Skylark House

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 were protected from the risk of harm and abuse by staff who understood their responsibilities for safeguarding people. People told us they felt safe, one person said, “I do feel safe, I can trust the staff and if I was worried I would talk to them.” People and their relatives were involved in planning care and in managing risks. Staff knew people well and were knowledgeable about their needs and risks. Safe systems supported staff to monitor any changes and review their care needs regularly. One person told us, “They (staff) are lovely, they know us all very well.” There were enough staff to care for people safely. We observed people did not have to wait for their care needs to be met. A relative told us there were enough staff, saying, “They pop in and out all the time.” Staff had received the training they needed to be effective in their roles and told us they felt well supported.

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.

We observed people appeared to be happy, comfortable and relaxed with staff who knew them well and demonstrated a good understanding of their needs and preferences.

The registered manager reviewed incidents on a daily basis to ensure any safeguarding incidents were managed and reported in line with the provider’s safeguarding policy. Training records confirmed staff had received training in safeguarding and issues of consent. Care records showed how staff had given consideration to supporting people with consent, including when there were restrictions on people’s liberty to support their safety. Appropriate mental capacity assessments had been completed and DoLS appliations had been made.

All the people we spoke with told us they felt safe living at Skylark House and knew who to talk to if they had any concerns about their safety. One person told us, “I trust the staff to keep me safe.” People told us the staff were kind and caring in their approach. One person said, “They are amazingly kind and can’t do enough for you.” Relatives spoke highly of staff and described having confidence that staff were caring for people and supporting them to remain safe. One relative said, “It is a great relief not to worry when I go home.”

Staff had received training in safeguarding people and demonstrated a good understanding of their responsibilities, including how to recognise signs that might indicate abuse and how to report any concerns. One staff member told us, “If I see bruises I would put on a body map and report.” Another staff member described how they supported people with dementia to remain safe and used distraction techniques and reassurance to diffuse situations where altercations between people with dementia could lead to safeguarding situations. Staff told us how they had received training on the Mental Capacity Act and DoLS and explained how this had supported their understanding about gaining consent and making decisions in people’s best interests where they lacked capacity to do so themselves. The registered manager explained how they monitored incidents on a daily basis to ensure any safeguarding incidents were identified and managed appropriately. They told us, “Staff know to contact me about any incidents, I like to know about them so there are no surprises when I come into work.”

The registered manager confirmed staff completed incident and accident forms consistently. These reports were monitored by senior staff to ensure all appropriate actions were followed up, including making referrals to partner agencies if necessary. Where learning was identified following an incident this was discussed during daily care meetings, handovers or in clinical meetings. Staff were knowledgeable about risks to people and the measures that were in place to support them. One staff member described how a person was assessed by Speech and Language Therapist (SaLT) but they had recently asked the GP to review medicine as they were having difficulty with tablets. A staff member explained how they used care plans to support people including those with complex needs. They described how they used distraction and redirection for someone who had dementia and sometimes needed support with emotions. Another staff member described how incidents and accidents were monitored to ensure changes to risks were effectively managed. They said, “I would report any incident to a manager or leader and document it.” They described how this information supported identification of triggers and patterns to inform strategies for managing risks.

Risk assessments were completed and reviewed regularly, including when people’s needs changed. Records were comprehensive and well personalised and reflected people’s views and wishes. Appropriate assessment tools were used to identify the level of risk and care plans reflected the measures put in place to reduce risks. Where restrictions were in place to support people’s safety, appropriate consideration had been given to issues of consent and to using the least restrictive option where possible. Incidents and accidents were recorded and reported to senior staff. Analysis of incidents was used to identify patterns, trends and likely causes, and to capture learning to improve the service.

People and their relatives told us there were involved in discussions about managing risks. One person said they remembered the conversation saying, “It was very comprehensive.” People described being involved when their needs changed. One person said, “If anything changes, I know they change the plan and I think it is reviewed now and again too.” One person told us they were at high risk of falls and described how staff supported them to remain safe. They told us, “Well they(staff) remind me to call for help, not attempt things by myself.” People said they were supported with managing risks associated with their health and two people said they had noticed improvements since living at Skylark House. One person said, “I am on less tablets now than I was when I came in.” Another person said “My blood pressure is much better since I have been here.”

We observed how staff supported people to move safely, for example ensuring they had equipment they needed. One person needed support to eat and a staff member ensured they were in a good position, supported them in a caring way, talking to the person and explaining what they were doing and waiting for their response before continuing. Support was provided at a good pace that suited the person’s needs. The staff member was sensitive and respectful throughout the interaction and made sure to preserve the person's dignity whilst eating and drinking.

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

Staffing rota’s showed that staffing levels had been maintained and were consistent. Staff received the training, support and supervision they needed to be effective in their roles. There were safe recruitment procedures to ensure that staff were suitable to work with people.

People and their relatives were consistent in their view that there were enough staff on duty. One person said, “They could always use more, but they cope and you never have to wait for long for anything.” Another person said, “If I use my bell they come quickly.” A third person told us, “ The staff are very on the ball, they are there in a flash if you need them.” People told us they had confidence in the skills of the staff who they felt were well trained. One person said, “They(staff) seem to know what they are doing.” People spoke highly of the staff and described them as kind and caring. One person said, “They are a lovely lot.”

We observed that there were enough staff deployed throughout the service. People were being supported with activities and occupations they had chosen. Some people were supported to go on a trip to a local farm others were enjoying accessing the garden. Staff were responsive to people’s needs and acted quickly to provide support. We saw staff answering call bells promptly when people rang for help. At meal times there were enough staff to support people who needed help with eating and drinking. We observed that staff were not rushing and took their time when supporting people to ensure they were not rushed.

The registered manager described improvements in the recruitment and retention of staff. Agency staff were rarely used and staffing levels and deployment were consistently maintained. Staff were positive about improvements in staff deployment. One staff member said, “It’s really good now, families like the same staff and we get to know the residents and families better. Handovers are much better, even at night.” Another staff member said, “We have enough staff now, they hired more people, we don’t use agency now, it is much better.” Staff described being well supported in their roles and said they received the training and support they needed. One staff member told us about recent dementia training they had completed and described the positive impact this had on their practice. They told us, “There is a lot of dementia training and it really helps suggests options to use (to support people).”

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.