Crowstone House

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.

The service was previously in breach of legal regulation in relation to people’s safe care and treatment due to risks not always being managed safely. At this assessment we found improvements had been made and the service was no longer in breach.

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 registered manager had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and reported safety events. Lessons were learnt to continually identify and embed good practice. The registered manager had systems in place to investigate and share learning with staff from all accidents, incidents and safety concerns at the service.

The registered manager 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. Before people came to live at the service the registered manager did a full assessment of their needs to ensure they could be met at the service. The assessment included people, relatives and other health professionals involved in their care to ensure a smooth transition into and out of the service.

The registered manager 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 registered manager shared concerns quickly and appropriately and investigated these in partnership with the local authority to keep people safe. People and their relatives told us they felt safe using the service. One relative said, “My husband has 24/7 care here, and I am more than happy with the care he receives.” A person told us, “I am happy here, the staff are nice.” Staff told us if they had any concerns, they would raise these with a senior member of staff or would raise them externally from the organisation. The registered manager clearly displayed how staff could raise concerns internally and externally.

The registered manager worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Staff understood risks to people, and these were regularly reviewed and updated when needed. Risk assessments of people’s health needs were in place which directed the level of support and intervention people needed from staff. Where people displayed distressed behaviour there were guidelines in place for staff to follow to help lessen their distress and offer positive support.

The registered manager detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The registered manger implemented a process for monitoring the home environment to identify and manage risks relating to the condition of the building. Risks identified at the last inspection had been addressed such as wardrobes being securely attached to walls to prevent risk of toppling over. The environment was now well maintained with risks identified and mitigated against. We found signage could be improved to help people with dementia navigate themselves around all the facilities, such as directions to lounge areas or toilet facilities. The registered manager informed us they were reviewing signage and provided evidence they had added more signage after our visit.

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 who looked after them were kind and caring. One person said, “I like living here. The staff are kind to me.” A relative said, “I am happy with the care here, staff are kind and caring, and I am always made to feel very welcome.” Staff told us they had a supportive team and felt they had enough staff to provide support to people.

Staff were employed after the appropriate recruitment checks had been made. Staff received an induction before they commenced work and were supported with on-going training and supervision. One member of staff said, “I had a four-day induction when I started, but did not feel this was enough and asked for more time, and this was given to me.”

The registered manager assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Staff had received training in infection and prevention control and the provider had policies in place for staff to follow should there be any outbreaks of infectious diseases. There was personal protective equipment (PPE) placed around the service for staff to use. The service was clean and well maintained with regular cleaning schedules in place. The registered manager completed regular audits on cleaning and infection control and took action when needed.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Medicines were managed safely. Staff had received training in managing medicines and had their competency to support people with medicines checked. There were detailed documents in place to support people to have their medicines safely. This included medication administration records, ‘as and when required’ medicine protocols, patch placement and topical cream application records.

Audits were in place to check medicines were being managed safely and people received their medicines when they needed them.