Signature at Banstead

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 told us they felt safe and protected from the risk of harm and abuse. There were systems in place to ensure risks to people were reduced. Staff received training appropriate to their role. People and their representatives were involved in the formulation and review of their own risk assessments. Care plans contained clear and comprehensive guidance for staff to meet people's needs. There were sufficient staff deployed to meet peoples’ needs. The service did have safe systems for appropriate and safe handling of medicines. Systems and processes were in place to support people and manage risks. Accurate and up-to-date information about peoples medicines were easily accessible from care plans.

This service scored 38 (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. There is no score yet for this quality statement for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. There is no score yet for this quality statement for Safe.

Most people and their relatives told us they felt safe. One person told us, "I like being here… I like the staff , they are always nice to me” and a relative told us, “We consider it a very caring safe place and she's well, she's having needs met and if there are any issues they respond.” People were protected by the provider's safeguarding process and procedures. Staff and management took appropriate action in response to concerns.

Staff received training in safeguarding and understood their responsibilities to keep people safe from harm or abuse. Staff knew how to raise concerns, who to raise concerns to and felt confident they would be dealt with effectively.

Observations noted risks to peoples’ safety were managed, and staff were observed responding to peoples’ needs without hesitation.

Accidents and incidents were recorded onto a tracker, detailing the date, incident, action taken and outcome. We saw evidence the provider reported appropriately all notifiable incidents and accidents to the relevant agencies. The provider reported all safeguarding incidents to the local authority’s safeguarding team and worked with them to investigate these and put systems in place to prevent further risks. Lessons were learnt when incidents and accidents happened, and through discussions and meetings, improvements were made to prevent recurrences.

People were involved in care planning and individual risks were assessed and managed in line with their needs, wishes and abilities. Where appropriate, people's relatives were also involved in care planning and care reviews.

Staff were aware of people's risks and knew how to manage them while promoting independence. Staff knew when to escalate concerns to the registered manager, who responded promptly to mitigate and manage risks.

Staff were observed assisting people with their needs and supporting people to maintain their independence whilst ensuring safety was maintained.

People were supported to maintain their independence and take managed risks on a day-to-day basis. Risks were assessed, managed and mitigated appropriately and regularly reviewed. People who people who knew them well were involved in risk assessments. We viewed a range of risk assessments. These were detailed and thorough. For example, one person who smoked had a comprehensive risk assessment in place looking at all aspects of the risk, such as suitable non-flammable clothing. A shelter had also been built in the garden for the person.

We did not look at Safe environments during this assessment. There is no score yet for this quality statement for Safe.

Some people and their relatives were satisfied with the quantity and quality of staff available, however others did not feel there were always enough staff to meet their needs.

When we raised peoples’ concerns with the registered manager, he told us he was aware of this and were in the process of rectifying this through a recruitment drive. The registered manager further advised that the recruitment drive was successful, and the home would 90% permanent staff within the next month. The registered manager also told us there has been a recent significant decrease in the use of agency staff through the recruitment of new staff and anticipates this will reduce further once all new starters have been inducted. Most staff we spoke with told us they felt there were enough staff to provide care to people and were provided with the training required to meet peoples’ needs. One staff member told us, “we have enough staff now, it has increased over the last year.”

Staff were observed assisting people with meals. Staff provided assistance where needed, encouraged people with eating and drinking, and supported people to be independent.

People received care from staff who were well trained. The provider ensured all staff received training they identified as mandatory, such as safeguarding adults, health and safety, first aid, moving and handling and infection control. They also received training in relation to people's needs such as dementia care and end of life care. In addition, the district nurses provided training such as skin integrity. The provider ensured they always use regular agency staff who were familiar with the needs of people who used the service. We saw evidence that each agency staff undertook an induction of the service before being allowed to support people. Induction included an orientation of the service and fire and emergency procedures, information about people, infection control, use of equipment, medicines, and the necessary policies and procedures. Each agency staff member had an up-to-date profile evidencing their training, employment history, confirmation of identity and recruitment documents. The provider used a dependency tool called ‘staffing ladder’. This tool looked at the individual needs of each person, so the right number of staff were in place. There had been some staff shortages managed by agency staff, but this has improved since more staff have been recruited. We viewed the rotas for the past 4 weeks and saw that there were always enough staff available to meet people’s needs. There had been a number of new staff recruited recently, some were still in their induction period.

We did not look at Infection prevention and control during this assessment. There is no score yet for this quality statement for Safe.

People and relatives told us staff met their responsibilities in relation to medication administration. One relative told us, “They help her with her medications and there’s never been a problem as far as I’m aware.”

Staff told us that they were trained and assessed as competent to administer medicines and supported by senior staff. The service had systems to ensure staff knew about incidents. Learning from medication incidents was shared with team, so patients received their medicines safely.

Stock of prescribed medicines was managed appropriately. Medication was administered at the times prescribed including time critical medication, however specific administration instructions were not always documented. Care plans were detailed, and person centred to support staff with managing specific health needs, however this was not always the case with as required protocol (PRN) where guidance on variable doses was lacking. People were supported by staff to self-administer their own medication.