Victoria House 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

People received safe care and support by staff trained to recognise signs of abuse or risk and understand what to do, to safely support people. People told us that they felt safe with all the staff who supported them. One person said, “ I do feel safe, they are very good, and “I don’t have a problem telling staff if things aren’t right but I haven’t had to, they are trained and very good to us.” A visitor said, “My relative happy here and I'm confident that she is safe.” Risks to people's safety were assessed and reviewed. The care plans had individual risk assessments which guided staff in providing safe care. Risk assessments for health-related needs, such as skin integrity, weight management and nutrition, falls and dependency levels had been undertaken and regularly reviewed to minimise and prevent the risk of harm. For example, staff had requested a pressure relieving mattress for one person who was at risk from pressure damage due to their low weight and general frailty. The staff were pro-active in supporting people, who had capacity, to make decisions about the risks they took in their day to day lives. Where people lacked capacity, the registered manager ensured people’s rights under the Mental Capacity Act were respected. People were supported to take positive risks, to ensure they had as much choice and control of their lives as possible. The provider ensured that when things went wrong, accidents were recorded, and lessons were learned. There were enough staff to keep people safe. People received care and support in an unrushed personalised way. Comments from people included, “There are always staff when I need help,” and “I am more than happy.” Rota’s confirmed staffing levels were stable, and the skill mix appropriate. For example, there was always a medicine giver on each shift. Staff were recruited safely which had ensured that only suitable staff were employed to work at the service.

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.

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.

Staff were aware of their responsibilities to safeguard people from abuse and any discrimination and knew of the signs of abuse and how to report safeguarding concerns. They were confident the management team would address any concerns regarding people’s safety and well-being and make the required referrals to the local authority. A staff member said, “We get safeguarding training, we also get updates of any changes, the training is really good and interesting.” Another staff member said, “Inform senior and document everything. I have never seen anything that worried me. Not sure what happens once it's reported to manager, we haven't had that here," and "If i witnessed abuse, I would report to manager and then safeguarding, and a meeting would be held. I would feel comfortable raising issues." Staff were aware of the different types of abuse regarding people with fluctuating capacity, One staff member said " We make sure they have care when they need it, if they refuse, we offer it later, everyone is accepted and I have had never witnessed any discrimination in the home."

People were happy, comfortable, and relaxed in their interactions with staff. They told us they felt safe living at the service. Comments included “ I do feel safe, they are very good,” and “I would talk to manager she is always here or one of the other staff members,” and “I don’t have a problem telling staff if things arent right but I havent had to.” Relatives told us, “My relative happy here and I'm confident that she is safe, -we have been happy with the care,” and “We as a family have been very happy with the care, really feel they are safe.” People told us they had access to information about how to raise any concerns they might have. One person said,” I know how to complain, if I was worried or someone was cruel to me I would talk to manager,” and “I have a folder in my room and which tells how I can complain.”

There was a safeguarding and whistleblowing policy which set out the types of abuse, how to raise concerns and when to refer to the local authority. Staff confirmed that they had read the policies as part of their induction and training. Staff received training in equality and diversity awareness to ensure they understood the importance of protecting people from all types of discrimination. The provider had an equalities statement, which recognised their commitment as an employer and provider of services to promote the human rights and inclusion of people and staff who may have experienced discrimination due to their ethnicity, religion, sexual orientation, gender identity or age.

The provider used a computerised care plan and risk assessment system. Risks to people had been assessed on admission, reviewed monthly or more often if required and their safety and monitored. People were kept safe through formal and informal sharing of information about risks. This included handover sessions, care review meetings and audits. The people who lived at Victoria House Care Home had various levels of communication and understanding and so the staff used different techniques to help people understand risks. These included visual signage, both pictorial and written. Every person had a personal emergency evacuation plan (PEEP) in their risk assessments, which detailed what support each person needed in the event of a fire or other evacuation of the premises. These were all up to date and reflective of people's current needs.

Staff knew the people they supported well, and this enabled them to keep people safe and reduced the risk of harm. Staff told us how they encouraged and supported people to make choices to reduce risks and stay safe, whilst also respecting people's rights to make their own decisions within a risk assessment framework. One staff member said," we have two people who like to help out with laying tables and washing up, its been risk assessed it and we support them to do these tasks, they wear gloves and aprons." Another staff member said,"We have someone who has diabetes and we monitor her and found that their sugar levels were too high due to an increased sugar intake, we managed it and let the district nurse know. The nurse sees her every day. We updated her risk assessment and spoke with their visitors." Care plans and risk assessments were reviewed and updated regularly or as necessary and contained up to date information to support people safely and effectively. Staff were able to discuss peoples’ individual risks and demonstrated a good level of understanding when identifying new potential risks, managing the risks, and keeping these under review. Especially for those whose mobility was decreasing and were in need of further support or the use of moving and handling equipment. Staff told us that they all had access to peoples risk assessments that contained up to date information to support people safely and effectively. One staff member said, "We read the care plan and risk assessment to see if anything has changed," Staff understood their responsibilities for reporting accidents, incidents, or concerns. Staff had identified when changes to peoples' health, both physical and mental could impact on their safety and, that of other people who lived in the service, staff, and visitors. Staff were able to discuss peoples changes and how they supported people at these times.

Risks to people were managed effectively so they were safe but still allowed them freedom of choice and control without restrictions. We saw that people were encouraged to take positive risk to maintain their independence and enjoy their life. Some people were able to tell us that they had been involved in planning their care and had discussed what they wanted from staff and how staff could support them. One person said, "I have been involved, staff ask me and we discuss it, I like a bath, but can't do it on my own, staff use a special chair to get in the bath, which is really good, ," "They have to help me into my wheelchair and down in the lift -always done carefully and I feel safe wth staff." Another person said, "The staff worry about me and the stairs, they have put little signs up to remind me to use the lift and call staff if I need them."

Staff supported people in a professional and kind manner, we saw that staff discretely supervised people and intevened respectfully when people were up and walking freely by redirection if there was a potential risk identified. For example, when 1 person became distressed and restless and were unable to stand independenly, staff immediately approached and spoke with them gently and de-escalated the situation, whilst asking for staff to get the necessary equipment to help the person stand to be re-positioned. Throughout the visit, staff were observant and pro-active in reducing risk by their knowledge of people and taking preventative action. People who were at risk of choking were sat upright whilst being assisted with their meal from a staff member who was sitting by them. The food was prepared to the corect consistency and staff ensured they took their time assisting people ensuring they were swallowing before offering more food.

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

The feedback we received from people told us there were enough staff to support them at this time. One person told us, “Very prompt when I ring for help, I am very lucky,” “Not had to wait for help when I need it, same staff most days -occasionally I see someone I don’t recognise but not often,” and “ Very competent, never worry about staff, they are always here and know what they are doing, good staff.” We looked at recent surveys and feedback forms and all were positive regarding staffing levels and there were no grumbles or complaints. During our visit, staff were seen to answer call bells promptly and there was always staff in the communal areas to support people if they needed it. People and relatives told us they felt staff were equipped with the necessary skills to support people safely and effectively. Comments included, “They are certainly competent, know what is needed” and “Always know what to do, well trained, I believe, if I ask them anything they answer and if they don’t know, they will find out.”

There was evidence of robust recruitment procedures. All potential staff were required to complete an application form and attend an interview, so their knowledge, skills and values could be assessed. The provider undertook checks on new staff before they started work. This included checking their identity, their eligibility to work in the UK, obtaining at least two references from previous employers and Disclosure and Barring Service (DBS) checks. The DBS helps employers make safer recruitment decisions and prevent unsuitable people from working with vulnerable people. There were systems in place to review staffing levels against peoplers dependency, these are reviewed regularly, inline with changing needs and new admissions. Training and supervisions were reviewed regularly and were part of the organisational auditing processes.

Staff confirmed there were enough staff available to meet people’s needs. The rotas evidenced staffing levels were stable and we were told that levels would increase if someone became very unwell and needed one to one support. We reviewed the duty rota against the training programme, it told us there was a suitable skill mix and experience during each shift. The registered manager told us they used regular agency staff to ensure continuity of care. This was usually to cover annual leave, one to one and sickness. There was evidence of on-going training completed by staff in a variety of subjects such as food safety, nutrition, infection control and moving and handling. Other training had been sourced to meet peoples' individual needs such as care of catheters, Parkinsons disease, learning disability and sepsis. One staff member said, "We do get a good training," and "Lots of training." New staff completed an induction aligned with the Care Certificate. The Care Certificate is an agreed set of standards that sets out the knowledge, skills and behaviours expected of specific job roles in the health and social care sectors. Staff spoke positively about their induction experience. One staff member said, "The induction was thorough, I worked alongside other staff till I felt confident.” Staff confirmed that they had completed an induction and received regular supervision. The documentation to support staff induction and supervisions confirmed this. Staff received regular supervisions with their line manager. Staff said they were well supported in their roles. One staff member said they valued their supervision as it was a chance to discuss their professional development and an opportunity to discuss further training.

We observed that there were sufficient, experienced and trained staff deployed during our visit. Staff responded to call bells promptly and professionally. The majority of people preferred to spend time in communal areas once up and dressed and there was always a staff member in the communal areas to engage with people and assist them as necessary. We saw staff sit with people and assist them with drinks and meals in an unrushed manner, taking time so people would enjoy that interaction. There were people who required support to stand and to go to the bathroom and staff assisted those people with the use of equipment in a safe manner, all the time talking with the person to ensure they were engaged and aware of the manouvre. People were well presented and attention had been to their personal wishes regarding personal care, such as hair, nails and for those that wished it make-up and jewellary. Staff assisted those in remained in bed due to their physical fraility regularly and we saw that they were comfortable, clean and were given regular drinks and meals throughout the visit.

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.