The Cumberland

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. We identified breaches of regulation as potential risks had not always been assessed, guidance was not always available to staff informing them how to keep people safe, there were not enough staff deployed to meet people’s needs and people’s medicines had not always been appropriately stored or recorded. The previous breaches of regulation had been met, and the provider was no longer in breach of regulation. 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.

There was a positive culture of safety based on learning from incidents and accidents to reduce the risk of a re-occurrence. The registered manager liaised with the appropriate health care professionals following an incident such as, the local authority, safeguarding team and the persons’ next of kin. Appropriate action was taken following an accident such as, staff re-training and recompletion of their competency assessment. Staff knew how to record and report an accident or incident and told us about improvements made to people’s outcomes because of an accident or incident. For example, 1 staff member told us, “After 1 resident had hit another in the lounge, we increased our monitoring of them, so the risk of this happening again was less.”

Relatives told us they felt confident to raise any safety concerns with the staff which would be acted on. Comments included, “[Staff] keep me informed and will always listen to me if I have any concerns” and, “The staff are great will always listen.” This relative told us that action had been taken following an incident and their loved one’s care records had been updated as a result.

Systems were in place to ensure people’s needs continued to be met when moving between services. Hospital passports were in place to ensure people’s needs and preferences were respected if they needed to go into hospital. The registered manager told us they ensured that a member of staff would go in the ambulance with the person and stay with them in hospital until they were admitted, discharged or a family member arrived. Discharge summaries were requested by staff which were then discussed in handover meetings and the person’s care records were updated accordingly.

Relatives told us they had been involved in the development and review of their loved one’s care records. Relatives confirmed that staff liaised with external health care professionals to ensure their loved one remained as healthy as possible. A relative said, “[Loved one] has been into hospital a few times and the staff here make sure they attend any follow up appointments.”

Relatives told us they felt their loved one was safe with the staff who knew them well. A relative said, “My [loved one] has been looked after very well since they came here.” Observation showed the environment felt calm and relaxed with staff engaging and chatting with people respectfully. People were observed smiling and laughing in the presence of staff.

Staff had been trained and knew the signs to recognise potential abuse and how to report any concerns. Staff felt confident that any concerns they raised would be acted on and followed the provider’s policy and procedure. The registered manager understood their responsibilities to report any concerns promptly to the relevant external agencies. Records showed that concerns had been investigated, and any learning had been shared with the staff team during handover meetings, staff meetings and in supervisions.

Potential risks posed to people had been assessed and mitigated. Relatives confirmed they had been involved in the development and review of their loved one’s risk assessments. A relative said, “My [loved one] is no longer able to walk and has a bed that can be lowered to the floor and a crash mat in case they rolled out of bed. I feel they are as safe as they could possibly be.”

Risk assessments were robust and included the action to take to reduce the potential identified risk. Staff were aware of people’s risk assessments and understood how to meet people’s needs. Guidance had been developed and was followed from external health care professionals in relation to the potential risk of choking, the risk of falling and the action to take if a person was at times of distress. Staff gave examples of how they supported a person when they had become distressed by offering the person a coffee or hot chocolate and spending time talking with the person which helped them to relax and become less distressed.

The premises, environment and equipment were well maintained to ensure it was fit for purpose and safe. Relatives felt the interior of the service needed refurbishment in some places and a plan was in place for this. A relative said, “The home does look tired in some places; I did write a letter to the owner about some of the chairs in the lounge having stuffing coming out, he said he would be dealing with this.”

Staff had been trained in health and safety and fire awareness and were able to tell us about the fire procedure that was in place and how to evacuate people safely in the event of an emergency. Information was recorded within the dining room of the staff fire wardens that were on duty for that day. Regular checks of the alarm system and firefighting equipment took place. Each person had a personal emergency evacuation plan (PEEP) in place which was easily accessible to emergency services if an evacuation was required.

Observation showed that emergency exits were unobstructed and clearly marked with appropriate signage to direct people. Evacuation sledges were in place and well maintained. Checks were made of any equipment used such as, window restrictors, bed rails and any pressure relieving equipment that was used.

There were enough skilled and competent staff available to meet people’s needs. Relatives confirmed they felt there were enough staff and observation showed throughout the assessment that staff were available to spend time with people whilst meeting their needs. There was a visible staff presence in all communal areas and staff were observed routinely visiting people who stayed in their rooms.

Staff confirmed they had received an induction before they started work and had received the training, support and supervision they needed to fulfil their role. A member of staff said, “The staffing level is good. We have enough staff on duty. If there is something happening in the home, they book extra staff in. For example, if a resident has a hospital appointment and needs a staff member to take them.”

The registered manager used a dependency tool to determine the levels of care staff required to meet people’s needs. Staff had been recruited safely. Staff confirmed they had regular supervisions and felt supported in their roles. Staff told us they could discuss any matter concerning their work at supervision meetings with their line manager. Care staff were also supported by ancillary staff such as, catering, domestic and maintenance staff.

People were protected from the risk of infection. Relatives told us they felt the service was clean and free of odours. We observed staff wore the appropriate personal protective equipment (PPE) and had access to a variety of PPE throughout the service.

Staff had been trained and followed the providers policy and procedure in relation to infection control. The registered manager had introduced 3 members of staff who were hand washing champions to encourage people and staff to wash their hands in the correct way. Housekeeping staff followed a schedule of cleaning tasks which were audited by a member of the management team.

People received their medicines safely and as prescribed by staff that had been trained and had their competency assessed. Relatives told us they did not have any concerns in relation to their loved one’s medication and said that action would be taken if their loved one required any additional medication such as, pain relief. A relative said, “The staff would make sure [name] was comfortable and keep us informed.”

Systems were in place for the safe storage, ordering and returning of any unused medicine. Staff were observed following safe systems to administer people’s medicines. Staff wore a red tabard to alert others they were administering medicines so that they would not be disturbed. Staff were observed to check they were administering the correct dose of medicines to the correct person at the correct time. Medication administration records (MAR) were neat, clear, easy to follow and showed no gaps in the signing of medication administration.

Some people had been prescribed ‘when required’ (PRN) medicine for times such as, being in distress or for pain relief. Staff followed PRN protocols following guidance from the prescribing health care professional. Guidance and legislation were followed for anyone requiring ‘covert medication’ this involved administering medication in a disguised form, such as in food or drink, without the person’s knowledge or consent.

Checks and audits were completed on a regular basis by the administering staff and the management team. Staff followed the providers medicine policy and procedure, and they knew the action to take if there had been a medicines error.