Allingham House Care Centre

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

Individual risks were identified for people and there were robust care planning processes in place to promote people’s safety and wellbeing. People felt safe and staff understood how to safeguard people. The Registered manager was proactive in addressing any actions arising from safeguarding meetings and ensuring good outcomes from lessons learned. There were generally enough staff deployed to meet people’s needs, although there were times when people had to wait before they were supported. There was a stable staff team who knew people well. Suitable recruitment processes were being followed. Staff received appropriate training and supervision and any areas of shortfall we found during assessment were quickly addressed by the registered manager. Suitable systems to assess people’s capacity were in place and there had a been a recent change in policy in relation to a potentially restrictive practice to ensure best interest decisions were made. There was a lack of clarity in some electronic records in relation to the responsible persons under legal power of attorney (LPA) and this was quickly rectified by the registered manager.

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.

People told us they felt safe living in the home and told us the service was responsive to learning lessons from incidents, accidents and complaints. For example, one person told us they had been concerned about other people invading their living space. After making a complaint they had been provided with a key to their room and told us, “I feel safer now that I have my own room key.”

Ensuring people remained safe was a priority for the registered manager and wider management. Staff told us they felt supported in the workplace and were encouraged to raise concerns and report any errors. The home operated a ‘no blame’ culture and the registered manager’s open-door policy was apparent during the assessment. Staff we spoke with told us they were confident they would not be blamed or treated negatively if mistakes were made. Feedback from professionals regarding how the service managed safeguarding incidents, how lessons were learnt and good outcomes were achieved was positive. One stakeholder told us, “The team are always proactive; [they are] open to constructive comments and action any request in a very timely manner.”

Processes were in place to deal with and investigate any concerns raised. Incidents and complaints were appropriately reported, investigated and shared with relevant stakeholders. There was a culture of learning lessons from safety incidents, poor practice or human error, as staff completed reflective practice accounts. Risks were not overlooked or ignored but dealt with and seen as an opportunity to put things right, learn and improve.

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.

People were protected from abuse and neglect. People felt safe living at Allingham House and were happy with how they were cared for and supported. One person told us, “Oh yes, I feel very safe, there are always people around.” A relative commented, “My [Relative] is 100% safe.”

Managers and staff were committed to keeping people safe from abuse and neglect and worked with safeguarding partners and professionals in a collaborative way. Staff were supported to reflect and learn from incidents that potentially exposed people to harm. For example, staff completed a reflective log in response to medicines errors or managing incidents of distress and aggression. The registered manager completed reflective practice account of what had gone wrong, actions taken to reduce the risk of it reoccurring in the future and what the service might have done differently following safeguarding incidents. Outcomes from safeguarding meetings were shared with clinical staff in flash meetings and care staff in handovers, so all were aware of any actions to be taken or changes in care practice.

We observed staff were responsive to people needs and provided care and support in a safe way. Action following previous safeguarding incidents had been actioned and remedied.

Processes were in place to deal with and investigate any safeguarding concerns identified or raised. Findings from investigations were shared with professionals and relevant stakeholders. There were systems in place to ensure people were protected from abuse, neglect and discrimination, with appropriate actions taken to reduce any identified risks. There was an understanding of the Deprivation of Liberty Safeguards (DoLS). Best interest decisions were made following meetings with relevant stakeholders, including people’s relatives, advocates and social care professionals. However, electronic care records did not reflect the details of those who held a valid Lasting Power of Attorney (LPA) and in what capacity they could make decisions on behalf of people. It was not clear that decisions made in people’s best interests were being made legally by their relatives or representatives. We brought this to the registered manager’s attention, who took timely action to update records and ensure these were clear and accurate.

People felt staff knew how to provide care safely and managed any risk to people. One person told us, “Staff encourage me to walk as much as possible, [but] they go mad if I stand up on my own; they don’t want me to fall. They follow me with a wheelchair.”

Staff understood about the risks posed to individuals and how staff practice helped reduce those risks. They told us that risks were communicated in various ways, for example in electronic care plans, in daily handovers and staff meetings. Staff were confident that they had all the relevant information to manage risks.

We observed safe and appropriate use of equipment during both days of this assessment. People were monitored where necessary when using walking frames or other equipment to help people mobilise. Where wheelchairs were used these were used safely with footplates in place.

Risks associated with people’s health and welfare were assessed and responded to. This allowed people to have as much independence as possible and be supported to be safe. Staff were able to discuss people’s risks and how they were responded to, in order to reduce any potential risk. Where needed, one to one staffing was used for some people to keep them safe.

People spoke positively about the environment and were happy with the rooms. One person commented. “My room was recently painted.” People had the equipment they needed to help them retain their independence.

The registered manager had instigated input from the dementia support team with regards to the specialist dementia unit. As part of this input, dementia support professionals had carried out an environment assessment of the unit and met with the registered manager and maintenance to discuss implementing improvements.

People were cared for in safe environments that were designed to meet their needs. The service was clean and tidy and there were a variety of spaces for people to spend time, which included a cinema room and pub areas. Some areas of the home could be utilised more fully. Care and treatment was delivered using equipment properly, for example hoists, walking frames and wheelchairs, all of which were stored securely when not in use.

There were effective arrangements to monitor the safety and upkeep of the premises. Maintenance issues were on the agenda for ‘flash’ meetings held 3 times a week, attended by all heads of department, including a member of staff responsible for maintenance of the home. Processes were in place to identify and log running repairs needed in the home. These were monitored and addressed by maintenance staff on site, or external contractors scheduled to visit the home. There was good use of technology to maintain people’s safety with door, floor and chair sensors in place.

People were generally satisfied with staffing levels in the home. People told us staff were well-trained to provide care and support and there was a good mix of long-standing and new staff. People felt staff worked hard. Some people felt that the home would benefit from having more staff, but this had not negatively impacted on their care and support. People who needed the support of 2 members of staff, for example they needed to be hoisted, told us they had to wait to receive support at times. However, others told us staff responded quickly when they needed help.

The registered manager told us that the dependency tool indicated that there were enough staff to meet people’s current needs, and this was regularly reviewed. Where it was identified that people needed constant monitoring to keep them safe, for example with 1 to 1 care, staff numbers were in place to deliver this. Managers and nurses had responsibilities for the supervision of staff. A supervision matrix indicated that staff received regular supervision and were encouraged to progress if this was their wish. The registered manager was supported with recruitment and disciplinary processes by a team and head office and had an assigned human resource lead, whom we met during the assessment. They ensured recruitment law was followed and that staff were treated fairly.

We observed a teamwork approach by staff on duty on both days of assessment. Call bells and requests for help and support were answered by staff in a timely manner. The atmosphere in the home was calm. Morale amongst the staff was positive; staff told us communication with each other was key.

Processes were in place to ensure the registered manager and other senior staff had oversight of staffing levels in the home. Rotas and a daily staff allocation sheet reflected the staff on duty during the day and night and where in the home, for example on the residential unit or specialist dementia unit. There were robust and safe recruitment practices in place to make sure that all staff, including any bank staff, were suitably experienced, competent and able to carry out their role. At the time of this assessment the home were not using agency staff and had not needed to for some time. The registered manager relied on permanent staff, a pool of bank staff and a thorough recruitment process, handled by a team at head office to ensure that the home remained appropriately staffed. Staff received training appropriate and relevant to their role. We noted that 5 staff had not completed any elements of the e learning training and queried this with the registered manager. The registered manager was responsive and staff that had not completed pertinent training in a timely were way were taken off care duties and supported to access the training in work. Staff received the support they need to deliver safe care, including supervision, appraisal and support to develop, both personally and professionally. The registered manager provided several examples of staff who had initially been appointed as care staff who had been given opportunities to train and gain internal promotion into other more senior roles.

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.