- Care home
Canal Vue
Report from 21 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
We identified some improvements were needed in people's care plans and risk assessments because they were not always up to date. Provider was working towards ensuring all aspects of health and safety were met. People were protected from abuse and avoidable harm. Their liberty was protected where this was in their best interests and in line with legislation. Mental capacity assessments were completed whenever needed. When people raised concerns about safety, they felt they were taken seriously and issues resolved promptly. People were supported to make choices that balanced risks of harm with positive choices about their lives. Medication was managed safely. Everyone noted positive changes to staffing levels and and we observed there was enough staff on the day of our inspection. Staff were skilled and recruited safely. The home was clean and tidy.
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 felt safe at the home and staff were open and transparent with them. People and their relatives could raise concerns without feeling blamed or treated negatively. Risks to people’s health and safety were taken seriously and lessons were learnt from incidents. For example, one relative said, “My [relative] fell out of bed so staff put measures in place to keep them safe and prevent from hurting themselves.”
Safety of people and staff were the provider’s main priority. Leaders were open and transparent and displayed a positive culture to learning. They had plans to further drive improvements at the service. For example, to hold more frequent and structured staff meetings to improve care for people. Care staff felt confident and supported by the leaders when raising concerns.
Leaders had systems in place to record accidents and incidents. However, further work was needed to ensure that this data was analysed for patterns and trends. Leaders had developed new processes to ensure that feedback was shared with people and staff regularly to allow people to reflect on lessons learned from incidents and accidents.
Safe systems, pathways and transitions
Safety issues were resolved promptly. People felt safer since the new arrangements of increased staffing ratio at the home. People and their relatives’ comments included: “When another resident used to hit my [relative], I talked to the staff about it, and they resolved it.” “I did think it was not always safe. Some of the residents bullied my [relative] last year. That has now got better.”
Leaders collaborated with partner agencies to ensure a smooth admission of people into the service. For example, prior to a person moving into the service, leaders liaised with community mental health services, the district nursing team, and GPs. Leaders were aware of the importance of continuity of care and ensured they captured enough information to meet people’s needs. Staff were aware of risks to people and supported them to reduce the risks and to keep people safe.
Partner agencies noted improvements in how the provider managed and assured people’s safety. One professional said, "The home had managed [person's] needs sensitively, they demonstrated knowledge and experience in managing their challenging needs. [Person] was placed on regular and frequent observations and staff worked hard to engage [person] with their interests, they managed concerns and risk well by consulting with the dementia outreach team, the D.O.L.s team and the Safeguarding team".
Systems and processes identified risks to people across their care journeys. Leaders collaborated with partner agencies, for example the Local Authority, to address risks to people’s safety. As a result, the number of safety incidents, such as altercations were reduced. Due to the joined- up approach and arrangements in place, people’s care was organised with them together with partners and communities in ways that ensured continuity.
Safeguarding
People felt safe living at Canal Vue. Relatives reflected on how staff improved people’s safety and put measures in place to reduce the number of safeguarding incidents. People and their relatives were supported when they expressed concerns about safety.
Leaders understood their responsibility of keeping people safe. Staff completed safeguarding training and had good understanding of safeguarding and how to take appropriate actions. Staff comments included, “If I had safeguarding concerns, I’d document and report it to the manager and if the manager is not around, I’d report to a senior carer.” Another staff member said, “I have not had any safeguarding concerns, but if I did, I would go to the manager. If it were involving management I would go higher.” Staff knew who to contact and had contact details of appropriate safeguarding bodies.
People were protected from avoidable harm by staff that were aware of risks to people. People were comfortable with staff during all interactions we observed.
Systems and processes were effective in ensuring that people’s human rights were upheld, and they were protected from abuse, neglect, and discrimination.
Involving people to manage risks
People and relatives received information about risks and engaged in risk assessments. People had the freedom to make their own choices. For example, staff respected when people wanted to smoke, and they supported them to do so safely. One person did not like their belongings being moved, so the care and domestic staff respected the person’s wishes and only tidied in a way the person allowed them to do so.
Leaders collaborated with people and their representatives to plan people’s care. Leaders valued getting to know people and what works best for them. They promoted people’s independence and were proactive in recognising people's changing needs. Staff had access to people’s care plans and risk assessments and took the time to read and understand them.
Staff helped people with understanding and managing risks. For example, when supporting them with moving and handling or when people were upset or distressed.
Whilst there were systems in place to identify risks to people, care plans and risk assessments were not always up to date. People’s care was not always monitored in line with their care plans. For example, one person’s care plan was not updated with the most recent changes to their diet and as a result this person was at increased risk of choking. Another person’s fluid intake was not consistently recorded in line with their care plan and as a result the person was placed at increased risk of dehydration. Following our feedback, leaders took immediate actions to address the issue. There were systems to support people with emotions and distress in a positive way. The restraint policy supported staff to only use restraint as the last resort. Staff assessed peoples’ individual needs which supported people and respected the choices. For example, when people decided to smoke, staff completed risk assessments to ensure that it had no negative impact on the health and safety of other people.
Safe environments
People were pleased that the home environment was safe, and they had the equipment they needed to support them in every day lives.
Leaders were aware of shortfalls in the health and safety of the home environment and were working towards addressing it. For example, they scheduled for new fire door to be fitted and arranged for Portable Appliance Testing (PAT) to take place for all equipment. Leaders completed daily walk-rounds, monthly audits and ensured staff were present around the home to monitor safety. Staff had the facilities and equipment to deliver care safely. Maintenance staff received appropriate training to keep the premises safe.
Overall, the home environment was safe, and all existing health and safety concerns were already identified by the leaders prior to our inspection and work was scheduled to address them.
There were systems and processes to monitor safety of the environment. Where shortfalls were identified, action plans were in place and maintenance jobs were booked without delay.
Safe and effective staffing
People and relatives reflected on the positive changes in staffing levels and that staff were skilled in what they were doing. People comments included, “There are more staff lately, they must have hired more.” “They seem to know what they are doing.” “They usually come pretty quickly.”
Leaders recently changed the way they delegated staff and increased staffing levels. The middle floor of the home was not in use which allowed to designate staff more effectively between the remaining two floors. Leaders conducted regular meetings and supervisions with staff to ensure staff well-being and good performance. Staff had training opportunities and were well equipped to do their job. Staff comments included, “I have just been put forward for NVQ level 3 so that is good, we [staff] constantly get training, including for specialist needs, for example, dysphagia”. Staff received support to deliver safe care, including supervisions and support to develop. One staff member said, “We [staff] get a lot of training , they invest in our qualifications- I have been put through NVQ level 4. Managers are very supportive.” Staff said there were enough staff to support people safely.
On the day of our visit there were enough of skilled, appropriately delegated staff. Staff attended to people promptly and had the time to talk to them and engage them in activities.
There were robust and safe recruitment practices to ensure all staff were suitably experienced, competent, and able to carry out their role. The systems and processes were fair and reviewed to ensure there were no disadvantage based on any specific protected equality characteristic. Leaders used a tool to determine appropriate number of staff that was in line with people’s care needs at the time. Leaders monitored and recorded staff training in a training matrix and acted if staff training needed to be updated. Clinical supervisions, appraisals and staff development plans were clearly documented. Staff at all levels had the opportunities to learn, and poor performance was managed appropriately.
Infection prevention and control
People were pleased with how clean and tidy the home environment was and confirmed that staff worn appropriate Protective Personal Equipment (PPE) whenever needed.
Domestic staff had the resources needed to keep the home clean and hygienic. Leaders had measures in place to ensure that clean environment was maintained. For example, the daily manager walk-rounds and monthly audits.
The home was clean and tidy on the day of our site visit.
There were cleaning schedules in place and regular audits of infection prevention control (IPC) were completed by leaders. Staff completed relevant training, for example Infection Prevention and Control and Food Hygiene Training.
Medicines optimisation
People had no concerns about how staff managed their medication. Staff supported them promptly when they were in pain by administering pain relief medication.
Only trained staff were responsible for the management and administration of medicines. Staff received medication competency checks and completed mandatory training. Staff had team meetings bi-monthly to discuss medicines management. A senior staff member said, “I feel supported by the management, and we work well as a team to ensure medicines safety.”
Systems and processes, including medicines policy were in place to ensure safe medicines management. Medicines stock checks were conducted by a clinical lead. There were arrangements for safe disposal of sharps bins and medicines. People’s medicines were appropriately prescribed, supplied and administered in line with the relevant legislation, current national guidance and the Mental Capacity Act 2005.