Veronica House 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 requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 69 (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. Staff listened to concerns about safety and reported safety events. The management team investigated and ensured lessons were learnt to identify and embed good practice. The registered manager shared examples with us of incidents that had been reviewed to ensure improvements could be made. Staff told us learning from events was shared with them through daily flash meetings as well as staff meetings and email updates. One staff member told us, “ABC (incident) charts are reviewed weekly as part of a multi-disciplinary team approach to assess the effectiveness of the care plans people have in place, this is effective."

Although the provider worked with people and healthcare partners to establish and maintain safe systems of care, this was not always effective. Feedback from partner agencies reflected that when healthcare professionals had given advice about someone’s care, which required staff to follow a specific care plan, they were not always confident this would be done. External professionals shared concerns with us about the systems used by the management team to share changes in people’s care plans with the whole staff team. However, they also commented that the home had significantly improved since the last inspection resulting in an overall improved experience for people.

The provider worked with people to understand what being safe meant to them and the best way to achieve that. The provider shared concerns quickly and appropriately. People’s feedback reflected they felt safe living at the home and 1 relative told us, “[Person] is safe here. I don’t worry about them at all.” Staff were able to identify concerns for people’s safety or wellbeing and knew how to escalate those concerns. The provider had established systems to support staff to raise concerns and staff had received training in protecting people from avoidable harm. Where restrictions were in place, the management team had applied for Deprivation of Liberty Safeguards (DoLS) to ensure people’s care was delivered lawfully.

The provider worked with people to understand and manage risks. However, staff knowledge about people’s risk was not always up to date. We reviewed a person’s care plan that had recently been updated following an incident that placed them at risk of harm. Although the care plan had been reviewed to ensure the person’s safety, not all staff we spoke with were aware of this change and so there was a risk they may have acted in a way that failed to protect the person from a known risk. We raised this with the registered manager who told us they would take immediate action to ensure staff were updated about this specific risk. People shared with us how staff supported them to manage risks. This included the use of pressure cushions to reduce the risk of skin damage, and prompting the use of mobility equipment to reduce the risk of falls.

The home received support from a behavioural specialist who was employed by the provider to reduce the use of restraint and provide support to the staff team when managing behaviours exhibited by people who were anxious or distressed. The management team told us this input had been effective and external partners had reflected positive feedback about care planning for people with behavioural support needs.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. We saw the environment was safe for people and relatives told us they had observed staff using equipment, such as hoists to aid mobility for people, in a safe way.

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. We received mixed views about staffing. Some relatives told us they felt there could be more staff at times, but did not feel this had impacted people receiving timely care. Most of the staff we spoke with felt there were enough staff to meet people’s care needs. On the day of inspection, we found there were enough staff to meet people’s planned and responsive needs. Staff were trained and had the skills required to support people well. One staff member told us, “Staffing levels are good, I think it is excellent we can allocate staff all day to each task and there are always staff available, staff at breakfast have food and fluid responsibility.” Staff spoke positively about the induction they had received to ensure they were ready to start providing care. One staff member commented, “Inductions include lots of information on different needs and training and this includes face to face training and shadowing support.” However, some people did comment that newer staff did not always know how to support them. The registered manager told us there were a lot of newly recruited staff who were undertaking training, this included working alongside more experienced staff to get to know people. Recruitment records showed relevant checks had been carried out prior to staff commencing their employment, to ensure they were safe to work with people.

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. We saw the home environment was clean and people were protected from the risk of cross infection. Staff were aware of any restrictions or guidance about current infection risks and the management team had proactively managed risks and responded effectively to guidance provided by local infection control agencies. Personal Protective Equipment (PPE) was available throughout the home and staff had received training in infection control.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. People told us they were supported to take their medicines and records showed they received their medicines as prescribed. We saw medicines were stored and managed safely. Where people used ‘as required’ medicines guidance was in place to ensure they received these consistently. Staff told us they were trained to administer medicines and had their competency checked to ensure they were safe to do so.