Cliff Court 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 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 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. Following an accident or incident staff recorded what had happened and what immediate actions were taken. This was then reviewed by the registered manager. Staff told us accidents, incidents, safeguarding’s and complaints were discussed with the team to ensure they were all aware of any changes in care or practice to reduce the risk of a reoccurrence. Where appropriate the local authority safeguarding team and CQC were notified of any incidents. People’s relatives told us they were informed following any concerns related to their loved ones.

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. The provider told us about the procedure they followed before people were admitted to the home. This included a pre-admission assessment, to meet the person and discuss their needs. The provider told us about the importance of a robust assessment to ensure their needs could be met. They spoke about the negative impact on people if their needs could not be met and a further move was required shortly after admission. The provider told us, as far as possible, they encouraged family members to visit the home to help ensure their loved one’s needs and choices would be met. This was confirmed by relatives. They told us how they had visited various homes before deciding that Cliff Court would be their preferred choice. The provider acknowledged that over time people’s needs may change and they may require more complex care such as nursing care which could not be provided at the home. They told us how any changes to care provision were discussed with relatives and relevant professionals to ensure any transition to a new service was managed safely and compassionately.

The provider 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 provider shared concerns quickly and appropriately. Relatives told us their loved ones were safe at the home. Comments included, “Mum is absolutely safe” and “They (staff) are all lovely here and mum is very safe. I'm very happy with her care.” Staff had a good understanding about the importance of protecting people from the risk of harm, abuse or discrimination. They told us they would report any concerns to the management team and local authority safeguarding team. There were procedures for staff to follow if they had any concerns about abuse and contact details for the safeguarding team were displayed for staff.

Staff provided care that met people’s needs that was safe, supportive and enabled people to do the things that mattered to them. However, improvements were needed to aspects of record keeping to ensure all risks were identified and addressed with clear guidance for staff. Care plans and risk assessments did not include all the guidance staff may need to help keep people safe. For example, some people had been identified at risk of developing pressure damage but there was no guidance for staff as to how this would be managed. Staff were able to tell us how they prevented pressure damage for each person and actions they would take if they identified any concerns. This helped to mitigate risks to people however clear guidance for staff is needed to ensure safe and consistent care. Relatives told us their loved ones were safe at the home. Relatives spoke about the risks their loved ones were exposed to due to memory loss and general frailty and how these were managed safely at the home. One relative told us their loved one was previously very fearful at night and did not sleep well. Since moving into the home, with the assurance of knowing they were not alone and assistance was nearby, their sleeping had improved, and they were much less fearful. Staff knew people well. They understood the risks associated with their care and support and were seen to provide this support appropriately and safely. Some people required specialist diets and thickened fluids. Staff were able to tell us about these people and how they ensured they received the correct diet. Some people needed support when mobilising and staff provided this, for example, ensuring people were using the correct walking aids. There were stairlifts which supported people with safe use of the stairs. When required sensor mats were used at night to alert staff when people, who were at risk of falls, left their beds.

During our visit we saw some radiators that were hot and did not have covers to protect people from the risk of burning. The provider explained these radiators were in use because of a problem with their main heating system and the need to keep people warm. The main heating system was repaired promptly and the extra radiators were then not in use. The provider also identified specialist covers that could be used with these radiators and told us these were being ordered for future use. Following the inspection the provider told us risk assessments were now in place for the radiators that were not covered. Areas of the home were in need of some redecoration. The provider told us there was a plan to address some of these areas. However, this did not impact on the safety of the environment. The provider had a system to ensure the home and equipment was maintained and serviced. There were regular servicing contracts which included electrical safety and fire risk assessment. Regular checks took place to ensure a safe environment was maintained. There was fire, water temperature and window restrictor checks. Staff received fire safety training and fire drills were undertaken to ensure staff knew what actions to take in an emergency. Each person had a personal emergency evacuation plan to guide staff in case an evacuation was required at any time. Staff and relatives told us that maintenance issues were addressed.

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’s relatives told us staff were always available. One relative said, “There always seems to be enough staff on duty to deal with any needs from my mother’s point and also of the other residents.” Relatives also told us staff were knowledgeable about the care and support their loved ones needed. Staff told us there was enough of them working each shift. They told us in cases of staff absences they would be supported by agency staff and as far as possible this would be with agency staff who knew the service. Throughout the inspection we observed staff attending to people in a timely way. Staff had been recruited safely. Relevant checks had been completed before staff started work at the home. This included criminal record checks and appropriate references. When staff started work at the home they completed a period of induction as did agency staff to introduce them to people and their care and support needs. There was a training program which staff completed and was regularly reviewed and updated. Following training, staff completed knowledge checks to demonstrate their understanding. There was a supervision program and this allowed staff time to talk with the management team and identify any areas they needed support or wished to develop.

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. People’s relatives told us the home was clean and tidy. One relative said, “It’s always clean and tidy and there’s never any smells.” Staff received infection prevention and control (IPC) training. They understood their own roles and responsibilities related to the cleanliness of the home and the prevention of infection. Personal protective equipment (PPE) was available throughout the home and staff were observed to be using it appropriately. The home was clean throughout, if any area became soiled staff addressed this promptly when they identified it or it was brought to their attention. There were processes in place to prevent the risk of infection and maintain the cleanliness of the home. This included a daily cleaning schedule and checks took place to ensure appropriate cleaning had been completed. Monthly infection prevention and control (IPC) checks were completed to further ensure cleanliness and protection from infection. The laundry arrangements were appropriate to segregate washing items and reduce the risks of cross contamination.

Improvements were needed to some aspects of record keeping related to medicine management. However, systems were in place to ensure medicines were managed safely. People’s relatives told us their loved one’s medicines were, “All taken care of” by staff. They told us they were updated about any changes to the medicines their loved ones received. Systems were established to ensure medicines were ordered, stored, administered and disposed of correctly. Only staff who had received medicine training and been assessed as competent gave people their medicines. Staff were knowledgeable about the medicines people had been prescribed. Medicine administration records were completed when medicines had been given. Improvements were needed to some aspects of record keeping in relation to medicines. Where people had been prescribed ‘as required’ (PRN) medicines there was a lack of detail regarding when these should be given. For example, where PRN medicines had been prescribed for people who may be distressed there was no details of how the person may display their anxiety or what actions staff should take before giving the medicine. However, staff were able to explain the information to us. This helped to reduce the risks of people receiving their medicines inappropriately. When medicines needed to be added to the MAR by staff the provider policy stated this should be checked by a second staff member. We identified occasions where this had not happened. The provider took immediate steps to ensure the policy was followed.