Cleveland House

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 requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

The provider was previously in breach of legal regulations in relation to safe care and treatment. Improvements were found at this assessment, and the provider was no longer in breach of this regulation.

This service scored 75 (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.

Accidents and incidents were recorded. Those records were reviewed by the registered manager and actions taken to reduce the likelihood of them happening again. Learning from incidents and investigations took place as these were discussed during staff meetings. Procedures were in place for staff to follow in an emergency. There was an on-call system in place so there was always a member of the management team available. A member of staff told us, “We have phone numbers in the office of people we can contact in an emergency."

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored.

Before people started to use the service, an initial assessment was carried out of their needs. This included all aspects of care, such as the person’s mobility, their nutritional needs, personal hygiene care, medicines, and social lifestyle. The management team obtained as much information as possible from people and their relatives to ensure they had enough information to enable them to meet people’s needs. This helped to ensure people received care from staff who understood their health conditions or preferences in how care and support were delivered to people. The registered manager explained their processes of how they managed transitions into the service. People and their relatives were encouraged to visit the service as part of their transition plans. People also stayed overnight and there were appropriate processes in place to ensure people who did so were safe and appropriately cared for.

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 who used the service were protected from the risk of abuse. The provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. The service had policies and procedures in place for safeguarding adults. This subject was discussed during staff meetings and supervisions.

People told us they felt safe at the service and did not raise any concerns on the way staff supported. A person said, “It is a safe place, the staff are always very helpful and kind.” A relative told us, “The home is safe and yes [person] is safe there.”

Staff had received safeguarding training. There were procedures for staff to escalate any concerns to external agencies. The registered manager and staff were aware of their responsibilities on how to protect people from abuse. A member of staff told us, “I will report any safeguarding immediately to my manager.”

Staff knew how to escalate any concerns that they might have to external agencies.

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.

At our last inspection, we found that systems were not always in place to effectively assess and manage risks to people while they received a service.

During this assessment, we found risks about people’s safety were assessed to ensure they were supported to remain as safe as possible.

Risks to people were assessed and monitored. Each person had a range of risk assessments specific to them; these included environmental risks and any risks due to their health and support needs. Where the staff had identified a risk, there was guidance in place to address how the risk could be prevented or minimised. For example, when people went out in the community. Risk assessments were reviewed on a six monthly basis or more regularly if there was a change in the risk to the person. Staff knew about people’s health needs and ensured they were safe when carrying out any task. Support plans contained clear instructions for staff to follow.

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

At the last inspection, we noted that the systems were either not in place or robust enough to demonstrate safety was effectively managed.

During this visit, we found this had improved. The provider had a system to ensure all equipment was maintained and serviced. We looked at records which confirmed that checks on the premises and equipment were carried out to ensure health and safety of people, staff and visitors to the service. We saw checks had been carried out on the electrical hard wiring and gas appliances.

People had a personal emergency evacuation plan (PEEP) in place. These are documents which advise of the support people need in the event of an evacuation taking place.

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.

There were sufficient numbers of staff working at the service to meet people's needs. The registered manager ensured there were enough staff on duty on each shift to keep people safe. This included when people were transitioning to the service.

People and their relatives told us there were enough staff working for the service. We reviewed the staff rota and this showed there were enough staff on duty. Some of the staff had worked at the service for some time. This helped people to receive consistent care from staff who knew them.

The provider had effective recruitment procedures to make safe recruitment decisions when employing new staff as checks had been undertaken before they started working for the service. Checks included staff’s previous employment history, proof of identity, written references, criminal records check and their right to work in the United Kingdom. This helped to prevent unsuitable staff from working with people who used care and support services.

People were cared for by staff who were supported to deliver care and support safely and to an appropriate standard. The provider had a training programme in place for all staff to complete whilst they were employed at the service. Staff had attended various training programmes related to their roles, such as safeguarding adults, medicine management, infection control, moving and handling, and health and safety. Staff told us the standard of training was good. One member of staff said, “We have regular training as well as refresher training when they are due.”

Staff were given appropriate support which helped to ensure they were able to provide effective care. Staff had regular one to one meetings with their line managers, where a number of areas were discussed such as their training needs and people’s care needs. A member of staff told us, “I had my supervision not long ago, we discussed different things, like training, and how I am doing etc.”

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 provider had policies and procedures regarding the prevention and control of infection. Staff were aware of their responsibilities regarding infection control and prevention. Staff had received training in this area, and they were provided with personal protective equipment (PPE) such as gloves and aprons to protect the spread of infection.

At the last inspection, we noted some of the flooring needed deep cleaning or renewed and some areas of the service needed redecorating. Work had happened and was on-going when we inspected. The lounge/dining room was being painted on the day of our visit. There was also plan to replace the worktop in the kitchen and to refurbish the bathrooms and shower room.

People told us they received their medicines when they needed to have them. A person told us, “Staff help me take my medications.” Relatives did not raise any concerns about the way staff help people with the medicines.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities, and preferences. Staff involved people in planning, including when changes happened with their medicines.

At the last inspection, we found people’s medicines were not always managed safely because we found shortfalls around the provider’s arrangements to make sure people received their medicines safely. We noted the temperature in the room where the service kept their stock of medicines as well as the controlled drugs was above the recommended level. There was also no clear guidance for staff on protocols they should follow for PRN [when required] medicines.

During this assessment, we found the provider had taken actions to ensure there were suitable arrangements to protect people using the service against risks associated with the unsafe management of medicines. Medicines were stored at the recommended temperature. Where people needed assistance to take their medicine, there was guidance in place on how staff must support them. People were supported with their medicines in a safe way by staff who had been appropriately trained.