Adalah Residential Rest Home Limited

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.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. The registered manager shared learning with staff from incidents, accidents, complaints and safeguarding so that the service could continually improve and develop positive outcomes for people. Information was shared with staff through handovers, supervisions and meetings.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. The registered manager/health professionals made sure there was continuity of care, including when people moved between different services. Staff told us they read through the care plans to ensure they had all the information they needed to provide support safely. Relatives told us they were happy with the transition and admission to the service. A relative told us, “Staff are wonderful with [relative] and have helped so much to settle [relative] in, I don’t have the words to thank them for how they have helped.” Another relative told us, “[Relative] has only just gone into care, it was very difficult to find somewhere suitable and this is a really lovely home, they are very nurturing and caring, [relative] is not just a resident, and I have felt this from the very beginning.”

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately. Staff had received training in safeguarding and knew how to raise concerns. A member of staff told us, ''I know how to report any form of abuse, and I would take immediate action. I would know who to report to and I would continue to escalate further to the Local Authority if I needed to.'' Staff could recognise signs when people experienced emotional distress and knew how to support them. For example, a member of staff told us they would know what to say and how to manage a person's distress when they became anxious.

The service worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled them to do the things that mattered to them. People were involved in planning their care and managing risks. Care plan and risk assessments were person centred and aimed to provide positive outcomes for people whilst maintaining their choice and independence. However, most relatives told us they had not seen a copy of the care plan and had not been involved in care plan reviews . The registered manager told us a relatives meeting has been arranged to discuss care plans and care reviews. A health professional told us, “I visit clients to support them through care reviews and planning, and DOLS authorisations. The information provided by staff is clear and accurate and the care plans are easy to read. Staff are available to ensure any questions I have are answered.”

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The environment was adapted to meet the needs of people living there. Maintenance staff were employed to ensure the premises were well-maintained and safe. There were systems in place to ensure any maintenance needed were recorded and responded to promptly. Records of checks on equipment and the premises were up to date.

The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. Staff worked together well to provide safe care that met people’s individual needs. The registered manager had processes in place to ensure all staff received an induction and staff we spoke with told us they had an extensive induction. Appropriate checks were in place before staff started work including providing full work histories, references and a Disclosure and Barring Service (DBS) check. DBS provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. A relative told us, “I think there are quite a lot of staff. [Relative] walks around sometimes and the staff will assist to do this, and I feel happy that [relative] can have a wander and do it safely. However, another relative told us, “I think during the day it is probably fine, but I am not sure about the night times. If I have phoned at night, then I have had to wait a long time.” A health professional told us, “I believe the staff ratio is suitable to meet the needs of those within the service.”

The service assessed and managed the risk of infection. They detected and controlled the risk of infection spreading and shared concerns with appropriate agencies promptly. The service was clean and tidy with no odours. Staff had personal protection equipment situated throughout the service giving them easy access to wear when needed. The registered manager carried out regular checks and completed regular audits to monitor the cleanliness of the service. A relative told us, “Things have improved, the décor, very clean and nice and [relative] is very happy there.”

The service made sure that medicines were safe and met people’s needs, capacities and preferences. Staff had received training in managing medicines and had their competency checked. A member of staff told us, “I had my medicines training, and my manager carried out observations and checked my competency.” Staff we spoke to were knowledgeable about the people in the service and their medicines needs. However, we found protocols missing in some records for medicines prescribed as required (PRN). Protocols are important as they help staff understand when it is appropriate to offer PRN. Staff told us they will update medicines records to include a PRN protocol. Following the on-site assessment, the registered manager confirmed with us they had contacted the GP to update people’s PRN protocols.