- Care home
Aspen Manor Care Home
Report from 6 June 2024 assessment
Contents
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
Improvements had been made to partnership working with external agencies and this continued to be an area of focus for further improvement. Systems and processes meant people’s health care needs were shared and responded to, including referrals and access to health care professionals. Records and actions to mitigate risks to people’s health, safety and wellbeing had improved. There was a proactive culture to support learning from incidents. Effective processes and training of staff in safeguarding supported people to live in safety. Staff were recruited safely, and there were sufficient experienced and skilled staff to meet people’s needs. Systems, processes and staff training meant people received their medicine as prescribed. The environment was well maintained, which included good infection prevention and control practices.
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.
Learning culture
People and relatives spoke of open communication, which meant they were kept informed of any changes regarding safety, health and wellbeing.
Managers encouraged staff to raise concerns when things went wrong and staff meetings were held to discuss any incidents, accidents or safety alerts. Information was shared with staff about people’s needs including any changes in their health, safety and wellbeing. Managers from the provider’s 3 care homes met regularly to share any lessons learnt and good practice. The registered manager had improved processes to support the monitoring of people’s food and fluid intake.
The provider had processes to share information regarding incidents, accidents, safety alerts, safeguarding concerns and complaints. Weekly manager meetings were held and action plans developed, which were communicated to all staff to support continuous learning and improvement.
Safe systems, pathways and transitions
People told us they could access healthcare and other services they required, and were supported to do so. One person said, “The doctor comes every week, I was told the results from my tests.”
Managers told us about the work they undertaken to improve relationships with partner agencies and healthcare professionals. They attended networking meetings with the local authority and external healthcare professionals. Staff told us how they contacted healthcare professionals such as GP’s and dietitians. There was a weekly GP ward round so people who required any medical review could be seen, however if the need was more urgent additional GP visits were requested.
Partner agencies views were mixed, which included the need for continued improvement to ensure referrals to health care professionals were timely. All partner agencies spoke of improved communication with management and staff of the home. Improvements by partner agencies had also noted improved internal communication and sharing of information as to people’s needs amongst the staff team.
Systems and processes for safe partnership working had been reviewed and changes made to bring about improvement. Risks were assessed and where risk was identified the appropriate health care professional was consulted to support safe systems of care. People had a ‘hospital pack’ should they require admission to hospital, which included information about their health and wellbeing, medicine, care and preferences. This supported the safe pathways of care when people moved between services and settings.
Safeguarding
People told us they felt safe and were asked if they had any concerns. A person told us, "I couldn't be anywhere better, this is a wonderful place. They really want you to speak up and say."
Managers kept under review all safeguarding concerns and incidents and shared any learning or changes made in response with staff. Staff were confident about speaking up if they had any concerns and assured any concerns raised would be listened to and the appropriate action taken.
Staff supported people consistent with their risk assessments and care plans to promote people’s safety, which included supporting people during periods of anxiety and distress. Staff interactions with people were positive, respectful and compassionate.
Safeguarding systems and processes were in place, underpinned by staff training and policies, which included a whistleblowing policy supporting staff to ‘speak up’. Safeguarding meetings were attended by a member of the management team and any lessons learnt from these were implemented and shared with staff. Processes for supporting people who did not have capacity to make an informed decision, including best interest decisions were recorded within care plans, along with information of authorised Deprivation of Liberty Safeguards (DoLS).
Involving people to manage risks
People told us they felt safe and spoke of staff supporting them to manage risks, which, included making decisions and choices.
Improvements had been made to reduce risks, promoting people’s safety. For example, the number of falls people had within the home had reduced following regular meetings held and advice being sought and implemented from a dedicated team of local authority staff who focused on falls prevention and reduction. Staff were aware of the action to take in the event of an accident or incident, which included the seeking of medical attention. Staff were confident and knowledgeable as to how people’s risks were to be managed, which included responding to accidents and incidents, and the seeking of medical advice.
People were supported in the least restrict way to manage risks when moving around the service. Assistive technology was used to reduce risk, which included motion sensors and mobility aids to prevent falls and encourage independence. Staff took action to reduce known risks and promote people’s safety. For example repositioning of people and the use of pressure relieving equipment to prevent sore skin.
Risk assessments and care plans were in place. For example, risk was assessed for developing pressure sores, falls and malnutrition. Where risk was identified, staff took appropriate action such as regular positional changes and use of specialist mattresses to prevent pressure sores. Assistive technology was used to reduce risk of falls such as motion sensors and people had their food and fluid intake monitored to ensure they had enough to eat and drink. All accidents and incidents were recorded, reported and analysed for trends and patterns; changes were made to reduce further risk. Processes were in place to record accidents and incidents, which were analysed to identify patterns and themes, so action could be taken to reduce risk. Risks were assessed and kept under review.
Safe environments
People were happy with the environment; this included their private room and communal areas. They said the premises were well maintained and to a good standard.
Managers told us they carried out a daily walk around of the service to check both the premises and equipment were in good working order. Staff told us any maintenance concerns were documented within the maintenance book and quickly dealt with by the maintenance team.
All areas of the service were furnished and decorated to a high standard, and equipment was in good working order.
Systems and processes were in place to support a safe environment. Records showed systems and equipment were maintained and inspected by external companies to promote people’s safety, including gas, electrical, fire, passenger lifts, and moving and handling equipment.
Safe and effective staffing
People said there were enough staff and made very positive comments about them. One person said, “they are all wonderful.” Another person said, “The carers are smashing.”
Managers spoke of people’s needs being met as they had a full compliment of care and support staff. Staff told us they were supported to do their jobs, through supervision and training. They said there were enough staff on each shift to meet people’s needs and keep them safe. A staff member told us, “Staffing is a lot better they [managers] do fight our corner and listen to us.” Staff felt they had enough training and support and described the training they had attended and the positive impact this had on care delivery.
Staff had the skills and knowledge, and were employed in sufficient numbers to meet people’s needs. Staff knew people well and were positive and respectful in their interactions, and responded to requests for assistance a timely way.
Processes were in place to support safe recruitment practices, including induction and training. Regular supervision and ongoing monitoring of staff provided an opportunity to discuss performance and any learning and developmental needs. Staffing numbers were kept under review and were based on the needs of people, with consideration being given to the skill mix of staff required. Short notice staff absence was managed by the use of existing staff or agency staff.
Infection prevention and control
People were happy with the cleanliness of the service. They told us their rooms were cleaned daily and to a high standard.
Managers carried out daily check to ensure the service was clean and staff were following safe policies and procedures for the prevention of infection. Staff confirmed they had access to personal protective equipment, including gloves and aprons. Staff were knowledgeable about what to do in the event of a suspected infection to reduce the likelihood of it spreading.
All areas of the service were visibly clean. Staff wore personal protective equipment and disposed of waste correctly to keep people and themselves safe from the spread of infection.
Systems and processes assessed and managed the risk of infection and promoted people’s safety, health and wellbeing, underpinned by the provider’s practices in line with their infection prevention policy. The local authority prevention and control team undertook an audit in February 2024. The overall score was 99%, which included a score of 100% for governance and care planning, and environmental cleanliness.
Medicines optimisation
People told us they received their medicines at the right time and in the right way. People who wished to, were supported to manage their own medicines.
Managers spoke of improvements made to medicine systems and processes, which had reduced medicine errors. Staff said they had undertaken training in medicine management and had their competency assessed.
The provider’s role in relation to people’s medicines was clearly detailed in relevant policies, procedures, and training. Current and relevant professional guidance about the management of medicines was followed. Medicines were given as prescribed and recorded and stored securely consistent with the policy. People were given their medicines safely and at the right time. There was a person centred approach to support people to have their ‘when required' medicines when they need them. Improvements had been made to the management of Insulin, which had included additional training. Protocols were in place so staff knew when Insulin should and should not be given based on people’s blood glucose levels. The service had a process for identifying areas for improvement in medicines management. They completed regular medicine management audits to ensure they were delivering safe and effective care.