Florence 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

People were protected from the risk of abuse. Risks to people were identified, assessed, documented and reviewed to ensure their needs were safely met. Staff were deployed effectively to meet people’s needs.

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.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People said they felt safe. One person told us they felt safe because staff knew about their health conditions, and they were always there to support them. A relative told us their loved one was safe because the staff made sure their loved one’s needs were met.

Staff told us they would report any abuse or poor care practice to the nurse in charge and the home manager. They were confident the home manager and registered manager would make a referral to the local authority safeguarding team and CQC if they needed to.

We observed that staff treated people with respect and dignity. Staff spent time with people providing support and showing care and concern for their well-being.

People were supported to stay safe and were safeguarded from abuse and avoidable harm. Safeguarding policies and procedures in place were reviewed and up to date with best practice to ensure people’s safety. Staff received safeguarding training and were aware of their responsibilities to report and respond to concerns. Staff we spoke with understood the different types of abuse, the signs to look for and actions to take. At the time of our assessment the registered manager was implementing a safeguarding log tool to assist with the monitoring and reviewing of safeguarding concerns raised. We saw records of safeguarding concerns were kept and records showed the registered manager and provider worked with health and social care professionals to address any concerns raised. Following our on-site assessment of the service the registered manager sent us a copy of the safeguarding log tool that they had implemented. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA, whether any restrictions on people’s liberty had been authorised and whether any conditions on such authorisations were being met. People were consulted and supported to make choices and decisions for themselves.

People were involved in planning for their care and support needs. One person told us, “I have a care plan and staff talk to me about what I want to go in it. They (staff member) always listen to my point of view. A relative told us staff discussed their loved one’s needs with them and listened to what they had to say.

Staff told us how they supported people who were assessed as being at risk due to their medical or health conditions. One staff member told us how they supported a person at risk of choking to eat and drink safely. They told us they would follow what was in the persons care plan. They explained they would make sure the person was sitting upright, make sure the person was alert, if the person was on a purred diet they would check for lumps in their food and have it re-blended if need be. They told us one person had thickened fluids and were supported to drink using a teaspoon. Another staff member told us how they supported people with epilepsy. They told us they would follow what was in the persons care plan. If the person was having a seizure, they would make sure there were no hazards around the person, protect them from injury, call for the nurse to support them. If the person needed to go to hospital the nursed would call an ambulance. A third staff member told us how they supported people that were diabetic. The chef was knowledgeable about people medical conditions. They showed us records which detailed people’s individual dietary and cultural needs. For example, some people had modified textured diets where they were at risk of choking, some people had diabetes, and some people preferred to have meals in line with their culture or religion (Halal foods).

Throughout our assessment, we observed positive and caring interactions between people and staff. Staff spent time with people providing support and showing care and concern for their well-being. We observed staff members using handheld devices to record the care they had provided to people. A staff member showed us they were recording what a person had eaten and drank. They told us this information was then recorded on an electronic care planning system and was kept under review.

Risks to people were assessed, documented, and reviewed to ensure their safety and well-being. Risk assessments identified potential areas of risk to people providing guidance for staff on how best to manage and minimise those risks. Risk assessments were person centred and detailed ways in which people could live independently as much as possible whilst remaining as safe as possible. Risk assessments informed people’s support plans which detailed how best staff should support people in the prevention of and to minimise the likelihood of harm. Risk assessments and support plans were completed for varied areas of risk such as mobility, falls, wound management, seizures and diet and nutrition needs. For example, we saw that when people were at risk of malnutrition, food and fluid targets were set and monitored by staff to ensure their dietary needs were met. Risk assessments were reviewed on a regular basis to ensure staff had up to date information that reflected people’s needs. Risks to people were safely managed and staff knew how to support people appropriately. Records showed speech and language therapy eating and drinking assessment reports were completed with recommendations on the support people required. These were kept in people’s bedrooms for ease of information. A staff member told us copies of these were kept in people’s bedrooms, the kitchen and in peoples care records, “That way everyone knows how people need to be supported to eat and drink safely.”

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us there was always enough staff on duty to meet their care and support needs. One person told us, “There is plenty of staff here. If I must use my call bell the staff come as quick as they can. I never have to wait long for support.” A relative told us there was always enough staff around when they visited their loved on.

Staff told us there was always enough staff on duty to meet people’s needs. One staff member said, “At the moment 2 staff are off work, so we have 2 agency staff helping today.” Another staff member told us, we always have 5 care staff and a nurse on duty. We don’t have to rush care, and we have time to spend with the residents.” Staff told us they had received training in relation to peoples care and support needs. They told us they were up to date with training the provider considered mandatory. Staff told us they had completed an induction when they started working at the home. This training consisted of eLearning and face to face training. A staff member told us they had completed training for example on emergency first aid, medicines administration, infection control, safeguarding adults, fire safety, health and safety, food hygiene and nutrition and hydration. A nurse told us they kept up with their continued professional development and had completed training in topics such as catheter care, UTI, wound care, diabetes, epilepsy, falls and sepsis. They also received support from the local authority dementia team and St Christophers Hospice.

We observed there were enough staff deployed throughout the home to ensure people's needs were met when required.

The home manager showed us a dependency tool and told us they used this to work out staffing levels required to meet peoples assessed care needs. If there were new admissions or people’s needs changed, then they would review the staffing levels at the home. The home manager showed us a staff rota. This reflected the names and numbers of staff on duty. Robust recruitment procedures were in place. Recruitment records included completed application forms, employment references, health declarations, proof of identification and evidence that a Disclosure and Barring Service (DBS) check had been carried out. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. The provider had a training plan in place. We looked at the training matrix. This confirmed that most staff had completed an induction and extensive mandatory training relevant to peoples care and support needs. However, some staff were not up to date with adult safeguarding training. The manager told us they would make sure all staff were up to date with training on adult safeguarding. There was a probation process in place that offered support and feedback to staff. Records showed that staff had received regular supervision.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.