closely monitor staffing levels and evaluate the changes made.

Staff told us they had received the training required to carry out their roles effectively, and records reviewed confirmed this. This meant people using the service were supported by staff who had been properly vetted and trained, reducing the risk of harm and promoting safe, effective care delivery. Staff were recruited safely, with appropriate checks completed to confirm their suitability to work with people using the service. These included verification of employment history, references, right to work, and Disclosure and Barring Service (DBS) checks. DBS checks for convictions and cautions recorded supporting employers to make informed and safer recruitment decisions.

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.

We observed that bedrooms and communal areas were clean and tidy and housekeeping staff were responsive to any spillages or cleaning needed. Personal protective equipment (PPE) was readily available, and staff were seen using and disposing of it in line with best practice. Staff had received training in infection prevention and control and were able to clearly explain the processes in place to help keep people safe. This reduced the risk of infection and helped ensure people lived in a clean, safe environment where staff understood and followed effective measures to protect their health and wellbeing.

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 told us they received their medicines as prescribed and that pain relief was available when needed. One person said, “Medication - they know what they are doing, it is all recorded.” Effective systems were in place to support the safe management of medicines, and medicines were administered in line with the prescribers’ instructions. Records demonstrated there were no missed doses, and running balances were maintained so that any discrepancies could be quickly identified. Where medicines errors had occurred previously, these were appropriately reported and lessons were learned to reduce the risk of recurrence.

The medicines room was well organised, and medicines were stored securely. Records showed regular temperature checks were carried out to ensure medicines were kept within the recommended range to maintain their effectiveness. During the inspection, a new air conditioning unit was being fitted in the medicines room to ensure medicines were stored at their optimum temperature. Medicines were audited regularly by a range of staff to ensure systems remained effective. Records evidenced that all staff who administered medicines were appropriately trained, and their competency to follow safe medicines processes was regularly assessed.

This demonstrated that people could rely on receiving their medicines safely, consistently, and at the right time, reducing the risk of errors and ensuring their health and pain management needs were effectively met.