The Dunes

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 inspection we rated this key question good. At this inspection 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.

The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Lessons were learnt across the service and the provider’s locations. The service had systems to record, review and analyse incidents and accidents. Details of incidents and accidents were recorded by the staff team. Records confirmed staff were informed of relevant incidents and lessons learnt through team meetings and supervisions. Relatives told us they knew how to raise concerns and report any issues about the care of their family members.

The service 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. Relatives told us staff at the service communicated when required with external health and social care professionals.A relative said, “The staff are very good at this.” Electronic based summaries of people’s needs and relevant medicines information were available to staff in case of an emergency hospital admission. These could be printed and given to the emergency services. Staff used the system to ensure the summaries included the most up to date information. This meant a safe transition between services. Relationships between the service and external professionals were established and operated effectively.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They 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 service shared concerns quickly and appropriately. People’s relatives told us The Dunes was a safe place to be. Staff received training in safeguarding, and the provider had a safeguarding policy in place. Staff told us they knew how to raise concerns with the registered manager and felt all information would be acted on. We observed staff working in safe ways, for example, when providing emotional support to people. The provider had a process they followed to ensure people were protected and concerns were reported to the local authority without delay. The registered manager knew how and when to raise concerns and the importance of this. We checked whether the service was working within the principles of the Mental Capacity Act 2005 (MCA), whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). All legal applications had been made in accordance with DoLS, this meant people’s rights were fully respected. The registered manager had oversight of DoLS applications and authorisations.

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Staff worked well to keep people safe and understand people’s needs. All people had care and support plans and risk assessments which were regularly reviewed. Staff told us they understood people’s risks and individual care needs and were confident where to find the relevant information. People were involved in planning their care and making day to day decisions. We observed staff working safely with people. People were supported to spend time doing activities they enjoyed.

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People could move around the service safely and without restriction. The service was accessible and had environmental risk assessments in place and these were reviewed and updated often. Robust safety checks were carried out regularly. The service used external specialists and contractors to undertake some checks, such as gas, electrical and fire safety. Certificates were in place for all household assessments carried out by external professionals. Fire safety drills and checks were routinely conducted. A fire risk assessment had taken place. Each person had an individual plan on how to manage fire safety and evacuation.

The service 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 were available when people needed them. Relatives told us there was enough staff to meet people’s needs. Staff had regular supervisions and attended team meetings. Staff told us they felt part of a team. Training records confirmed staff completed training to ensure they had the skills and knowledge to carry out their roles. We observed staff supporting people in a person-centred way, for example when supporting them with activities. A relative said, “The staff have been there a long time, it is consistent team.” Recruitment procedures were in place to ensure checks were carried out on staff before they commenced their employment. This included enhanced Disclosure and Barring Service (DBS) checks for adults. DBS checks provide information including details about convictions and cautions held on the police national computer. The information helps employers make safer recruitment decisions. A health and social care professional said, “They are a stable staff team who know people well.”

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.The service was clean and tidy, this included people’s own bedrooms and communal areas.Staff had received training in infection prevention and control and had practical hand-washing checks. There were cleaning schedules in place. We observed the service to be clean and hygienic. Personal protective equipment (PPE) was worn correctly by staff. A relative said, “I have never seen the place dirty or unclean.” Safe infection prevention and control procedures were in place, and this underpinned practices within the service. Infection control procedures and audits were in line with good practice guidance. Staff had plentiful supplies of cleaning materials, products, and PPE.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened. People received their medicines as prescribed. Medicines were given in a safe way, and this included if medicines were prescribed to be given ‘when required’. Medicines were stored in accordance with pharmacy guidance and infection control guidelines. Medicines were well managed and organised. There were suitable arrangements for the storage, administration and disposal of medicines. Daily checks were carried out to ensure there had been no medicines errors. Medicine paperwork was clear, well organised and available to staff. A relative said, “The staff carry out medicines for [person] correctly and well.” Staff had received training to administer medicines. Policies and procedures were in place for staff to follow to support the safe administration of medicines. The registered manager confirmed people were supported to attend their annual medicines reviews.