Nova 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

People were safe and protected from avoidable harm. Staff were trained to recognise abuse in all forms and knew the steps to take if they saw something of concern. Some staff needed prompting about who to refer safeguarding incidents to and one safeguarding policy was out of date but this was being addressed by the registered manager. Policies and procedures were in place to support staff with managing risk. Risks to people had been identified and documented with clear guidelines for staff to take in the event of an accident or incident. Staff knew people well and were attentive, spending time with them and getting to know their needs and concerns. The staffing team were supported regularly by agency staff but these staff all worked regularly at the home and similarly knew people well. There were enough trained staff on every shift to meet people’s needs. Staff had been safely recruited.

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.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People were safe and were protected from avoidable harm. People told us they felt safe living at the service. A person told us, “Staff are very good, I have a call bell around my neck.” Another said, “Staff keep me safe.” Relatives told us they felt their loved ones lived safely, comments included, “Nice to know they are safe,” “It’s safe here, it’s warm and they have people here who can help them” and “No concerns.” People and relatives told us they were confident to raise issues and concerns and they knew that any matters raised would be resolved in a timely way. Throughout our visit we observed pleasant interactions between staff and people with staff talking with and reassuring people. It was clear people enjoyed the company of the staff and felt safe.

Staff had received training in safeguarding and received regular refresher training. Staff were able to identify the different forms of abuse and circumstances that amount to a safeguarding. Staff were able to tell us the initial steps they would take on suspecting abuse or wrongdoing. A staff member said, “I’d report to the manager or owner if needed. Safeguarding can be abuse in any form, neglect or unsafe practices.” Some staff were less clear about who else to report safeguarding issues to and had to be prompted with notifying the local authority and the Care Quality Commission.

Safeguarding and whistleblowing policies were in place. However the safeguarding policy despite having been regularly reviewed was an out dated policy. This was brought to the attention of the registered manager. The registered manager was aware of their responsibilities on discovering or being informed of a safeguarding incident. Whistleblowing is a process that allows staff to raise concerns about the service whilst protecting their anonymity. Staff told us they were confident to use the whistleblowing policy if needed.

Staff knew people well. They knew about specific risks to people for example, people living with diabetes and people with mobility issues who were more susceptible to falls. Care plans and risk assessments were reviewed monthly or more frequently in the event of an accident or incident. Staff told us they had time to catch up with people’s notes and any updates about their support needs after returning from days off. A staff member said, “I would know about a fall or other incident from handovers, if I’d been off for a few days. I always make time to read the care plans though.” The kitchen staff told us how they supported people living with diabetes with weekly and daily menus, bespoke to each person. Several people lived with diabetes. Staff told us how they managed people’s needs for example a staff member said, “They are on a pressure relieving mattress. Can be reluctant to be turned but we are supported by the district nurse team. There are no pressure sores. Staff are good at spotting and acting on issues.” A professional said, “They are pretty good at following up, they are also good at highlighting issues, contact us in a timely way.” Personal emergency evacuation plans were in place. A staff member told us, “We have fire alarm tests every Friday. We have paper copies of PEEPs, easy to get hold of if needed.”

Risks to people were documented and managed. People told us they felt supported by staff who knew them well and were aware of their medical, health and social needs. People were encouraged and supported to be independent with daily tasks and activities but without compromising their safety. A person told us, “Staff keep me safe, I ask for pain meds, I don’t always have them but can always ask.”

The service had moved to a computerised system of staring and updating information. This included care plans, risk assessments, medicines, auditing processes and daily notes and activities. Risk assessments were presented under clear headings including trigger factors, options to consider to reduce risks and actions to take in the vent of an accident or incident. Each risk had likelihood of occurrence score which was colour coded to highlight the risk to staff. Examples of risks identified included catheter care, use of bedrails, diabetes management and mobility and falls risks. A clear process for managing and reporting accident sand incidents was in place although very few had been reported recently. There was a ‘near miss’ record kept by staff, overviewed by the registered manager. Fire safety equipment was in date and accessible throughout the home. Testing of fire and other equipment was recorded and there were weekly fire alarm tests and mock drills. The home had recently installed a new fire alarm system throughout the home.

Staff were attentive to people and were available to provide support when needed. For example, we observed lunch being served. Most people were able to eat and drink independently but some required prompting and some support. Staff ensured people were comfortable and were given the correct meals. Similarly, most people were able to mobilise around the home independently. However, some people required walking aids and were more susceptible to falls. We observed staff being on hand and available to support people as they moved around without being intrusive but stepping in, for example, to hold their arm, if needed.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

During the day there were a minimum of 6 carers on duty plus, senior and specialist staff for example, kitchen, domestic and maintenance staff and managers. At night there were a minimum of 3 carers. We observed sufficient numbers of staff available to support people. Call bells were answered within a few seconds and people in communal areas requesting help from staff were attended to promptly. During mealtimes and during activities people who remained in their rooms were supported 121 by staff. Similarly, people who spent time in communal areas were supported by sufficient numbers of staff who were present and spent time talking with people.

Staff were recruited safely. We looked at 3 staff files and each contained the required documents confirming safe recruitment. Documents included application forms, photographic identification, references and in date copies of Disclosure and Barring Service forms (DBS). DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. Staff training was up to date with refresher training ongoing in all areas for all staff. Staff were supported by managers with regular supervision meetings and staff meetings. Staff told us they had opportunities to raise issues or concerns and that they were confident issues raised would be dealt with.

Feedback received from people and their relatives confirmed that there were enough staff at the home at all times. People told us that there were changes in the staff themselves but that there were always enough to meet their needs. Comments from people included, “Staff come and go, there seems to be enough,” “Staff are good, they do their best” and “Been here a few months. Very nice staff are good and would come to help me if I needed them.” A relative added, “Staff do everything they can. They did seem short staffed at one point but absolutely fine now.”

The registered manager told us they had concerns over staffing numbers and that there was a dependence on agency staff most weeks. Despite this, there were enough staff on every shift, staff rotas confirmed this. Agency staff were used but in most cases, the same agency staff returned and some worked exclusively at the home. There were therefore no adverse effects on people’s support. A member of staff told us, “Staffing can be a little pushed at times however agency help us fill the gaps. People get the support they need. It’s a good staffing team.” New staff completed a 4 week induction and ongoing support was provided through competency checks and supervision meetings. A staff member told us about their induction, “Shadowing and online training and in-house training. Deputy manager then shadowed me and finally had a meeting with (registered manager) to make sure I was confident.” The staff member added, “I have ongoing regular online and face to face training, 15 modules every year. I have regular supervisions.”

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.