Melford Court Care 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 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 72 (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.

Incidents and accidents were reported and investigated in line with the provider’s governance processes. Staff understood their responsibilities for recording events promptly and accurately, and managers reviewed each incident to determine what had happened and whether further action was needed. Lessons learned were routinely shared with the wider team through handovers and team meetings ensuring staff were aware of any changes required to ensure safe practice. Incidents were analysed over time to identify patterns or recurring themes, and where trends were identified, the provider took action to reduce the likelihood of re-occurrence.

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.

Records showed that people were referred to a range of external health professionals for assessment, treatment and specialist advice whenever this was required. These included GPs and other multidisciplinary partners. Staff demonstrated a clear understanding of when referrals were appropriate, and they acted promptly when people’s needs changed or when additional clinical guidance was necessary. This helped ensure people received timely access to the right support and prevented delays in care.

Health professionals we spoke with told us that the staff team were consistently proactive in seeking advice and escalating concerns. One professional commented that staff regularly contacted them not only when issues arose but also to check progress and clarify recommendations. We were told, “The home is very proactive and follow the protocols stringently – the care is good.”

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.

There were clear safeguarding processes in place, People and their relatives told us they felt the service was safe and that staff provided reassurance when needed. One person said, “It’s very nice here, we are all friendly. I feel safe here, I’ve got a buzzer, but I never use it, I cannot think of anything not nice here.” Another person told us, “It is alright here, they look after you well, feed you well. I feel safe as there is always someone about here, staff you cannot fault them.”

All staff received safeguarding training, and those we spoke with demonstrated a good understanding of safeguarding concerns, including when and how to make a referral. One staff member told us, “I would escalate if necessary. If the manager was implicated or they failed to take appropriate action. I would then contact the local authority’s adult safeguarding team. Then inform the regulators CQC if I felt the care provided was unsafe. I would not investigate the situation myself as this could contaminate evidence.” Another staff member said, “If there was a safeguarding issue I would go to my manager, or if it involved them, to their manager.”

The environment also supported people’s safety. Systems were in place to ensure no one entered the home who should not be there, and staff carried out regular checks to maintain security. A member of staff said, “I believe we do a good job of keeping [people] safe. Anyone who rings our intercom is asked who they are, and to identify who they are here to see, therefore reducing the chances of anyone unwelcome entering the building. Regular security checks are made on our night shifts, ensuring all external doors are secure, and windows closed as applicable. Any concerns around safety or safeguarding can be easily raised with [registered manager] or [deputy manager], both of whom are very approachable and available most days.”

The provider identified when people were potentially being deprived of their liberty and complied with the principles of the Mental Capacity Act. Applications and urgent authorisations were submitted in a timely manner. Policies, procedures and oversight systems supported effective monitoring of Deprivation of Liberty Safeguards (DoLS). We observed staff applying their training in practice; care was delivered in the least restrictive way, and people were offered frequent opportunities to make informed choices.

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.

Whilst people told us they felt safe living at Melford Court the provider did not always manage all risks well. Where potential risks had been identified, a risk assessment had been completed and a plan of care was in place; however, care was not consistently recorded in a way that enabled emerging concerns to be identified and escalated promptly. Despite these gaps in recording, there was no evidence that people experienced harm or that care was not being delivered. Staff were knowledgeable about people’s needs and were providing day‑to‑day support in line with what people required. The registered manager was already reviewing people’s care plans at the time of our inspection and took immediate action to strengthen risk management systems and address the shortfalls we identified.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The environment was visibly clean and generally well maintained, however, we noted that some areas of the home were in need of redecoration and refurbishment. The provider told us that refurbishment plans were in place, although no confirmed timescales had been set for when this work would be completed.

Records showed that routine checks were carried out to ensure the premises remained safe, including regular water safety monitoring and fire safety checks to confirm that alarms and extinguishers were functioning appropriately. Staff also completed scheduled checks of moving and handling equipment, such as hoists and hoist slings, to ensure these were in good working order and safe for use.

Each person had a Personal Emergency Evacuation Plan (PEEP) in place, which had been reviewed regularly and updated when people’s mobility or support needs changed. This ensured staff had clear guidance on how to support people safely in the event of an emergency evacuation.

People also had access to a secure and well‑maintained garden area, which provided a safe and pleasant outdoor space for relaxation.

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.

Feedback about staffing levels at the service was mixed. Most people and relatives told us they felt there were enough staff on duty, and several described staff as responsive. One person explained, “I press my call bell when I want to go to bed and they come straight away, I do feel safe here, I am looked after.” However, other feedback highlighted concerns, particularly during certain shifts. One person’s relative told us, “They are short of staff sometimes if only 2 carers, they do struggle and are rushed off their feet. There are usually only 2 carers on here in the afternoon.”

Staff also expressed differing views about staffing levels and pressures. Some staff described increasing strain on the team, with one staff member saying, “Staffing is always a bone of contention, with it never feeling like we can have enough staff. Especially lately, the company seem to want to cut back, giving one less [staff member] per shift, which has a real impact.” Another member of staff told us, “It can become overwhelming at times when there are very busy times in a 12 hour shift and [assisting with personal care] on top of this, turnaround times are hard to manage on occasions.” These comments reflected a perception among staff that workload and staffing ratios can fluctuate, and that this sometimes affected how manageable the shift was.

Despite this feedback, we observed sufficient staffing levels during our visit. We saw that call bells were answered promptly, staff were visible within the home, and care was delivered without rushing. Staff also took time to sit and talk with people, providing reassurance and building relationships. This demonstrated that, at the time of inspection, staffing levels were adequate to meet people’s needs safely.

We explored these mixed views with the registered manager and provider who told us staffing levels were determined using a dependency tool and were regularly reviewed based on people’s individual care needs. They also confirmed that no reductions in staffing levels had taken place or were planned. Records confirmed that updates were made as people’s needs changed, offering assurance that staffing decisions were carefully monitored and adjusted appropriately. The registered manager also committed to continuing close oversight of staffing levels to ensure they remained safe.

Safe recruitment practices were in place. Staff told us they received regular supervision and were appropriately trained. Several staff described having good access to ongoing development, including enhanced clinical training for nurses. One staff member told us, “I feel fully trained for my role and am confident I know how to give good care and do my job correctly.” Another explained, “The training, supervision and support received as staff is excellent. This training includes dementia care. Recently we also have a clinical lead nurse to support us.” This feedback demonstrated that staff felt well‑supported and equipped to carry out their roles effectively.

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.

The home was clean and well maintained, and we observed that standards of hygiene were consistently upheld throughout the environment. Communal areas, bedrooms and facilities were tidy and free from odours, reflecting the provider’s ongoing commitment to maintaining a safe and hygienic setting for people living there.

Staff followed safe infection prevention and control procedures in their daily practice. This included practising good hand hygiene, such as washing and sanitising hands at appropriate times, and using personal protective equipment (PPE) correctly to minimise the risk of infection spreading. We saw staff applying PPE in line with current guidance and disposing of it safely, which further reduced cross‑infection risks and helped maintain a safe environment for people, visitors and other staff.

The registered manager carried out regular care and compliance audits that reviewed key aspects of infection prevention and control. These audits included checks on cleanliness, correct use of PPE, and adherence to hand washing and hygiene procedures. Findings were used to maintain oversight of standards and to identify any areas where improvement was required. This structured approach supported the service to sustain consistently high hygiene standards and ensured that infection control measures remained robust and effective.

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.

Medicines were managed safely across the service, and people received their medicines as prescribed. People told us they were confident in the staff administering their medicines and described a reliable and reassuring process. One person told us, “I have tablets morning and evening and always around same time. None are missed and they always stay with me till they are gone.” Another person explained, “I have my medicines on time which includes pain relief. I can ring my call bell if I need more and they come quickly.” These comments reflected people’s confidence in the timeliness, consistency and responsiveness of medicines management.

We reviewed medicine administration records and found they were accurate, complete and maintained to a high standard. Staff followed national guidance and the provider’s policies for the safe receipt, storage, administration and disposal of medicines. This included clear labeling, secure storage arrangements and routine checks to ensure stock levels were correct. We also observed staff administering medicines and noted they did so attentively and safely, remaining with people until medicines were taken and providing reassurance, explanations and support where needed.

Staff understood their responsibilities and took appropriate action when changes in people’s needs required medicines to be reviewed or adjusted. This meant people received medicines in a way that supported their health, protected their safety and promoted positive outcomes.