- Care home
McRae Lane
Report from 14 August 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
People were protected from the risk of abuse or harm. Staff understood their duty to safeguard people and what action to take to make sure people would be protected. Safety concerns were dealt with in an appropriate way. Risks to people were managed well. Staff understood how to reduce risks to keep people safe from injury or harm. People were supported to live in a safe environment, which was regularly checked and maintained to ensure risk to people was minimised. There were enough suitably skilled and experienced staff to support people. Staff received relevant training to meet people’s needs. Staff were supported through supervision and appraisal to continuously learn and improve their working practice. Recruitment checks were undertaken on staff to make sure they were suitable to support people. Staff followed current practice to ensure infection risks to people were minimised. People received timely support with their medicines and these were administered as prescribed.
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 were supported to live in an environment where their safety was a priority. A relative and 2 advocates for people using the service were confident that staff took appropriate action to address any safety concerns and made sure learning from concerns was reflected in their practice.
Staff understood how to record and report safety concerns so that appropriate action could be taken to support people. The home manager encouraged a culture of openness and honesty at the service. They told us, “I really encourage an open place of work. I also encourage a place where staff are encouraged to observe people, as people here are non-verbal, and to raise anything of concern.”
Systems were in place to support prompt reporting and investigation of safety concerns, should these arise. The service had policies and procedures in place which required learning from investigations to be used to support staff to continually improve their practice and provide safe, high quality care to people.
Safe systems, pathways and transitions
People’s safety was managed well when they first started using the service. Information was obtained about people’s individual needs and risks to their safety and used to ensure people received safe and appropriate care and support as soon as they started using the service.
The home manager made sure people, and others involved in their care, were involved in assessments and planning of their care and support, to aid a smooth and safe transition when they started to use the service.
We contacted health and social care professionals that worked with the service for their views about safe systems, pathways and transitions, but we did not receive any feedback.
Systems were in place to help staff identify and report safeguarding concerns to the relevant persons and agencies. The registered manager understood their duty and responsibility to work in line with the service’s policy and procedure for safeguarding people. This included making timely referrals and working proactively with agencies to ensure people were safeguarded from further risk.
Safeguarding
People were safe at the service. Staff supported people to live in an environment where they were protected from the risk of abuse, neglect, bullying or harassment. A relative told us, “I do think [family member] is safe at McRae Lane. What makes me think that? It’s just the staff and the way they are with people and their attitude. I don’t have any concerns about the staff team and the way they support [family member]…I’ve never seen anything untoward towards [family member] or to others at the home.” An advocate for people using the service said, “I feel people are safe and I have no concerns about people’s safety.”
Staff understood their responsibility to safeguard people and received relevant training and support to do so. A staff member told us, “You should be vigilant and if you notice anything that is not right you report to the manager. You make sure you record all the information you get. You make sure people are safe within the environment to prevent harm. I would also say providing the necessary daily needs is important as without these [people] are being neglected.” The home manager undertook checks to seek assurances that people were safe using the service. They told us, “I do my observations of staff and the culture and have conversations with them if I see behaviours that concern me. I also do unannounced spot checks and calls to the service.”
The service was calm, relaxed and homely. People responded in a positive way when staff interacted with them which indicated they were comfortable and at ease being supported by them. Staff were attentive to people and alert to any changes that might indicate people were experiencing discomfort or anxiety.
Systems were in place to help staff identify and report safeguarding concerns to the relevant persons and agencies. The home manager understood their duty and responsibility to work in line with the service’s policy and procedure for safeguarding people. This included making timely referrals and working proactively with agencies to ensure people were safeguarded from further risk.
Involving people to manage risks
Risks to people were managed well. Staff made sure risks to people’s safety and wellbeing were mitigated to reduce the risk of injury or harm to them. An advocate for people using the service told us, “Management of risk has definitely improved under the current manager and they have robust risk assessments in place and the staff team are well supported by the manager if they need more guidance.”
Staff understood risks to people and how these should be managed to keep people safe. A staff member told us, “The information about risks to people are in their support plans. You have to make sure you have read this and understood this and know how to provide care that suits their needs.”
People could move freely around the service and spent their time as they wished, with no unnecessary restrictions. Staff were aware of where people were and remained present and available in case people required their assistance.
Systems were in place to ensure risks to people were continually assessed, monitored and reviewed. People’s care records contained information and guidance for staff on how identified risks should be managed to keep people safe from injury or harm.
Safe environments
People were supported to live in a safe environment, which was regularly checked and maintained to ensure risk to people was minimised. An advocate for people using the service told us, “The staff have been trained to use equipment to support people. They know exactly where people are and they are hot on making sure there are no safety issues that might affect people.”
Staff understood how the environment and equipment could pose risks to people’s safety. They knew how to minimise these risks to keep people safe. A staff member told us, “I make sure that whatever task I am doing is safe. For example, if I am hoisting I make sure the equipment is safe and ready for use. I will check it’s been serviced. You make sure that anything you are working with in the service is safe for use and won’t cause any harm. In the environment it’s making sure it’s free from clutter. Any spillages should be cleaned up. Anything that could cause harm you have to make sure this is dealt with to keep people safe.”
The layout of the home supported people to move around freely. The environment was clean, tidy and free from slip or trip hazards. Grab rails were placed at an appropriate height around the home. Adaptions had been made to support people’s sensory needs. Staff were confident using equipment when supporting people. Equipment appeared in good order.
There were arrangements in place to ensure safety systems and equipment used at the service were maintained and serviced at regular intervals. Staff undertook health and safety checks of the premises at regular intervals. The provider acted promptly to address any safety concerns identified through these checks. This helped to ensure the environment, and equipment used, remained in good order and safe for use.
Safe and effective staffing
People experienced continuity of care as they were supported by a consistent and experienced staff team who knew them well. An advocate for people using the service told us, “It’s the same staff team and I think that’s great for consistency and those staff know people really well and their needs.”
Staff received relevant training to support them in their roles. The home manager encouraged them to continuously learn and improve their working practice. The home manager said, “I really try and push staff to be confident and understand their roles and why we do what we do, for example, why do we support someone with a specific medication? It’s the bigger picture for people and getting staff to look beyond doing a task but understanding why this is important for the person.” Staff were allocated enough time to undertake their duties and meet people’s needs. They worked well together as a team to ensure people’s needs were met. The home manager told us staffing levels at the service were reviewed regularly to make sure there were always enough staff to meet people’s needs.
Staff were present, available and provided care and support to people when they needed this. People did not wait long to receive care and support from staff. Staff were observant when people were moving around and made sure people remained safe at all times.
The provider operated safe recruitment practices which meant only suitable staff were employed to work at the service. There were enough staff to meet people’s needs. Staffing rotas were planned well in advance based on people’s dependency and needs. Staffing levels were consistently maintained which ensured continuity of care for people using the service. Staff were provided with regular and relevant training to meet people’s needs. They were supported through a well-established programme of induction, supervision and appraisal to continually learn and develop in their roles.
Infection prevention and control
Risk to people was mitigated because staff working practices reflected current national guidance and practice for management of infection risks.
Staff received relevant training and knew the processes to follow to minimise the risk and spread of infection. The home manager undertook checks to ensure risk of infection to people was minimised. They told us, “I do my own checks and visual checks to make sure staff are following this and the place is clean and tidy.”
The environment was clean and hygienic. Staff wore appropriate PPE when this was required. Handwashing guidance was displayed to prompt good hand hygiene practice. Bathrooms and toilets had hand wash, hand towels and sanitiser readily available to support this practice. Food preparation areas were clean and clear. Food in the fridge and freezer was in date and clearly labelled.
Arrangements were in place to manage infection risks. All staff had completed infection prevention and control and basic food hygiene training. There were sufficient supplies of PPE for staff to help them minimise infection risks. Staff maintained cleaning and food safety records to provide a clear audit trail of measures taken to reduce infection risks. The provider’s infection prevention and control policy was current and reflected national guidance.
Medicines optimisation
People received their medicines safely and as prescribed. Staff followed current national guidance and practice for safe administration and management of medicines.
Staff received relevant training and understood the processes to follow to support people with their medicines, including accurate recording of medicines administered. The home manager undertook checks to make sure medicines were administered and managed safely. They told us, “We do medication audits and I check these and I check the stock, balances and records to make sure this is all in line with our policies. We have streamlined our paperwork around this and made sure our audit trail is clear.”
There were regular audits of medicines at the service. This included checks of staff’s practice to ensure they remained competent and safe to administer and manage medicines. Medicines stocks, balances and records showed people consistently received the medicines prescribed to them.