Franklin House Limited

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. Lessons were learnt to continually identify and embed good practice.

The provider had systems in place to review and investigate accidents, incidents and safeguarding concerns. Staff managed accidents and incidents safely. Systems were in place for recording events, and changes had been implemented in response to lessons learnt. Systems were in place to analyse incidents and spot trends.

Staff reported an open culture where they were encouraged to report all concerns. They told us, “I feel confident reporting concerns to [managers], they deal with stuff straight away and address everything quickly.”

People were encouraged to raise concerns and staff supported them to do so. A relative told us, “We can go to them [manager] with anything, no qualms, they [managers] are brilliant like that. They reassure us and address concerns and complaints, they are dealt with quickly.”

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

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.

People were protected from the risks of abuse and staff were trusted to keep them safe. People told us, “I am happy living here. I feel safe,” and “I am safe here.” A relative added, “They [relative] receives safe and good care.”

Staff had received training in how to safeguard people. Staff we spoke with were confident to report concerns and satisfied that action would be taken to investigate them. Staff told us, “I would report any concerns to the senior and manager, and I know I can inform the local authority also” and “I have had training in safeguarding, I speak to my manager or senior if I had any concerns.”

The service was working within the principles of the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. Information about people’s cognition was recorded in their care plans. Concerns about people’s mental capacity were escalated to the local authority and health care professionals.

Staff received training in the MCA and deprivation of liberty safeguards (DoLS). Staff understood consent, the principles of decision-making, mental capacity and DoLS. One staff member told us, “Some people have the mental capacity to make decisions and other people don't have the mental capacity to make decisions. MCA is used to assess those people who don’t have capacity and make best interest decisions for them.”

Measures were in place to ensure people received the support in the least restrictive way possible. Care records contained the relevant level of information in relation to people's capacity, any DoLS authorisations and systems were in place to ensure consent to care was obtained.

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.

Risks to people were assessed and actions were taken to reduce the risk of harm. For example, in relation to dehydration, malnutrition and skin breakdown. Staff we spoke with were aware of these and understood how to support people safely.

Care plans provided guidance for staff to ensure people received safe and responsive care and support. Risk assessments were person-centred and regularly reviewed.

People and relatives were involved in managing risk and care planning. This was reviewed regularly or when people’s needs changed. A relative told us, “I am kept updated and I can check on the care plan and reviews as I can't always be here. They [staff] update me all the time.”

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

The provider did not always make sure there were enough qualified, skilled and experienced staff. They did make sure staff received effective support, supervision and development.

We were not assured there were always sufficient staff to meet people’s needs. Although the provider used a staffing assessment tool, we received mixed feedback about staffing levels. Some staff told us there were not always enough staff and people often had to wait to receive personal care, particularly during the night shifts. We fed this back to the provider who told us they will monitor and review their night staffing levels.

Recruitment checks were robust to ensure staff were suitable to work with vulnerable adults. Staff had the necessary safety checks in place before starting work and completed a full induction. A staff member commented, “The induction was good. I got everything I needed.”

Staff received regular training and competency checks to ensure they were skilled to carry out care tasks. We observed safe staff practices in moving and handling. A staff member told us, “We get regular training, it is good. I have regular moving and handling training.”

Staff had opportunities for supervision [1:1 support sessions with their line manager]. A staff member commented, “We get regular 1:1s and can ask for another whenever we want.”

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 service was well maintained and appeared visibly clean with no malodour. People and their relatives told us, “It is clean and tidy”, “The cleaners are brilliant,” and “I always see staff cleaning.”

The provider had systems and processes to prevent and control infection. There was guidance and information displayed for staff, cleaning schedules were completed, and a number of infection prevention and control (IPC) audits were regularly undertaken to ensure the cleanliness of the environment and staff competence. Laundry was safely managed, with systems to reduce the risk of cross contamination,

Staff were trained in IPC, and we observed them using personal protective equipment (PPE), such as gloves, masks and aprons, appropriately.

The provider did not always make sure that medicines and treatments were recorded appropriately. Medicines and treatments were safe and met people’s needs,capacities and preferences. Staff involved people in planning, including when changeshappened.

We observed senior staff administering people’s medicines. We found 1 person’s controlled drug medicine had not been signed for appropriately and was not stored safely. Controlled drugs need to be securely stored because they can cause serious harm. The recording and storage of this controlled drug medicine was rectified during the inspection.

The recording of prescribed fluid thickeners was unclear. Care staff administered the fluid thickeners, however, this was not clear on the medication administration record (MAR) as senior care staff filled out the MAR to document the administration. This issue was noted in our last inspection in 2024; the registered manager took action during the inspection and had implemented a new process to document the administration of fluid thickeners. However, during this inspection we found staff had reverted to the old process. The registered manager addressed the concerns and re-implemented the correct recording tool during this inspection. The registered manager also updated their medicine auditing process to include the auditing of fluid thickeners.

People received their medicines in a safe way and systems ensured timely administration of medicines. People told us, “I get my medication and I can see the doctor when I need to,” and “I receive my medication when I need it. I also have [prescribed] creams, and they [staff] apply it.”

Staff were trained to administer medicines. Staff had to undertake training before they could administer medicines and received competency checks to ensure they administered medicines safely.