Abney Low Nursing home

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

We assessed all quality statements in the safe key question and found areas of good practice. The assessment of this key question found improved practice since the last inspection, our rating for this key question has improved to good. Lessons were learned from safety incidents and shared with staff to help improve practice. Incidents were appropriately investigated and reported. People were protected from the risk of abuse and harm. Risks to people were assessed, mitigated and managed by staff who understood them. The service provided a safe and hygienic environment for people to live. Staff were recruited safely. There were appropriate staffing levels and skill mix to ensure people received safe, good quality care that met their needs. People’s medicines were managed in a safe way. People’s behaviour was not inappropriately controlled by medicines. There were appropriate arrangements for the safe management, use and oversight of controlled drugs.

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.

People's feedback confirmed there was a culture of safety and learning and that risks to people were managed and not overlooked. People’s relatives also told us they did not have any concerns and told us they were contacted if anything happened to their family member. One relative commented, ‘I'll get a phone call straight away if [Name] has had a fall, if they’re having a bad night - they [Staff] keep me posted’. When reviewing care after an incident another relative confirmed, “They [Staff] do discuss it with me.”

Feedback from staff and leaders confirmed safety was a top priority for everyone and that risks were not overlooked or ignored. Lessons learnt from safety events were communicated to help support improvement. Staff were encouraged to raise concerns. Staff told us they had no concerns about people’s safety and if they did, they would raise it with the manager. Staff knew about the providers policy and procedure for reporting and recording accidents and incidents and were confident about what steps they needed to take if an accident or incident occurred. One member of staff told us, “I would tell the manager or nurse in charge right way about any incidents. There are forms we fill in about what happened.”

Processes were in place to help ensure risks were treated seriously and safety and learning were part of the culture of the service. Policies were in place to help ensure people’s safety, such as a whistle-blowing and safeguarding policy. Staff had completed safety related training, including safeguarding.

People's feedback confirmed that safety and continuity of care was treated as a top priority in the home. People were happy with their transition into the home and told us any equipment they required was always available. One person confirmed, “Equipment is always available, wheelchair, hoist and sling.” People also told us they were supported to access health professionals when needed. Comments from people included, “They [Staff] were quick to call the GP” and “The podiatrist comes regularly, and I am waiting for the optician”. Relatives told us they were kept informed regarding any referrals made.

Staff and leaders understood their responsibilities for ensuring safe systems of care including working with other professionals and services, to help ensure people received continuity of care. Staff told us they were confident in recognising and responding to any changes in people’s needs. Comments included, “I’d tell the nurse right away” and “I’d check the resident and refer if needed.” Staff explained how they were kept informed about people’s needs. Comments included, “We are kept up to date from care plans and daily notes” and “We have shift handover meetings to pass on information about the residents including if they have any appointments and arrangements for them.”

Feedback from partners confirmed the service worked well with them to ensure people received the care they required. We saw written feedback from one professional who described staff as engaging.

Processes were in place to help ensure people received continuity of care and appropriate referrals when needed. Referrals were uploaded to people’s electronic care records with advice or outcomes being recorded in people’s care plans.

People’s experience confirmed they were protected from the risk of harm, abuse and neglect. People were supported to understand what being safe meant to them and how to raise concerns. People told us they felt safe living at The Anchorage and relatives confirmed this. Most people knew who to speak to if they did not feel safe. One person told us, “I’d tell the office.” People told us they were treated well. One person told us, “Yes, they [Staff] are nice.” Another person told us “Staff are sound.”

Feedback from staff and leaders confirmed there was a strong understanding of safeguarding and how to take appropriate action. Staff confirmed they had completed safeguarding training and that they knew about the providers whistle blowing policy and procedure. Staff understood their responsibilities about protecting people from the risk of abuse and harm. Staff described the different types of abuse and signs to look out for which may indicate abuse has or is taking place. One member of staff told us, “Abuse can be many different things, such as physical or verbal and neglect. I would be worried if I saw a bruise or mark on someone.” Staff knew the procedure for reporting any safeguarding concerns. Comments included, “I would keep residents safe and report to manager or nurse in charge right away” and “I’d make sure everyone is safe, put in a safeguarding concern to the Local Authority. I know I would need to let CQC know too.”

We observed staff treating people well. We observed staff comforting and reassuring a person who appeared anxious and upset. A staff member sat next to the person and spent time talking to them about how they were feeling, visibly reducing the person’s distress.

Processes were in place to help people receive care in a safe way and to help keep people free from the risk of abuse and harm. There was an easy read safeguarding booklet available to people, to help people understand how to raise any concerns.

People’s experience confirmed they were informed about any risks and how to keep themselves safe. People told us they felt supported to manage their risks, were involved in decisions and that staff explained anything that may pose a risk. One person commented, “Yes, they [Staff] involve me.” Relatives also told us they were kept informed of any changes to their family member’s needs.

Feedback from staff and leaders confirmed they understood the risks to people and how to keep them safe. The area manager explained how alerts on people’s records were activated to notify of risks and how discreet symbols were used on people’s door frames to notify staff and visitors of potential risks.

We observed staff keeping people safe. We observed one person being supported to smoke outside the home who required assistance from staff when mobilising, this assistance was provided in a safe way.

Processes were in place to help ensure there was a balanced approach to risk in line with their choices and ability. Assessments reflected positive risk taking and the abilities of each person and were reviewed in a holistic way. Care plans were updated to reflect people’s current needs and wishes.

People’s experience confirmed they were cared for in a safe environment, and that the home was clean and safely maintained. One person told us, “They're always doing something in the building, they painted everywhere, and it looks tons better.”

Feedback from staff and leaders confirmed they had completed training in health and safety. They showed a good understanding of their responsibilities for ensuring a safe environment and the safe use of equipment. One member of staff told us, “I am up to date with all my safety training. I’d report any concerns right away to the manager.” Another told us how care plans included information about the equipment they needed to use to keep people safe.

We observed the environment of the home was safe and well maintained. Fire doors were closed and closed securely into their rebates. Health and safety notices and guidance was displayed around the premises.

Processes were in place to help ensure the safety of the environment and equipment. Safety checks on the environment and equipment were carried out at the required intervals and prompt action was taken to address any safety concerns. An up-to-date PEEP (Personal emergency and evacuation plan) was completed for each person and regularly reviewed, to help ensure people could be removed from the building safely in an emergency.

People’s experience varied with regards to having enough staff to help support them to meet their needs. Comments included, “Not enough staff, they are always short” and “Need more staff as it can make the job more difficult for them as there are not enough.” However, other people told us there were enough staff on shift. People told us staff knew how to do their job and were well trained.

Feedback from staff and leaders confirmed there was enough of them on duty to support people safely. Comments included “The home has really improved. There is always enough of us to help people.” Another staff member told us “Yes, I feel there are enough staff. I have no concerns around staffing."

We observed people receiving high quality care which met their needs. We observed staff spending time with people helping them with puzzles and asking them what songs they would like on. One staff member was helping someone choose what they would like for breakfast. Staff had time to ensure people were comfortable and offered people choices, such as a choice of a hot or cold drink.

Processes were in place to ensure staff were recruited safely and supported to perform their role in a safe and competent way. Staff had completed a full induction all mandatory training aligned to the principles of the Care Certificate. Staff could also source additional courses when needed. Staff recruitment records were safe and well organised.

People’s experience confirmed there were good standards of hygiene in the home. People told us the home was clean and well maintained. People told us staff wore PPE (Personal Protective Equipment) when supporting them with personal care.

Feedback from staff and leaders confirmed there were clear roles and responsibilities around infection control. Staff confirmed they had completed IPC and PPE training and had access to IPC guidance. They explained safe IPC practices including the safe use of PPE and disposal of waste. Staff told us they had access to PPE. Their comments included, “Yes, I’ve had IPC training” and “There’s always plenty of gloves and aprons.” Domestic staff told us they had plenty of cleaning products and equipment.

We observed the environment and equipment were clean and hygienic. There was a good stock of PPE located around the home and staff used and disposed of it safely. Staff were observed maintaining good hand hygiene practices and using appropriate PPE when required.

Processes were in place to ensure the risk of the spread of infection was minimised. Cleaning schedules were followed for both the environment and equipment. Regular IPC audits were completed, and any improvements notes were promptly acted upon.

People’s experience confirmed they received their medicines as prescribed and on time. One person told us, “Yes, it's on time and regular.” People’s relatives told us they were kept informed of any changes. One relative confirmed, “The nurse discussed a medicine with me as it changed to a liquid and then changed back with my consent.”

Feedback from staff and leaders confirmed how procedures around medicines had been overhauled since the last inspection to help improve safety. The area manager told us, “There is new paperwork in place for better oversight and management. We have new PRN (as and when required medicines) protocols. This is good guidance for staff, and we have pain checking tools in place to use which compliments the PRN protocols.”

Processes were in place to ensure medicines were given in line with best practice guidance and appropriate arrangements were in place for the safe management, use and oversight of medicines, including the use of controlled drugs. Processes were in place to help ensure people were involved in decisions about their medicines including their reviews. Reviews took place with the person’s GP and Pharmaceutical representative. Medicine audits were completed monthly. Any actions were assigned, and lessons learnt where errors had been found. This included supervisions with individual staff members.