Pear Tree Court

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 felt safe and were protected from the risk of harm and abuse. The provider assessed, monitored and mitigated risks to ensure people were safe. Effective learning took place from safety events. People and staff provided mixed feedback about staffing levels. Staff were safely recruited and received training to fulfil the requirements of their role. The environment was safe, and staff followed good infection control practices. Medicines were safely managed although improvements to records were needed for ‘as required’ medicines.

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 and relatives told us the service was safe and any areas for improvement were acted on. For example, 1 relative said, “Occasionally, I go to [registered manager] or [nurse] and it’s always dealt with promptly, efficiently and with empathy.”

Staff told us they would report any accidents and incidents, and that learning was taken from these events and actions taken to reduce future risks. For example, 1 person who had several falls when they first arrived in the home. Changes were made to the persons care and environment which resulted in them ‘feeling safer and greatly reduced the risk of falls.’

There was a robust process where complaints, accidents, incidents and safeguarding concerns were monitored. This enabled themes and trends to be identified and ensured timely investigations, potential learning and continual improvements in safety.

People told us there had been a smooth process when they moved into the service. For example, 1 person said, “I came here for respite and decided to stay.”

Staff and leaders understood their role in ensuring other healthcare professionals had up to date information about people when they moved between services. For example, 1 staff member said, “When a person goes into hospital, all their medical information is sent with them, why they’re being admitted to hospital, hospital forms, next of kin information, DNR (Do not resuscitate) forms and all essential information that needs to go with them is photocopied”.

We were unable to gain feedback from partners about safe systems, pathways and transitions but no one told us of any concerns.

Processes ensured important information was gathered about people and shared with other healthcare professionals as they moved between services. The service assessed people’s needs prior to people using the service to ensure they could be met.

People and their relatives told us people received safe care from staff who were kind and caring. Comments included, “There is always kindness displayed to her.” and “They [staff] are very caring and know my mother’s needs. It is the consistency and caring that my mother gets, which is very good.”

The registered manager understood their responsibility to share information with the local authority safeguarding team and to CQC to ensure allegations or suspected abuse were investigated. Staff understood their safeguarding responsibilities to keep people safe, challenge discrimination and report any concerns. They were confident any concerns raised would be dealt with effectively. For example, 1 staff member said, “Our manager takes everything seriously. I had an issue recently and no matter how small it is she will always take things very seriously and report safeguarding issues.”

People appeared relaxed and comfortable in the company of staff. We saw kind and compassionate interactions between staff and people.

The provider had safeguarding and whistleblowing policies and procedures which staff knew how to use. Records of investigations into concerns were maintained and the provider ensured learning and improvement was taken in response to any safeguarding concerns, where appropriate.

People and relatives told us the service managed risks associated with people's needs well. For example, 1 relative said, "They [staff] are very good. My [relative] is not too good on her feet so they always make sure her walker is nearby”. Another relative said, “I am very happy with the procedures they have put in place now that mitigates this [risk of falling].”

Staff demonstrated they knew people well and how to reduce any risks associated with their health conditions or support needs.

We observed staff supporting people safely and following people’s individual risk management plans. For example, people were provided with the right consistency of food to reduce the risk of choking.

Risks associated with people's health conditions and support needs were assessed, monitored and managed effectively. Individual risk assessments were completed, reviewed and updated to help ensure people's safety. Risks to people were discussed in meetings on a regular basis. This ensured all staff were aware of any changes, and actions were taken to reduce risks. Monitoring charts were used to ensure methods to reduce risks were being undertaken in line with people's risk assessments.

People and relatives told us the environment was safe.1 person said, “Safety first. No hazards.”

The registered manager and staff told us the environment was safe and explained that regular checks were carried out to ensure safety. For example, 1 staff member said, “The team and the management make sure it’s safe. We are in a locked unit; we make sure the pathways are clear from any obstacles.”

The home was safe for people to live in. It was spacious and tidy, which allowed people to move around freely. Emergency exits were kept clear, and fire doors were kept locked or shut where appropriate.

Systems ensured suitable checks and maintenance were carried out on equipment and the environment. Any environmental risks were assessed and monitored.

We received mixed feedback about staffing levels from people and relatives. Comments included, “They [staff] definitely need more staff to spend time with us and not to rush as they do. They are always rushing.”, “I do think they are a bit short staffed. I go in most days, and I can see the shortages.” and “Depending on staff levels they help as much as they can.” Others said, “From my point of view there’s enough [staff], 1 lady was taken unwell in the coffee lounge and 4 staff were there in 10 seconds.” and “There always seems to be adequate staff on duty during the day.” Everyone was positive about the skills of staff. For example, a relative told us, “I would describe the staff as caring, empathetic, loving, competent and professional.” A person said, “They’re [staff] wonderful. I keep them on their toes.”

Most staff told us there wasn’t enough staff for them to fulfil the requirements of their role. Comments included, “There’s so few staff here, we really need more.” “[Today, it’s been] hectic, we’ve been nonstop. I like it being busy as times goes quick but sometimes, we need another 12 hours to get it all done.” and “We want the residents to have more. Today I could have showered 3 or 4 people but I didn’t have the time.” Staff were positive about the induction and training they had received to equip them for their roles.

When staff were aware that people required support, they responded in a timely way and call bells were answered promptly. Staff supported people in line with their care plans and risk assessments and demonstrated they knew people well. However, there were periods of time where people lacked engagement from staff. Also, on 8 occasions we needed to find staff who were not readily available to help people who required support.

The provider assessed staffing levels based on people's needs. The registered manager confirmed staffing arrangements were reviewed regularly and undertook checks to ensure staffing levels were appropriate. However, the outcome from these processes did not reflect some feedback from staff and people or our observations about a lack of staff to meet people’s needs. Following the inspection, the registered manager told us about changes to staff arrangements to ensure staff were able to meet people’s needs. New staff received a comprehensive induction, and training was refreshed regularly. Staff were also supported to develop. For example, 1 care assistant had progressed to team leader and a nurse had been supported to enhance their clinical skills. Staff were recruited safely. Appropriate checks were completed to ensure staff were suitable to work at the service. The registered manager had worked hard to establish a stable staff team, and we saw from the staff turnover report, staff retention had improved over the year.

People and relatives told us the home was clean. For example, 1 relative said, “The cleanliness is impeccable here.” A person told us, “It’s kept immaculate. The cleaner is brilliant.”

Staff told us the home was kept clean and they had the necessary equipment to ensure good infection control procedures were followed. For example, 1 staff member said, “We have a touch point book regarding cleanliness of the home and infection control. We always wear aprons and gloves. We will wear masks if needed. Everything is always available for us to use. We have done training online regarding hygiene and the clinical lead does IPC (Infection prevention control) training with us in person. We will encourage the residents to wash their hands in between toileting and things like that. Anyone in the kitchen will wear an apron.”

The service was clean, and cleaning staff worked in the service each day. There was liquid soap and paper towels at hand washing areas and additional hand sanitizers throughout the service. Staff were seen to wearing appropriate Personal Protective Equipment (PPE).

The provider had effective systems and processes to prevent and control infections and ensure any infection outbreaks were effectively managed. Regular audits ensured infection control was embedded in staff practice.

People and their relatives told us they were happy with the medicine support people received. For example, 1 person said, “All my medicines are dealt with. I get them at the right time, 3 times a day and they are all explained to me.”

Staff responsible for managing medicines were aware of safe practice. They confirmed they had received training and competency checks. They knew people well and supported them in the way they preferred.

The provider had effective medicines policies and processes. Audits were carried out to ensure medicines were managed safely. However, protocols for ‘as required’ medicines were of a varying standard and did not always provide staff with enough information on when and why people might need their medicine. For example, we observed 1 person in pain who was not offered their ‘as required’ pain medicine The registered manager told us their pain was helped better by supporting the person to reposition, but this information was not on their protocol.