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

Processes were in place to ensure safety incidents were appropriately investigated and reported, and outcomes shared with the team. Staff had good knowledge about how to identify concerns and report these appropriately.

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.

Before people moved into Ribble Valley Care Home, a pre-admission assessment was carried out to ensure their needs could be met. Relatives told us if their family member needed support from a health professional, this was arranged and documentation we saw demonstrated this. If people required admission to hospital, information to support health professionals to make decisions was provided.

The provider did not always share concerns quickly and appropriately with us. They did work with people and healthcare partners to understand what being safe meant to them and the best way to achieve that.

The provider followed Lancashire guidance on recording and reporting safeguarding incidents. However, CQC guidance was not followed, and we had not been informed of some notifiable incidents that affected some people living at Ribble Valley Care Home. This was discussed with the manager and provider who stated they would review their processes.

Observations showed people felt safe around staff. One person told us, “I feel safe here and I have no concerns or worries.” One relative commented, “I haven’t seen any ill treatment.”

Staff believed people were safe. Staff told us, “People are safe living here. It’s not just a job, you feel and care for people.” And “We will always remember residents come first and we do whatever we have to, to keep them safe.”

Where people needed to be deprived of their liberty to keep them safe, the service ensured a deprivation of liberty safeguard (DoLS) was applied for through the relevant local authority.

There was an up-to-date safeguarding policy and staff had received safeguarding training and knew how to identify and report abuse.

The provider worked with people to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People told us they were informed about risk and well supported. One person told us, “I have a pressure mat, so they come running when I get out of bed, even if I'm just going to the toilet.” One relative had raised a concern that some areas of the home did not always have staff oversight which placed people at risk of falling should they decide to set off walking. They had shared these concerns with the provider who had reviewed the deployment of staff and used technology to minimise risk.

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

Security of the building and perimeter of the grounds were well maintained to keep people safe.

Each person had a personal emergency evacuation plan. This is a document that describes the help a person will need to evacuate the service in an emergency. This was available to staff and there was a business continuity plan to ensure staff had immediate guidance on how to respond effectively to emergencies.

Maintenance checks had been completed in line with recommended time frames, for example, fire checks and gas certificates were up to date to ensure peoples safety.

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.

The provider assessed the number of staff required to support people and keep them safe. People told us, “No problems with the staff. If I press the buzzer they come.” And “I think there are enough staff around .” People were helped quickly if they needed support, and staff were calm and supported people with patience and understanding.

The provider followed recruitment procedures to ensure all required checks were completed before staff started work at the service. Enhanced Disclosure and Barring Service (DBS) checks were carried out. DBS checks provide information about convictions and cautions held on the police national computer. The information helps employers make safer recruitment decisions.

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.

People were supported in an environment that was clean and hygienic. The housekeeping team worked to maintain cleanliness in all areas of the service. Personal protective equipment was available throughout the home, and we saw staff used this appropriately.

Ribble Valley Care Home had a food hygiene rating of 5 (out of 5). This meant hygiene standards were very good.

The provider made sure that medicines and treatments met people’s needs, capacities and preferences. However, they did not always ensure medicines were always stored safely and relevant paperwork was correctly and consistently completed.

Food and drink thickener was not always stored safely, as required to prevent accidental ingestion and potentially fatal choking. The thickener was prescribed to 1 person and was being shared between 2 people. The provider took action to keep people safe and informed staff of the new safety measures.

To stop them losing their effectiveness most medicines, storage requirements indicate to store below 25ºC, unless it is a medicine that needs to be refrigerated, in which case storage requirements are between 2ºC and 8ºC. The provider had 2 treatment rooms where they stored medicines. Neither room had their temperature checked and recorded. They did record the temperature of the fridges and trolleys used to store medicines, but this documentation was not consistently completed or completed correctly.

Guidelines for the administration of ‘as and when’ required medicines were missing for some people. Not having these guidelines could result in the over or under-medication and poor management of people’s intermittent conditions like pain or anxiety.

Three people each had a prescribed medicine in the medicine trolley that did not have any paperwork to monitor when it had been administered and what stock was present. The provider took immediate action to update paperwork and ensure medicines were stored safely.

People told us they received their medicines when required. One person told us, “I have medication each morning, but they never miss.” We observed staff administering medication. They shared what each item was with the person and were very kind and sensitive in their approach.