Princes Road Residential Care 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

Based on the findings of this assessment we found the service had made some improvements and addressed the outstanding breach we identified at their last inspection in relation to reporting safeguarding incidents to the relevant external agencies. However, new additional concerns were also identified at the time of this assessment. This was because we found multiple issues with the way the provider maintained and checked some equipment in the care home, as well as the way they maintained records some these checks, which were not always accurate, complete or up to date. We discussed all these new health and safety issues with the service manager who responded immediately during and after our onsite visit. They were able to provide us with additional evidence to show us how all these issues had now been met and/or were in the process of being met. People were now protected from the risk of harm and abuse. When concerns had been raised, the provider now reported these promptly to the relevant external agencies. Staff understood their duty to protect people from abuse and knew how and when to report any concerns they had to their line manager. Medicines systems were well-organised, and people received their prescribed medicines as and when they should. Staff suitability and fitness to work as care workers in an adult social care setting had been thoroughly assessed by the provider. However, staff supervision was not always up to date.

This service scored 66 (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 told us they felt safe living at the care home and with the staff who supported them. Relatives also told us they did not have any concerns about the safety of their family members.

Managers supported staff to safeguard people from abuse. Staff received safeguarding adults training as part of their induction which was routinely refreshed. Staff knew how to recognise and report abuse and were able to articulate how they would spot signs if people were at risk of harm. A senior member of staff told us, “I would challenge any abuse I saw here. It wouldn’t be tolerated. I know I have to let my line manager know straight away what I’ve seen or heard about and they will then report it to the local authority and the CQC.” Furthermore, the managers and staff understood their legal responsibility to refer safeguarding incidents to all the relevant external agencies without delay, ensure they were fully investigated and to take appropriate action to minimise the risk of similar incidents reoccurring.

We observed staff supporting people in a safe way.

At our last inspection, we found the provider had failed to ensure safeguarding incidents involving people living at the care home were always reported to the relevant external agencies. This represented a breach of regulation 13 (Safeguarding service users from abuse and improper treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we found enough improvements had been made to the way the provider now reported safeguarding incidents to the relevant external agencies, which meant they were no longer in breach of regulation 13. Systems and processes were in place to protect people from the risk of abuse. The provider had clear safeguarding and staff speak up policies and procedures in place which were up to date and in line with relevant legislation. Managers worked well with external agencies and acted in a timely way to make sure people were safeguarded and protected from further risk.

Relatives did not raise any concerns about the safety of their family members and told us they were kept safe from harm.

Managers told us they regularly conducted checks on the home’s physical environment and their fire safety equipment. Staff said clear guidelines were available to help them deal with emergencies. For example, in relation to fire safety we saw personal emergency evacuation plans were in place to help staff evacuate people in an emergency. Staff demonstrated a good understanding of the risk to people and the steps they needed to take to keep them safe from harm. This included encouraging positive risk taking and supporting people to take part in activities both in and outside the home in a safe and managed way.

We observed staff supporting one person in the home in a safe way, in line with their support plan.

Regular checks were completed by managers and staff to help ensure the safety of the home’s physical environment and equipment, such as fire safety equipment and mobile hoists, for example. However, we still found some areas needed attemtion. We found a radiator in a toilet that was not covered. The risk this radiator might present people living in the care needed to be risk assessed and appropriate action taken to minimise any identified risks including, covering or removing the radiator altogether. There was also an out of date fire safety policy kept on file in the home. We discussed these issues with the service manager who responded immediately during and after the inspection. They confirmed all the outstanding health and safety maintenance and fire safety issues described above in relation to equipment, record keeping and checks were now complete or were in the process of being addressed. The aforementioned issues described above notwithstanding other checks were routinely completed by managers and staff. This included regular health and safety checks on the care homes gas and water systems. The provider also had an up to date fire risk assessments in place for the building and personal emergency evacuation plans [PEEPs] in place for everyone who lived at the care home. People had individual risk assessments in place, however we noted that some of these were out of date. Although, we found no evidence that people had been harmed, staff need to have up to date records for people they are supporting. The provider responded immediately during the assessment and reviewed these, however concerns remained that no action would have been taken if this had not been raised during the inspection.

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 their relatives told us there were enough staff employed to keep people safe and to support them out in the community.

Staff that we spoke told us they felt supported and enjoyed working at Princess Road. One staff said,It’s a good place to work, they have supported me to gain level my Level 3 Social Healthcare. My training is up to date."

On the day of the inspection, there were enough staff on shift to support people who were in the home and also to take one person out in the community. We discussed staffing levels during the day and the night with the team leader which were appropriate to meet people's needs.

The provider operated robust recruitment checks, this helped to ensure that only staff who had been vetted correctly were employed. This included right to work, reference checks and Disclosure and Barring Service (DBS). DBS provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. Training records showed that staff training compliance levels were good. Staff received appropriate training in courses that were relevant to people using the service. This included Mental Capacity Act, Emergency First Aid at Work, Learning Disability and Autism Awareness, Reducing Restrictive Practice and Oliver McGowan Training. The Health and Care Act 2022 introduced a statutory requirement that regulated service providers must ensure their staff receive learning disability and autism training appropriate to their role.  The Oliver McGowan Mandatory Training is the standardised training that was developed for this purpose and is the government's preferred and recommended training for health and social care staff. However, we found some areas needed addressing. There was a lack of regular supervision for both permanent and bank staff. Supervision records for staff were not consistently up to date. The home’s policy is to conduct supervision every two months, but some records showed gaps of up to five months. We also found that following one incident which involved a medication error, although appropriate actions were taken to resolve it, there was no supervision record to show how this incident was addressed with the staff involved.

People told us staff kept the care home clean and odour free.

Managers told us staff had received up to date infection control and food hygiene training.

We found multiple portions of frozen meat which had been taken out of its original packaging and placed in plastic bags kept in the care homes freezers. Contrary to recognised best food hygiene practices and the providers own basic food hygiene policies and procedures, these items of food were not correctly labelled and/or dated. This meant it was unclear what the meat was, when it had been taken out of its original packaging, frozen, and more importantly by what date it needed to be consumed. We raised this with the service manager who confirmed all the meat kept in the care home which had been taken out of its original packaging was now correctly labelled and dated in accordance with recognised basic food hygiene standards and the providers own food hygiene practices. Although the provider responded immediately during and after the assessment, concerns remained that no action would have been taken if this had not been raised during the inspection. The care home was clean and tidy. We saw staff use personal protective equipment [PPE] effectively and safely.

Training records showed that staff had received appropriate training in relevant areas such as Food Safety and Infection Prevention and Control. The provider’s infection prevention and control policy was up to date. The provider had cleaning schedules in place to guide staff on maintaining the cleanliness of the care home. The provider continued to access COVID-19 testing for people living and working in the care home when they showed signs and symptoms of COVID-19.

People received their medicines as prescribed. People and their relatives told us they received their medicines on time.

Staff demonstrated a good understanding of people's support needs in relation to their medicines. They confirmed they had received training in medicines administration.

People received their medicines as prescribed and the provider's processes supported this. Medicines administration guidelines were in place for people which gave information about people's support needs, including medical conditions, their photo and other information. We found there was no review date on these which we raised with the manager during the inspection. Medicines Administration Records (MAR) charts were completed for people and these were completed correctly. Temperatures were taken of the medicines cabinet and fridges to ensure medicines were stored at the correct temperature.