Croft House Rest 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. For this key question we assessed 6 quality statements relating to; learning culture, safeguarding, safe environments, safe and effective staffing, infection prevention and control, and involving people to manage risk. We found the provider was in breach of the regulation; Good governance. Records related to people, their support needs and emergency evacuation procedures were not in place for everyone. Or did not reflect best practice. Robust and safe recruitment practices were not always followed. Staff were experienced and worked effectively together. The home was without any housekeeping staff when we visited. We observed areas of the home that were unclean. The provider recruited housekeeping staff during our assessment. We reviewed rotas which showed 3 staff were normally on shift and people had no complaints on their support. One person told us, “There are plenty of ladies around to look after everyone. I can sit in the lounge all day and staff go back and forwards checking on everyone. At night there are plenty of staff who check on rooms through the night. I never have to wait long for support.” However, on the date we visited 2 carers were on shift to provide support to 18 people.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us they had built positive relationships with staff and management and felt confident they would be treated positively if they raised any concerns.

The provider had acted and worked with the local authority when concerns had been raised. This had resulted in changes that improved care for people. Staff told us they would be confident that any concerns raised to the provider would not be overlooked or ignored.

Systems and processes were in place to support continued learning. These included supervisions, training, investigations of concerns and the completion of logs for incidents, accidents, and complaints.

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 were appropriately supported so they felt safe. They said they understood what it meant to feel safe and could say how they would raise any concerns. People told us they felt confident the registered manager and provider would act on any concerns raised. One person commented, “I am safe here, I have nothing to worry about, everyone looks after me. It is like a hotel.” A second person said, “I definitely feel safe, there are lovely carers here.”

Staff had received training in safeguarding and understood the signs that could mean a person was at risk of harm and/or abuse. Staff told us they would report concerns to the registered manager and senior leadership team, and they were confident any concerns would be actioned.

People told us they felt safe and knew who to speak with if they had concerns. We observed staff deliver care safely. People were appropriately supported so people did not feel unsafe or neglected. Staff were observed to respond to people’s requests and provide them with the support they asked for.

The provider had a system in place for the management of safeguarding concerns. This meant people were protected from the risk of harm or abuse. Staff had received training to recognise abuse and knew what action to take to keep people safe, including reporting any allegations to the appropriate person or authority. The provider had a process to learn and make improvements when something went wrong. Staff recorded accidents and incidents, which management reviewed on a regular basis to identify any trends, themes and areas for improvement. The manager sought legal authorisation where people were subject to any restrictions for their safety. Where deprivation of liberty safeguards (DoLS) authorisations were granted, we saw the service ensured any conditions were met.

When appropriate people were informed about risks and how to keep themselves and others safe. One person told us, “I am very happy here. I have been here for X years and have felt safe at all times. The staff are great and so if I have any worries, they sort things out for me straight away”.

The registered manager told us staff were knowledgeable on people’s physical and emotional needs and knew what to do to meet their needs and keep them safe. Staff told us they had been trained on what actions to take if there was an emergency, this included the administration of rescue medication. Rescue medicines are powerful drugs that are administered when people are very unwell. One person told us, “If I have worries, I can speak to any of the carers, they sort things out for me.”

We observed exit doors were secure, windows had restrictors and the home was free of obstacles to maintain people’s safety.

The registered manager had not ensured Personal Emergency Evacuation Plans (PEEPs) had been completed to show staff how to safely support two people in the event of a fire or the need for a building evacuation. The registered manager told us staff had been trained to use equipment to support people to safety in the event of an emergency.

People said they were cared for in a safe environment that was designed to meet their needs. One person told us, “I feel safe due to the quality of the building, the quality of the staff and all the doors are kept locked. I have heard them checking the fire alarm, which gives me piece of mind.’’

The provider had systems and processes in place to detect and control potential risks in the care environment. Staff had received fire evacuation training. This ensured staff knew what to do in the event of an emergency to lessen the risks and keep people safe.

We had a walk around the home to make sure it was homely, suitable and safe. Feedback from people, and staff was positive on the support delivered. We observed bed rails and falls mats were suitably maintained and operated correctly. Hazardous materials were securely stored. The home was unclean in places which was addressed during the assessment.

The management team used a variety of method to assess, monitor and improve the quality of the service provided. Smoke alarms, fire extinguishers and fire doors complied with British standards and were regularly checked and serviced. The manager sought legal authorisation where people were subject to any restrictions for their safety. Where DoLS authorisations were granted, we saw the service ensured any conditions were met.

We received mixed feedback on staffing levels from people. Most people we spoke with told us staff were responsive and attended to their needs. One person said, “There are plenty of staff. They walk around all day and I never have to wait for long if I need help. I have buzzer in my room which I can use for emergencies at night.” A second person commented, “The staff are about all the time, in and out of the lounge during the day. At night the carers pop their heads around my bedroom door to check I am ok.” However, a third person told us, “I think there could be more staff at times. They seem to need more staff between 10 and 11 a.m.”

The provider told us they had several staff leave their employment within a short period of time and they were recruiting additional staff. Staff told us they felt supported by the management and were provided with the correct training to give them the skills they needed to work with people.

We observed staff were attentive to people’s needs and demonstrated they knew people well and how they wished to be supported.

The provider did not always operate safe recruitment processes. Staff told us when they had been recruited and a range of checks including references, disclosure and barring checks (DBS) had been requested and obtained prior to starting work in the service. The information helps employers make safer recruitment decisions. Due to 1 new staff member being employed since our last inspection we looked at their recruitment file. Their records did not support best practice processes. This was discussed with the registered manager who amended their recruitment processes.

People told us the home environment was clean and well maintained. Feedback included, “The home is spotless. They also wash my clothes and bedding,” and, “I feel the home is clean. There is always a member of staff going round cleaning. My room is kept clean”.

There was no housekeeping staff at the time of our visit. One staff member told us, “We all just muck in and do the cleaning.” The registered manager told us they had chosen not to seek agency staff to complete the cleaning but had shared the tasks between current staff members. The provider employed a housekeeper after we had visited.

We took a tour of the home, carried out observations and spoke with people and staff. We observed some areas of the home were unclean. We made a referral to Lancashire County Council infection prevention team to see if they would be able to offer some support and guidance.

The home was unclean in some places indicating that cleaning processes were not robust. The provider has employed 1 cleaner since we visited. They have contacted an agency to employ housekeeping staff on a ‘as and when required’ basis to ensure the cleanliness of the home.

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