Telford Court Nursing 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 66 (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. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Incidents and accidents were recorded and used as a learning opportunity. The registered manager reviewed these monthly and referred to health professionals for guidance where required. Staff told us any lessons learnt were discussed and shared with them at staff meetings and by other communication. They said there was a culture where managers supported them to report any incidents or concerns.

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. One relative told us, “I was impressed on the day of (relative’s) admission, everyone knew his name and spoke to him to make him feel welcome.” In response to some issues, the registered manager had liaised with health professionals to improve communication for people and their relatives, when they moved to the service from hospital. The provider had designed an information pack to support people moving to the service.

The provider usually worked with people and healthcare partners to understand what being safe meant to them and how to achieve that. They concentrated on improving people’s lives or protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. Overall people told us they felt safe. Comments included, “I feel safe here, the staff very nice” and “I cannot fault the service, I’ve no problems at all.” Staff had received safeguarding training and understood their duty to report any concerns should the need arise. The registered manager reported all safeguarding concerns to the local authority; however, they needed to ensure they always used the most appropriate local authority reporting procedure. The registered manager confirmed they would undertake some refresher training. The provider had not always ensured Care Quality Commission were notified of all concerns relating to abuse or an allegation of abuse as legally required. During our visit, one person raised a safeguarding concern with us which we shared with the registered manager, and this was appropriately reported.

Overall, systems were in place to manage risk and staff worked together to mitigate identified risks. Risk assessments were in place and reviewed regularly. Staff used sensor mats and increased observations to help reduce the risk of falls. However, records were not always consistent and/or fully reflective of the actions taken by staff to manage risks. For example, staff had removed sensor alarm mats from 2 people’s bedrooms due to other risks. However, sections of their care plans still referred to the need to ensure the mats were in place, which could cause confusion for staff. We saw 2 people did not have a call bell within reach in their bedrooms, and people’s care plans varied in relation to the guidance they contained about their call bell usage. The registered manager acted following our on-site visit to review all care plans and risk assessments to ensure they were fully accurate and up to date.

The provider detected and controlled potential risks in the care environment. Overall, they made sure equipment, facilities and technology supported the delivery of safe care. Staff had completed risk assessments in relation to people being able to access equipment and food/drink in the kitchenette areas. However, these could be developed further to consider any potential risks posed to people requiring modified food or drink. The provider employed a maintenance team who undertook various checks and monitoring to maintain the safety of the environment. These were organised and well maintained. Water temperatures were checked to reduce the risk of scalding. However, we noted some temperatures were slightly higher than those recommended in relevant guidance. Following our feedback, the provider confirmed settings had been adjusted. Staff took part in practice fire drills, however, some staff had not recently taken part in one. The registered manager confirmed further drills would be planned as soon as possible to ensure all staff were included.

The provider 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. People told us, “Staff have the skills to manage (name’s) care” and “Staff are well trained and make me feel comfortable.” There was a stable staff team, and the provider occasionally used agency staff to cover absences. The registered manager reviewed people’s needs on a regular basis to ensure there were enough staff to respond and support people safely. A relative said, “There are some changes of care staff, but it’s a stable environment.” Staff were positive about staffing levels, training and the support they received. Records showed staff received supervision and appraisals meetings, however, several staff appraisals had recently become overdue, which the registered manager was scheduling. They had introduced a new staff role to oversee training, supervision and staff development. Staff were recruited safely, and systems were in place to ensure all required checks were undertaken.

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. The home was very clean and free from any unpleasant odours. Several domestic and laundry staff were deployed within the home and followed schedules to maintain high standards. Staff followed the provider’s infection control policy and had received relevant training. They used PPE and disposed of this in line with guidance. We noted some minor issues which we shared with the registered manager who addressed these immediately.

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. People received their medicines as prescribed. Staff were trained, their competency was checked, and they followed the provider’s policies. Staff were aware of best practice in relation to the safe use of certain medicines. A relative gave a positive example where staff had worked with the GP to stop a medication, as they were effectively able to support their dementia needs without it. Where medicines were administered covertly (hidden in food or drink) staff had followed the correct procedure to ensure this was done in the person’s best interests. Prescribed creams and ointments were applied, however, some creams stored in bedrooms did not have the date of opening recorded as per best practice. We shared this with the registered manager who addressed these immediately.