Park View Road

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• 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

This key question has been rated good. We reviewed 8 quality statements for this key question. Medicines were not always recorded accurately, and we found gaps in documenting returned medicines. The Provider ensured there were enough skilled staff to deliver person centred care that promoted choice and individual wellbeing. Safe recruitment practices and processes were robust. Relatives told us they felt people were safe at the service and feedback was positive.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives could speak to staff and the management team if they had concerns. Documentation demonstrated open and honest communication between relatives and the provider.

Staff feedback conveyed a positive supportive environment. Staff were confident to raise concerns and actions were taken when necessary. When lessons were learnt, it was communicated to all staff. Leaders informed us of a robust and comprehensive investigation process. Leaders were open and transparent, as well as passionate to learn lessons and implement new processes.

The provider has fostered an open learning culture whereby staff were confident to raise concerns, knowing these will be fully investigated. The provider has robust systems to ensure lessons are learnt and communicated to all staff. Investigations where needed were completed robustly and included actions taken by the provider. Management clearly communicates with staff when things had gone wrong to learn lessons together and improve practice. Appropriate actions had been taken for all safeguarding concerns, near misses and medication errors.

Relatives told us they were involved in the pre admission assessment process and contributed to the completion of their family members initial care plan.

Leaders had a good understanding of the referral process and understood the importance of a robust pre assessment.

The provider had established effective working relationships with people and partners to maintain safe systems of care.

The provider had processes in place to support safe admissions and transfers of care. The provider ensured safe admissions into the service, and visits between services were consistent and seamless. We saw evidence of continuity of care between different services, contained in care records for people.

People told us they felt safe in the service. Relatives told us communication from the service was good, particularly if there was an accident, incident or if their family member became unwell. A relative told us "Communication is good. They would let me know if there was an issue. [Registered manager] keep’s in contact with me." Another relative said, "They have an open door policy here. We can pop in anytime."

Staff told us they were aware of the process for reporting concerns and felt confident to do so. A staff member told us "Yes I can raise concerns and actions get followed through."

Staff were aware of peoples actual and potential risks. Staff supported people in line with their risk assessments. We observed staff using de-escalation techniques in accordance with people’s care plan to safely support them when they were experiencing distress. We observed staff supporting people in all aspects of their daily living activities whilst delivering safe care and treatment to them.

The processes in place to ensure people remained safe was effective. Although the provider did not complete an overall analysis of accidents, incidents or safeguarding to identify trends there was a robust reporting procedure in place which staff followed. The provider ensured debriefs occurred following incidents, and both staff and people were supported throughout. All notifiable incidents appear to have been reported and documented. The provider ensured systems were improved to keep people safe. Following a recent safeguarding incident, the provider responded by updating the processes and policies to ensure people's finances were safe and secure. Appropriate actions were taken following incidents and external partners were informed.

Relatives told us they felt their family members were safe and staff managed risk well. A relative told us, "I would say [person] is safe. I know they do risk assessments when [person] goes out."

We observed staff supporting people to make choices, access the community and actively managing risks to people. A staff member told us "We get them involved when planning for trips and whatever they say. We plan that for them. We look around the activities and identify if there are any risks around it. If there are outdoor activities, there will be a group of staff going with them. We make sure indoor activities are safe for people and staff." Another staff member said, "When someone is becoming distressed, distraction techniques are used. We follow their support plans, we speak to them find out what's happened. We know each person and know what works for them."

People received support in line with their risk assessments. We observed staff managing risks by adhering to people’s assessed needs and care plans. Staff knew people well and people received 1 to 1 support when needed. Staff were aware of people’s dietary needs, and adjustments were made as necessary, for example a person who was diabetic had sweet treats made from diabetic friendly ingredients. We observed staffs understanding of allergies, for example food and utilities was stored separately for people on gluten free diets.

Quality assurance measures identified and reduced risks. People had risk assessments in place with clear guidance to support staff on how to manage their risks. Risk assessments were up to date, reviewed regularly, and were person centred. People were able to do activities, go on day trips and take positive risks, which were well managed.

Relatives spoke positively about the environment and said it was suitable for people’s needs. A relative told us, "I think the layout of the building is good. It is a single storey [building] and so [person] can walk about, wander around alone at their will, which [person] needs. I am not sure what could be improved really." Another relative said, "I think they try and make it homely. They create a good environment and atmosphere."

Staff and leaders were all aware of the importance of maintaining a safe, homely environment for people. Staff provided examples of how they supported the maintenance and cleanliness of the service. There had been improvements made to people's bedrooms and rooms were personalised to people’s needs.

We observed the environment to be safe for people. Communal areas were clean and decorated to meet people's needs. Hazardous products were locked away to keep people safe. The service was welcoming, and bedrooms were personalised in line with people’s preferences. We observed fire safety and room temperature checks taking place to ensure the environment was safe.

The environment was safely managed. The provider had effective systems in place to ensure maintenance of equipment and the premises were up to date, and all required practices were complied with. People’s evacuation plans included relevant information needed to support safe evacuation. Actions identified following a fire risk assessment checks were completed promptly and the provider held regular fire drills. The fire evacuation policy was in date and reflected the needs of people.

Overall feedback from relatives was positive about staffing levels and they told us there was sufficient staffing. However, one relative told us, "I think the staff is a huge issue. They have a huge turnover of staff. I know it is a problem for the care industry."

Staff and the leadership team felt there were enough staff on shift. Staff comments included: "The environment is safe. Management are always on top of the safety. There are always staff around."

We observed safe staffing levels. We saw staff were approachable and engaging with people. Staff spoke about the meaningful activities people had taken part in during the day of our visits. Staff were always visible. People’s individual support needs were met. When people went out into the community, they had the right number of skilled and experienced staff to support them safely.

The provider processes ensured safe recruitment of suitable staff. Staff had been recruited with a range of checks including references, disclosure and barring checks (DBS). Staff had been trained appropriately. There were enough staff to meet the assessed needs of people in the service. Staff received regular supervisions and appraisals and had opportunities to discuss their own well-being, training and development in their role.

Relatives felt the service was well maintained and did not have any comments regarding the infection prevention and control practices in the service.

Staff had good knowledge of infection prevention and control (IPC) procedures. Staff said they received appropriate training, and followed IPC processes to reduce the risk of the spread of infection.

The service was clean and maintained to a good standard. We observed staff using PPE appropriately when required. The kitchen was clean and organised and kitchen staff adhered to the cleaning schedules.

Processes in place ensured the service complied with IPC guidance. The provider had robust cleaning schedules, IPC audits and processes in place. The leadership team reviewed the environment and cleaning schedules to ensure consistently safe practice.

Relatives gave positive feedback regarding the safe administration of medicine. One relative told us, "[Person] is on medication yes. I feel that is handled safely." However, improvements were required to the administration processes of a time specific medicine; therefore we could not be assured medicine was always managed safely.

Leader said they had recently improved their processes for medicines which included review of their medicines policy to ensure the safety of people in the service. Staff were aware of the changes made and were confident in their administration of medication processes.

The provider has appropriate policies and procedures in place to manage medicines safely, however guidance was not consistently followed. We identified the times medicines were dispensed were not recorded. This increased the risk of harm to people.