61 Kings Road Harrogate

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 the legal regulation in relation to good governance. 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. The provider had systems to learn from incidents and complaints. Accidents and incidents were recorded, and there was evidence of review and action taken. Action plans were tracked, and lessons learned were shared in team meetings.

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. Care records, including ‘hospital passports’ were accurate and up to date. Transitions were managed well, with clear communication between services.

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. Staff were trained in safeguarding and understood their responsibilities. People told us they felt people were safe living at the home. One person told us they felt safe and enjoyed joking with staff. A relative said, “It feels extremely safe. I trust them with [person].”

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that appropriate DoLS applications had been submitted where required, and authorisations were in place. Records showed that conditions attached to authorisations were being met, and staff monitored these effectively. This meant the service was acting lawfully and protecting people’s rights while ensuring their care needs were met.

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. Risk assessments were person-centred and regularly updated. People, and their relatives, were involved in decisions about their safety, including best-interest processes where needed.

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 home was well maintained and adapted for individual needs. Regular health and safety, and environmental checks and audits were carried out.

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. All required recruitment checks were in place. Staff received a range of training, and regular supervision and competency assessments.

We received mixed feedback about staffing from relatives; some relatives wanted more staff in the evenings and weekend, others felt there was sufficient staff to support people and do the things they wanted. Relatives said, “It’s very well staffed” and “Staff in the evenings and weekends; not nearly as much cover as there should be.” Review of rotas, activities and feedback we received, indicated that people received the hours they were commissioned for; including any 1:1 hours. Staffing was based around people’s needs and preferences and people were undertaking the activities they wanted to do; including a wide range of community-based activities. There was also evidence of regular review with local authority commissioners. This included a recent request for additional hours for one person, which was granted. Staff told us staffing levels allowed them to provide the support people needed. Managers demonstrated there was flexibility to adapt to people’s changing needs and preferences. They told us they would also offer to discuss staffing arrangements further with all relatives, to ensure people had the opportunity to raise any concerns they had.

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. Infection Prevention and Control (IPC) audits were completed regularly. Personal Protective Equipment (PPE) was used appropriately, and the home was clean. Relatives said, “The house is clean and tidy” and “It’s a lovely place, clean and well kept.”

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. People were given their medicines safely and in a timely manner. This was recorded on their medicines administration record (MAR) and medicines were stored safely and securely.

Detailed guidance specific about each person, on how to administer medicines prescribed as and when people required them, was available to staff. The service had individual fire risk assessments in place for people who were prescribed paraffin-based skin products. There were records of people’s preferences to indicate how they wanted their medicines to be administered. Records showed that staff had received medicines handling training. Staff competencies were assessed regularly to make sure they had the necessary skills. Managers and members of staff, qualified to handle medicines regularly, completed audits (checks) to make sure that procedures were followed.