Saffrons 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 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 63 (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.

Staff told us how incidents and accidents were reported and recorded appropriately. The registered manager investigated safety concerns and lessons learnt were seen as an opportunity to improve the service.

People and their relatives told us that they could confidently talk to staff and the registered manager if they had any concerns about their safety. One person said, “If I disliked something or felt unsafe, I would speak to the manager”. A relative said, “ [Staff] are easy to speak to and I feel listened to. Any issues raised are dealt with quickly.”

The provider worked with people and healthcare partners toestablishand maintain safe systems of care, in which safety was managed ormonitored. They made sure there was continuity of care, including when people moved between different services.

There were processes in place to ensure that staff could meet people’s needs prior to admission. Thorough assessments were completed by the registered manage which included contact with people, relatives, and professionals such as social workers. This meant that information was consistently shared to inform person-centred practices.

Reassessment of people’s needs was undertaken when moving between services, for example, upon hospital discharge. The registered managed recognised the limitations of the service, and concerns about people’s needs changing were communicated to ensure that safe care was provided.

Staff worked closely with health professionals such as GPs and community nurses. When people were admitted to hospital information packs were produced to provide information about needs and promote continuity of care during transitions.

The provider did not always ensure that records reflected practice in relation to the Mental Capacity Act. People told us that they felt safe at the service and that they could openly discuss safeguarding concerns with both the registered manager and staff.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making decisions on behalf of people who may lack the abilities to do so for themselves due to a cognitive impairment. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When lacking capacity any decision made on their behalf must be done so in their best interest and the least restrictive option supported.

Records of mental capacity assessments did not reflect people’s involvement in conversations to determine their understanding. Best interest meetings including the use of advocacy had not been recorded. However, staff had completed mental capacity training and knew about people’s mental capacity needs and how to support them to make day-to-day decisions. Following inspection, the registered manager identified that further learning was needed to ensure that best practice in relation recording mental capacity and best interest decisions was embedded, they planned on booking face to face training for senior care staff who undertake these.

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). Staff had received DoLS training. There were three DoLS in place at the time of inspection. Relatives told us, “We recently had a meeting with Saffrons and the social worker to discuss deprivation of liberty to ensure that [name] is safe. I do not have concerns about the restrictions in place.”

A robust safeguarding policy was in place. Staff received safeguarding training and understood how to report concerns. Staff told us, “I would speak to the manager about any concerns, if they weren't available then I would contact the directors. I would also report to CQC or the local authority.” The registered manager worked with local safeguarding teams to support investigations and promote positive outcomes for people.

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe,supportiveand enabled people to do the things that mattered to them.

Risk assessments were not always reflective of people’s individual needs. For example, some falls risk assessments were not in place for people with reduced mobility. This meant that they were at increased risk of experiencing recurrent falls and potential injury without appropriate measures in place to minimise harm.

Personal Emergency Evacuation Plans (PEEPs) are a document that gives staff and emergency services detailed instructions about the level of support people need to ensure their safety in the event of an evacuation. PEEPs for each person had been completed but some lacked information relating to the use of mobility aids.

Where people had specific health condition, such as diabetes, relevant information was recorded and guidance produced to ensure that staff knew people well and safe care was delivered. People were supported to take and balance positive risks to enhance their lives. For example, independently accessing the local community without restriction.

Systems and procedures were in place for events such as fire, business contingency and emergency planning. Staff received training in areas of risk including moving and handling, basic and emergency first aid and fire marshal.

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 home was well maintained. At the time of inspection refurbishment was underway to update the exterior of the building and there was a plan in place to make improvements to the communal dining area including changing the flooring to promote a cleaner environment.

People were able to personalise their bedrooms with belongings including photos. People had free access to an enclosed garden. One person told us, “It’s nice here.” There was a locked door in place for security, Deprivation of Liberty Safeguards had been applied for those people that were unable to provide informed consent to the restrictions.

Staff had completed training to support safe management of the environment including health and safety awareness and Control of Substances Hazardous to Health. There was an effective fire safety procedure in place. Fire call points and extinguishers were visible throughout the building. Premises risk assessments and health and safety assessments were reviewed on an annual basis, which included gas, electrical safety, legionella and fire equipment.

Adaptive equipment was in place and regularly maintained to meet people’s needs, this included manual hoists, bath seats, fire evacuation chairs and individual mobility aids. Reasonable adjustments had been made for people with reduced mobility by ensuring that a bedroom on the ground floor was provided to safely meet their needs.

The provider did not always make sure there were enough qualified, skilled and experienced staff available. The provider used dependency tools to calculate the staff needed to care for people. However, these were not always reflective of the support people required. This meant that staffing ratios did not match the needs of people living at the service. Staff were not available to oversee communal areas as they had been deployed to provide support with dedicated tasks such as personal care. Peoples at in communal areas experienced periods without social stimulation.

At the time of inspection there was no use of agency staff. Bank staff were used to cover shifts where needed. This provided continuity of care and ensured that staff overall knew people well. Staff had been recruited safely. Staff files contained the required documents and checks for example, references, photographic identification and Disclosure and Barring Service (DBS) records. DBS checks support managers to make safe recruitment decisions.

Staff had completed online and face to face training appropriate for their roles, this included specialist topics in relation to dementia and diabetic care. Staff told us, “I feel that there are plenty of training opportunities. I enjoy training and I am always keen to develop my skills.” Training was regularly audited by the registered manager to identify any outstanding needs. Staff received inductions, supervisions, and appraisals.

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.

At the time of inspection there was a pest outbreak. This had spread to two rooms in the building. However, the registered manager had sought treatment and advice from pest control services, and both the local authority and Care Quality Commission had been notified for transparency.

People were supported to maintain the cleanliness of environment by dedicated domestic staff. One relative told us, “The home is very clean.” We observed staff supporting with household chores including changing bed linen and laundry. Soiled clothing was washed separately in a red bag to prevent cross contamination.

Hand hygiene information was visible throughout the building and in the bathrooms with antibacterial hand gel available. Personal protective equipment was well stocked and available on each floor for staff and people to use when needed.

Staff had received training on infection prevention control (IPC) and food safety. Policies were in place for IPC, personal protective equipment, pest control and communicable infections management and had been recently reviewed.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning. Records were not always inline with the provider’s policy.

Handwritten medicine charts were not countersigned for safety on transcribing, medicine counts were not consistently undertaken, and staff signatures were not always clear. Following the inspection the registered manager identified that staff administering medicines needed refresher training and observations to ensure safe practices.

Medicine administration errors had not always been identified or recorded. For example, we found an unidentified tablet on the floor, though all medicines had been documented as having been correctly administered. Failure to administer medication as prescribed may place people at risk of worsening health conditions.

Medicines were stored safely and kept tidy. Staff had received training in medicines management, administration and had access to the provider’s policy and their competency had been assessed by the registered manager. The procedures of ordering, receiving, and returning medicines followed best practice guidance. People had individual medicines care plans that provided staff with vital information such as any allergies including when and how to administer people’s medicines.

One person told us, “They manage ordering my medicines well.” A relative told us, “They have a skin condition that needs cream. It had recently runout, staff made sure that it was reordered straight away so that there was no delay in it being applied.”