Penrose Court

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 requires improvement. At this inspection the rating has changed to 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 shared and discussed concerns about how people were being supported. Lessons were learnt to continually identify and embed good practice.

When incidents and accidents were reported these were investigated thoroughly to see if any lessons could be learned. The registered manager had a good oversight of these and monitored them to see if there were improvements that could be made. One relative told us, ‘‘[Family member] had a fall last year. They now have rails on the bed and a sensor mat. They have put a frame around the toilet, I can’t ask for anymore. It was a really good response to what happened.’’

The management team made sure they had regular meetings to discuss what was happening at the service. These discussions were about any changes people needed to their support, for example in relation to needing more support with food and drink. These meetings were an effective way of sharing information and made sure a learning culture was promoted throughout the service. A person said, ‘‘I used to have lots of falls but now I don’t. The staff spoke about how to help me with this.’’

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. Staff contacted professionals such as GP’s or speech and language therapists if people needed support. If professionals gave advice that needed to be followed, this was recorded and staff followed this. Staff knew people well and told health professionals how to best support people during appointments. People had specific care plans they could take with them to other services to help professionals and partners support them. One person said, ‘‘The GP visits every week, but the staff get me an extra appointment if I need it.’’ A relative told us, ‘‘[Staff] are very involved if [family member] needs to visit another service. I think they want to make sure [family member] gets the help they need and then gets home as quick as possible.’’

People and their relatives told us they/ their family member were safe living at the service. Staff were trained in safeguarding and knew what signs may indicate potential abuse and how to report concerns to external partners such as the local authority or CQC. Safeguarding concerns were reported, and any actions were taken seriously by the management and staff team. One person said, ‘‘I am happy and safe here. The staff are kind and thoughtful.’’ A relative told us, ‘‘[Family member] is at risk of falls, but has not had any at all since they moved in, so they are very safe.’’

People’s risk assessments and care plans were not always detailed in areas such as how to support a person to feel better when they felt upset or how to support a person who was at risk of social isolation. People’s daily records were sometimes not completed in detail, making it harder to identify if a person may need more help with some areas of their support. The registered manager acknowledged these were areas that may need some improvement.

However, other risk assessments and support plans were detailed and gave guidance to staff about how to mitigate risks as far as possible. People had risk assessments in place for areas such as pressure area care, specific health conditions and walking around the service. People and their relatives were involved in the creation and reviewing of care plans and risk assessments. One relative said, ‘‘The care here is the best. Staff make sure they follow the risk assessments, and my family member always has bed rails and bumpers up, so they are safe in bed. Staff know how risky it can be if they eat [food prepared a certain way] and so always make sure this is done properly.’’

On the first day of our inspection some areas of the environment in relation to the kitchen fire doors and other fire doors at the service were not safe. The registered manager acknowledged this and took immediate action to make the kitchen area safe. Staff also completed an audit of the other fire doors and showed us the plans they had to address this. This assured us people were not at risk.

Other areas of the environment were safe. Staff completed checks to make sure the environment and the equipment people used was safe, and these checks were audited regularly. We observed people to be happy and comfortable in their home environment. One person said, ‘‘It is like a hotel here really and I call this place my home.’’

There were enough staff to support people safely. However, at some times of day staffing levels and staff deployment meant people were not engaged with in a meaningful way for extended periods of time. We discuss this more in the Caring and Responsive areas of this report.

People told us there were enough staff to safely support them. One person said, ‘‘There are always 2 staff to help me when I need them, and the call bell is answered within seconds. I see the same staff all the time.’’ A relative told us, ‘‘[Family member] does not have to wait long for their call bell to be answered. I think the staffing levels are OK.’’

Staff had the training they needed to support people and their competency to support people was checked after their training. Staff were knowledgeable about their training. The provider recruited staff safely in line with legislation to help ensure they were suitable for their job roles. One person said, ‘‘[Registered manager] is very specific about who they employ and only take the best of the best.’’ A relative told us, ‘‘The staff team is very settled now, and this has made a big difference. They all know [family member] now and I am confident they all have the training they need to support them with everything that is needed.’’

The provider assessed and managed the risk of infection. Staff were trained in IPC and told us they had the necessary equipment to keep the service clean. We observed the service to be visibly clean. Staff whose role was to keep the service clean took pride in their work and knew how important it was for people’s home to be kept clean. Audits and checks were in place to monitor the cleanliness of the service and the effectiveness of the IPC measures in place. A person told us, ‘‘[Staff whose role it is to keep the service clean] do a fantastic job. They always stop and have a chat too. They know us just as well as [care staff].’’

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

Staff knew how to administer medicines safely and in line with people’s preferences. They were trained to do this and had their competency to do this checked regularly. Audits were in place to help make sure medicines were being managed effectively. Some people were supported to administer their own medicines, and this meant a lot to them. One person said, ‘‘[Staff] offered me self-medication and a locked cupboard, I keep my own chart, they supported me through the starting phase, I could tell them if I had any concerns.’’

People had protocols and guidelines in place for ‘as and when required’ (PRN) medicines and for ‘homely medicine’ (medicines not prescribed but purchased by people themselves). Staff made sure any specific guidelines for medicines were in place and being followed, for example, if people needed to have their medicines administered ‘covertly’. One relative said, ‘‘[Family member’s] medicines are very complex, and I am grateful the staff manage these so well.’’