Vaughan Lee 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

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm. At the last inspection of the service, we found breaches of regulation in relation to safe care and treatment, safeguarding people from abuse and improper treatment and staffing. At this inspection we found improvements had been made and the provider was no longer in breach of regulations. Further improvements were needed to make sure care plans gave staff all the guidance they required to support some people to minimise risks. Assurances were given following the inspection visit that improvements were being put in place.

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.

The provider had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. The registered manager was approachable and listened to concerns raised by people. One person told us, “If I had any issues I would go to [registered manager’s name.]” The provider recorded and analysed all incidents and accidents to ensure that action could be taken to prevent re-occurrence where possible. This included working with other professionals to make sure appropriate equipment and support was available to people. Staff said any changes to practice, or people’s preferences, were discussed at daily handover meetings. This helped to make sure staff were able to put learning into practice.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. People had their needs assessed when they moved to the service to ensure they received a consistent level of care. The staff arranged for any regular medical treatments to be carried on at the home when someone moved in. There was a weekly visit from a medical representative to support the staff in monitoring and treating people’s healthcare needs. One person told us, “A nurse comes every Thursday. Any problems you can discuss it then.” The provider kept paper records of people’s care needs so they could be shared with other professionals if needed, such as on admission to hospital.

People lived in a home where they felt safe with their care and the staff who supported them. Since the last inspection improvements had been made to staff understanding of the Mental Capacity Act and how to apply it. Appropriate applications had been made for people to be legally deprived of their liberty where they required this level of support to keep them safe. One person told us, “I feel very safe here. I wouldn’t want to be on my own as I feel vulnerable. Here suits me and makes me feel safe.”

Further improvements were needed to ensure staff always had the information they required to effectively and consistently support people to manage risk. Improvements had been made to how risks were assessed and managed since the last inspection. However, some risk assessments in care plans still did not give full information to make sure staff worked consistently to minimise risks to people. For example, some people had been assessed as being at high risk of pressure damage to their skin. Although pressure relieving equipment was in place, there was no clear guidance in the care plan for staff to follow. We found paper records were kept of the action staff needed to take but these actions had not been incorporated into care plans. This led to contradictory information which could lead to inconsistent care. For example, the care plan for one person stated they were able to reposition themselves, but the paper records stated they needed support to change position every 2-4 hours. The registered manager gave assurances that the care plan would be updated. Some risk assessments had been completed well and showed how people were being supported to make choices. For example, where people chose not to be checked on during the night there was information to show risks had been discussed and agreed with the individual. Staff spoken with knew people well and were able to tell us how they supported people. They told us they received up to date information about people’s needs during their handover meeting.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. There were a series of checks and audits in place to make sure the building was safe for people and staff. We identified one potential risk which had been highlighted by checks, but no action had been taken by the provider to reduce the risk. Action was taken before the end of the inspection.

People lived in a home where there were enough skilled and experienced staff to meet their needs. Staff worked together to make sure people received their care and support safely. Improvements had been made to the recruitment process and staff training. People were now being supported by staff who had been safely recruited and received appropriate training to meet people’s needs. One person told us, “I think they are very good. They are caring people. They respond to the call bell quickly. I think that they have enough staff.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. All areas of the home were clean and fresh. Appropriate steps had been taken to minimise the risks of the spread of infection. Staff had received training in infection prevention and control, and they had access to personal protective equipment.

People lived in a home where medicines were safely and effectively managed. People were involved in the planning and review of their medicines. Improvements had been made to medicines management since the last inspection. Clear records were kept of when medicines and prescribed creams had been administered. This enabled staff to monitor the effectiveness of all prescribed medicines. During the inspection visit we identified some minor issues. For example, we found one medicine had not been signed as given for two days and protocols in place for the use of ‘as required’ medicines were not always personalised to the individual. The registered manager gave assurances that action would be taken to address these issues. Following the inspection visit they provided evidence of the action taken. One person told us, “They do creams. They do tablets at the same time every day. Always tell you if anything has changed. Like if the tablet looks different because it is a different manufacturer.” Another person said, “I know what medication I am taking and why, and what it is for.”