Partridge House Nursing and Residential Care Home

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 good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

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.

The service 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. There was a positive culture of learning at the home. The newly Registered Manager (RM) was transparent and open with staff, we saw actions were implemented promptly with staff involved in improvements. Outcomes were shared with staff to encourage ongoing learning when things went wrong. The manager was aware of duty of candour. Relatives told us they were always contacted following an accident or incident. One told us, “About a year or so ago and she ended up in hospital. She had a fall; they were very good at keeping me informed.”

The service 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. The service worked with other external agencies to support good outcomes for people. Despite some challenges which had led to safeguarding concerns being raised, the manager and staff had worked hard to improve communication with other agencies to ensure people received safe, effective care and support. People told us they were supported to access other health care professionals when needed. Following an emergency admission to hospital for their loved one, a relative told us, “I went to the hospital when he was there, he was back the same day, communication between the two services was good, the medicines were sorted out by the GP. The service sorted that out with GP. It was sorted out quite quickly.”

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They 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. People told us they felt safe. Relatives confirmed they felt their loved ones were kept safe and well looked after. Processes were in place to protect people. Any concerns which needed to be referred to the local authority and/or CQC were actioned promptly. Staff had completed training and demonstrated a clear understanding around safeguarding procedures. Staff were confident any concerns raised with the RM would be responded to promptly. Any learning or actions identified following safeguarding referrals were shared with staff to ensure learning and continuous improvement.

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Staff knew people well, and risks to people had been assessed. Risk assessments were updated and reviewed regularly. People were supported to stay safe whilst being supported to remain as independent as possible, with a safe management of risk which did not limit their independence or choices. For example, some people liked to walk around the home, staff ensured they were safe but did not restrict people to specific areas of the home. Sensors were in place in people’s rooms to alert staff when people may need support, or if they entered or left the room. These were in place to reduce risk to people, for example those at risk of falls. People could access communal areas and return to their room as they chose. One person was regularly supported to access an outside patio area. People’s skin integrity risk was assessed, with pressure relieving equipment in place if required. A clear process was in place to document, assess and review any wounds or bruising. Accident/incident procedures were clear. Any concerns were documented by staff and reported to the manager who had oversight at all stages of the process.

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People told us they were happy with the home and felt it was ‘homely’ There was a designated maintenance employee who was responsible for the day-to-day maintenance in the home. External professionals were also utilised when required to ensure all aspects of the home and services were suitably checked and maintained. For example, gas, water, equipment and fire safety checks to ensure these were safe and fit for purpose. The RM carried out a daily walk around of the building to check for any environmental issues. Anything noted was reported to the appropriate team and actioned promptly. We saw that the home was nicely decorated, and people’s rooms were well maintained. We were told that a refurbishment of the kitchen was planned.

The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. Relatives told us staff were available when needed. One said, “I think that like all homes more staff would be good, sometimes in the afternoons it can be busy, but I have never thought it unsafe.” We observed staff responding to people promptly. A motion activated sensor on bedroom doors and call bells alerted staff to people’s movement and these were responded to quickly. The RM told us the dependency tool currently used was in the process of being reviewed. The provider had a recommended quota of 1 member of staff per 5 residents. The manager was aware that this did not incorporate the differing needs of people living in the home, therefore, they used a number of methods to monitor people’s dependency levels. Staff we met on the first day told us although staffing levels were safe and they were managing to meet people needs, a change to staffing levels from 5 to 4 care staff on the first floor had made a noticeable difference, even with a senior carer working over both floors. We shared this feedback with regional management, and we were informed an extra staff member had been added to the rota. Staff spoke positively about this and felt they had been listened to by management. Safe recruitment processes were followed for all new employees. Registered nurses (RN) and care staff completed an induction which included mandatory training and shadowing current staff. All staff had access to training to ensure they were able to meet people’s needs. This included refresher training, workshops and shared learning. For example, the home had an End of Life (EOL) Champion providing workshops for staff. RN’s told us they were supported with their professional qualifications.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Relatives told us the home always appeared clean and tidy. People were supported to maintain a good level of personal hygiene; for example, we saw that before lunch staff supported people to wash their hands or use hand wipes to freshen their hands before their meal. People’s rooms and communal areas had been cleaned to a high standard. Policies and procedures were in place to ensure infection prevention and control (IPC) measures were in place and followed. There was a designated housekeeping team who were responsible for the cleaning and laundry in the home. The home appeared clean and tidy throughout. Personal protective Equipment (PPE) was available and utilised by staff appropriately. Cleaning schedules were used to evidence daily cleaning and deep cleaning when required.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened. People received their medicines as prescribed, and these were administered by appropriately trained staff. We saw staff members giving people their medicines, this was done professionally, sensitively and kindly. Risk assessments were in place for certain medicines. Regular medicines checks and audits were completed, and any discrepancies or medicine errors were recorded and investigated with action taken as required. For ‘as required’ medicines (PRN) protocols were in place including those for Just in Case (JIC) medicines for people who had these prescribed by a GP as part of the palliative care pathway. Staff were trained and competent in the use of syringe drivers to administer medicines if required. There was a covert medicines pathway in place for anyone who needed this, with clear explanations for staff should it be required. The clinical room was clean and well organised. Medicines were stored safely as per manufacturers guidance in lockable cupboards and clinical fridge. Temperatures of both room and fridge were recorded daily. There were policies and training in place to ensure staff managed people’s medicines safely. The hospital admissions and discharge policy reminded staff of the importance of a safe handover with any medicine changes recorded. Staff were knowledgeable about the medicines they administered, and the processes they needed to follow to ensure they were safe. Staff told us they had annual competency checks and refresher training to ensure their practice is up to date. One staff member said, “We receive training and spot checks as well as a competency assessment. If I was unsure of medicine, there is a BNF (British National Formulary), and we can check online.”