Chertsey Parklands Manor 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 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.

Accidents and incidents were recorded and reviewed to identify any actions that could be taken to prevent a recurrence. Lessons were learned to identify and embed good practice. For example, following an incident in which a person experienced suboptimal care, the provider reviewed the circumstances of the event and found shortfalls in the recording and communication of important information. Reflective supervision had been carried out with the staff involved in the incident, and training in recognising and managing deterioration in a person’s health arranged for all nursing staff for October 2025.

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

There were procedures in place to ensure people’s transition from other services was well-managed, including effective communication with other relevant professionals.

People told us they had been given good support to adjust when they first moved to the home. One person said, “When I first came here I was a bit anxious, but I soon settled in because everyone was so kind. I had good support to settle in right from the beginning."

The provider worked with people to understand what being safe meant to them and the best way to achieve that. Staff focused on improving people’s lives while protecting their right to live in safety, free from abuse, discrimination, avoidable harm and neglect. The provider shared concerns appropriately when necessary.

When safeguarding concerns had been raised, the provider had worked with the local authority and the police to investigate these and provided all information requested by other agencies in a timely way.

Staff attended safeguarding training in their induction and had access to regular refresher training. Staff knew how to recognise potential abuse and understood their responsibilities to report any concerns they had.

Where people were subject to restrictions for their own safety, the provider had applied for Deprivation of Liberty Safeguards (DoLS) authorisations. The Deprivation of Liberty Safeguards are designed to protect people who lack the mental capacity to consent to their care or treatment, especially when that involves restricting their freedoms.

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.

Assessments had been carried out to identify any risks involved in people’s care. Where risks had been identified, information was provided for staff about how to mitigate these. We observed during our visits that staff supported people to mobilise safely and offered encouragement and reassurance to ensure people felt safe and comfortable.

Relatives told us staff understood any risks in their family members’ care and managed these effectively. One relative said, “I think [family member] is very safe here. She is unsteady on her feet, so it is quite a difficult job for staff to keep her safe, but they keep a close eye on her, and they made sure she had a bed close to the floor and put mats around in case she falls out of bed.” Another relative told us, “They are absolutely on top of any risks or concerns. An example would be that certain foods can make [family member] cough, which is a choking hazard. The staff have to make sure her food is cut up and soft. I think this is another example of why I consider that she is safe there.”

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 provider employed maintenance staff, who people told us responded quickly to any issues they reported. Maintenance staff also carried out and kept records of health and safety checks on the building and utilities.

The provider maintained appropriate standards of fire safety, and the fire alarm system, emergency lighting, and fire-fighting equipment were checked and serviced regularly. A personal emergency evacuation plan (PEEP) had been developed for each person, which recorded the support they would need to leave the building. The provider had a business continuity plan to ensure people would continue to receive their care in the event of an emergency.

There were enough qualified, skilled and experienced staff available to meet people’s needs. Staff were recruited safely and received effective induction, training and development.

People in most parts of the home told us staff were always available when they needed them. For example, one person said, “There are carers around all the time, even right through the night, and there is always a nurse if needed”, and another person told us, “When I press the call button, there is someone with me within a few minutes.”

However, people in some parts of the home told us staff were not always available, when they needed them, which meant they had to wait for their care. For example, one person said, “When you call first thing in the morning, you can press that [call bell] forever”, and another person told us, “I waited half an hour this morning when I used the call bell.”

Our observations confirmed what people had told us, that staff were available when people needed them in most parts of the home, but that people’s experience was different in other parts of the home. We shared this feedback with the provider at the end of the first day of our inspection.

On the second day of our inspection, the provider had allocated 2 additional members of staff to the areas of the home people reported staff were not always available when they needed them. The provider confirmed the staffing rota had been amended and these staffing levels would remain the same moving forward.

All staff had an induction when they joined the team, which included shadowing colleagues to understand people’s needs and how they preferred their care to be provided. Staff had access to the ongoing training, supervision and support they needed to carry out their roles effectively.

Staff were recruited safely. The provider carried out pre-employment checks including obtaining a Disclosure and Barring Service certificate. Disclosure and Barring Service checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

Staff assessed and managed the risk of infection. They controlled the risk of it spreading and understood their responsibility to share concerns with appropriate agencies if necessary.

Staff attended training in infection prevention and control (IPC) and understood how to protect people from the risk of infection. Housekeeping staff carried out regular cleaning, and there were checklists in place to ensure good hygiene was maintained in all areas of the home. We observed that all areas of the home were clean and hygienic during our visits.

People told us staff kept the home clean and hygienic. One person said, “The place is kept very clean. We have a lovely cleaner who comes in to do my room every Tuesday.” A relative told us, “I have never had any concerns about hygiene. [Family member’s] bedroom is always immaculate.”

Staff made sure people’s medicines and treatments were managed safely, and knew and respected people’s preferences about their medicines. People’s medicines were regularly reviewed to ensure they remained appropriate for their needs.

The provider had suitable systems for the ordering, storage, recording, and disposal of medicines. Medicines were audited regularly as part of the provider's quality monitoring processes.

Staff received training in medicines management, and their competency was assessed before they were authorised to administer medicines. Staff administering medicines during our visit followed good practice guidelines when doing so.

We identified 2 areas for improvement. The recording of time-sensitive medicines was not always clear, and protocols for medicines prescribed ‘As and when required’ (PRN) contained important information including the maximum dose and frequency of administration but omitted details such as how the condition for which the medicine had been prescribed may present in the person. We shared this feedback with the provider who agreed to address these issues.