Deer Park Care Centre

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

The rating for the key question of safe has improved to good. People told us they felt safe living at the service. They were supported by staff who knew them well, supported them to take positive risks and to remain as independent as possible. Potential risks to people’s health and welfare had been assessed and there was detailed guidance for staff to support people’s physical needs. However, when people were at risk of becoming distressed or anxious and communicated by non-verbal actions, staff did not have detailed guidance to support people during these episodes. Incidents had been recorded and analysed but there was limited evidence of learning to reduce the risk of them happening in the future.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their relatives felt safe to raise concerns with the service. One relative told us that their loved one “Doesn’t get overlooked and they’re very caring” and another said “They will do what [our relative] wants and we can’t ask for more” and “We know we can go in at any time." People told us “If I want help I’d just ask them” and “If I ring the bell they do come”.

Lessons had been learnt when things went wrong. One person became frustrated at times and was physically aggressive to other people. The registered manager had recognised most incidents occurred in the dining room and had deployed more staff in the dining room at mealtimes. On occasions the person ate their meals later when the dinning room was quieter and less stressful for them. Staff were aware incidents may occur in the dining room and described to us how they supported the person to remain calm or protected other people if the person did not calm. Staff and leaders understood what caused people to become frustrated and recognised the impact of changes in people’s lives on their emotional wellbeing. Staff told us they were confident to speak to a member of the management team if they made a mistake. They felt supported and told us there was always someone available to support them. One staff member commented, “They are really supportive”. The registered manager described the systems they had in operation to learn lessons. This included recording any medicines errors. Any errors were discussed with the staff member to understand if they had additional training needs. The registered manager analysed accidents and incidents each month to look for patterns and trends. They had recognised one person fell more often if they were unwell. No other patterns had been found. A complaint had been received about the care one person received at the end of their life. The registered manager had reflected on the concerns raised with staff and supported staff to share their feelings and experiences. They had also reassured staff they should continue to provide care while people had visitors. A staff member told us, “Residents have a right to complain”.

There were processes in place to record accidents and incidents and to complete analysis. When people had accidents, these had been analysed to identify patterns and action had been taken to reduce the risk of them happening again. However, incidents of emotional behaviour including aggressive behaviour towards others had been recorded and people referred to other health professionals, but there was limited action taken by staff to reduce the risk of these events happening again. Following incidents there was limited evidence learning had been used to develop strategies for staff to manage incidents. Complaints had been recorded, however, there were no details about what was in the complaint, the investigation and the outcomes. Following a complaint, a lessons learnt document was completed, but there was no information about the details of the complaint. The lessons learnt section did not clearly identify what lessons had been learnt and what action staff should take.

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 felt safe at the service, one person told us “I feel safe when I’m here” and another said “I want to stay here forever”. Relatives told us they felt their loved ones were safe at the service and they did not worry about them. One relative told us “I know [my relative] is in very capable hands and if there is a problem, a phone call will happen, so I can relax” and another said “I always ask if [they] feel safe and [they] always say yes”.

The registered manager had informed the local authority safeguarding team and CQC when they noted any safeguarding concerns. They worked with the local authority to investigate the concerns and put strategies in place to keep people as safe as possible. The registered manager met with the local authority during our on site assessment to agree safeguarding strategies for one person. Staff described to us how they would identify any potential safeguarding risks. They were confident to share their concerns with the management team and felt these would be acted on. People had been provided with information in a format they could understand about how to keep themselves safe while out and about and how to raise any concerns they had at the home or elsewhere with staff. When concerns had been raised around the safety of staff’s practice the registered manager had followed the provider’s disciplinary process. Staff who were no longer safe to work with people had been dismissed and referred to the Disclosure and Barring service for consideration. The registered manager told us there were no restrictions on visiting and people could receive visitors when and where they wished. Relatives were able to stay with people if they were at the end of their life. The registered manager was aware of the changes to regulation 9 related to visiting.

Throughout the day we spent time observing staff interacting with people. We saw that staff treated people with kindness, understanding and offered appropriate support. There was a calm and relaxed atmosphere throughout the home.

There were systems in place to report safeguarding concerns to the local authority. A safeguarding log was in place and had been completed, however, there was no specific detail about the action taken.

The service supported people to remain independent and safe whilst enabling them to do the things that mattered to them. People told us they liked to help out in the kitchen when they could, one told us “I wash up in the kitchen every Tuesday, I want to be independent and do things” and another person said “I like polishing the sink”. People told us they were supported to clean and tidy their bedroom. One person described to us how they swept the floor and made their own bed each day.

Staff described how they supported people to manage risks. Staff told us how a person's diabetes was managed, staff knew people’s usual blood sugar ranges and the action to take if they showed signs of being unwell. For example, offering them a glass of fruit juice if the levels were too low and encouraging them to drink water if they were too high. Some people were at risk of falling and action had been taken to reduce these risks. For example, with their consent a person had changed bedroom to one much closer to were they liked to spend their time during the day. This reduced the distances the person was walking. Some people used equipment to move from place to place or to stand up. Staff understood people’s needs fluctuated at times and described to us how they supported people. For example, encouraging them to stand without support or using equipment to support them to stand if they were finding it difficult at a particular time. Some people used smoking equipment including safety aprons and holders to manage risks of burns. The risks of people smoking in the building had been assessed and some people held their own cigarettes and lighter. Other people did not as there was a risk they would place themselves and others at risk by not smoking safely. Where this was the case strategies had been agreed with people to enable them to have a cigarette when they wanted too.

People were supported to take positive risks. We observed people coming and going from the service as they wished. Some people had mobile phones which they used to contact staff if they needed to while they were out. Other people carried contact information for the service in case they needed support and we observed they had this with them. Staff knew where people liked to go during the day and had made sure staff in these places had their contact details if the person needed support. Some people made themselves hot drinks when they wanted and others did their own laundry. We observed people moving freely around the building without the support of staff, this included people with visual or physical impairments. We observed staff supporting people to use equipment safely and adjust their support to meet the person’s needs at the time. For example, staff encouraged one person to stand from a chair using their walking aid. When the person struggled to do this staff supported them with standing equipment. They listened to what the person told them about how they felt at the time and used safe systems to meet their needs.

Potential risks to people's health and welfare had been assessed. When people had physical illnesses there was clear guidance for staff to support people safely, when they became unwell. When people had mental health conditions, there was information about the triggers for people. However, there was not detailed guidance for staff about how to manage episodes of distress or anxiety where people's actions put others at risk. People's care plans had not been been updated when incidents had happened to put strategies in place to help manage any future incidents.

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

People and relatives were complimentary about the home. People were satisfied with the care they received, and relatives were comfortable knowing their family members were well cared for. People told us there were enough staff to respond to their needs and provide safe care. One person said “I do like living here, it’s so nice with people around and the staff are kind”. A relative told us “They are wonderful, we can’t fault them, they helped us as a family as well as [our relative], that goes a long way”. Another relative said “I’m amazed by the quality and the care, the care workers are phenomenal”.

The registered manager told us they used a dependency tool to assess how many staff were required on each shift to meet peoples needs. Staff told us there were enough staff on duty and they had time to spend with people and were not rushed. The registered manager told us staff completed a 2 week inductions where they worked alongside experienced staff to get to know people and their preferences. New staff we spoke with confirmed this. Staff also completed a number of training courses, including practical moving and handling training, safeguarding, mental capacity act and fire safety as well as training around people’s needs such as mental health and learning disability. Staff confirmed they had completed this training and this had supported them to feel confident in their roles. A plan was in place with the local district nursing service to train some staff to administer people’s insulin. The registered manager described the system they had in place to support staff in their roles. Staff told us they met with a supervisor every 3 months and discussed their role as well as any development needs. A staff member told us they had been supported to develop in their role and had gained a promotion.

We observed throughout the inspection that staff were attentive to people’s needs and responded quickly to requests for support. Communal areas were not left unattended and people had staff on hand when needed.

Staff had received training appropriate to their roles. They received regular supervision to discuss their roles and to identify any training needs. New staff received an induction and their competency was assessed before they started to work independently. Staff had been recruited safely. Checks had been completed on staff’s character and conduct in previous roles. Identification checks had been completed.

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.