Queen Elizabeth Care Centre

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 provider was previously in breach of the legal regulation in relation to people’s safe care and risk management. Improvements were found at this assessment and the provider was no longer in breach of this regulation.

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 provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Staff were aware of their responsibility to report accidents and incidents. Records showed incidents forms were completed by staff and action was taken by the management team to minimise the risk of concerns arising again. Staff told us they felt learning was shared in order to help them keep people safe. One staff member told us, “We talk about these things in handover and at staff meetings. Everything is on the system, and we are alerted to it [any changes in people’s care].” We observed action was taken in response to concerns such as additional monitoring equipment being used to support people who were at risk of falls and changes to how staff approached people during times of anxiety. The registered manager reviewed and analysed accident and incident reports to identify any themes and trends.

The provider 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. The management team had built good relationships with the local authority and health partners. Feedback received from external agencies was positive and reflected staff were aware of when to make referrals and contact partner agencies. People told us they were able to have staff with them during appointments should they wish which made them feel more comfortable. This included when people had hospital appointments. When people were discharged from hospital a review of their care was completed and staff alerted to updated information the care planning system.

The provider 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 provider shared concerns quickly and appropriately. People told us they felt safe living at Queen Elizabeth Care Centre. One person told us, “I feel very safe. It’s all good, there’s always someone going by the door.” Staff were aware of their responsibility to keep people safe from abuse and had received safeguarding training. One staff member told us, "We have a duty to protect them from harm. If we say something to them [management team] and they do not listen, we have to go to safeguarding." Safeguarding and whistle blowing processes were displayed and available to staff. These contained both internal and external detail of who to contact should they wish to raise concerns. Records showed relevant concerns had been shared with the local authority safeguarding team as required. In relation to safeguarding people’s rights under the Mental Capacity Act, systems were in place to ensure the correct processes were followed. The registered manager maintained a Deprivation of Liberty Safeguards (DoLS) log which was regularly reviewed. This ensured DoLS applications were completed as required and any conditions could be monitored.

The provider 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. Care plans and risk assessments highlighted risks to people’s safe care and gave guidance to staff on how to support people safely. This included risks such as mobility, nutrition, falls, skin integrity and how to support people when they were feeling anxious. Staff we spoke with were aware of the risks individuals faced and the support they required to mitigate these. One staff member told us, “We have permanent staff here and we all know the residents well.” Records and observations showed people received the support they required to manage risks. For example, where people were at a high risk of skin breakdown, they were supported to reposition regularly, had the correct equipment in place and were supported with skin creams where appropriate.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People lived in a safe environment where regularly checks on systems and equipment were completed. The service employed a full-time maintenance manager to oversee the safety of the building. Processes were in place for reporting maintenance concerns and records showed these were addressed promptly. Where required, servicing and testing was carried out by more specialist companies such as legionella testing, fire equipment testing and lift servicing. People had personal emergency evacuation plans in place to alert staff and the emergency services to their needs in the event of an emergency.

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 and their relatives told us they felt on the whole there were sufficient staff to support people’s needs. One person told us, “Most of the time, if you ring the bell they do come. They are busy but there is always someone around if you need them.” One relative told us, “[Relative] does have a buzzer and there does seem to be enough staff whenever we visit.” One relative said there seemed to be less staff at weekends. Rotas showed that whilst there was less management presence in the home at weekends the same number of care staff and nurses were on duty over the whole week. We observed staff were responsive to people’s needs and people did not have to wait for their care. Staff made regular checks on people who remained in their rooms to ensure they had what they needed and were comfortable. Staff told us they felt the induction training and supervision they received supported them in their role. One staff member told us, "We have 2 types of training, face-to-face and online training. If we do not know about something, we can ask and they will provide [training] for us." Records showed that the majority of staff had completed their required training and had regular supervision to assess their performance and address any concerns they may have. The provider followed safe recruitment procedures prior to staff starting work in the home. This included obtaining reference checks, evidence of the right to work in the UK and a Disclosure and Barring Service check.

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. People and their relatives told us they felt the home was cleaned to a good standard and that staff wore personal protective equipment to minimise the risk of infection. One person said, “The cleaning is good: it’s always done well. They do wear their gloves when doing personal care.” One relative told us, “It is all cleaned daily, bathrooms are spotless too.” Staff confirmed they had access to PPE and the correct cleaning equipment to help stop the spread of infection. One staff member told us, “We have different sprays for different areas. We are told what we should use where.” Cleaning schedules were in place and monitored to ensure high risk areas were cleaned more regularly. We noted there were malodours in one area of the home. The registered manager told us they would arrange for a deep clean of the area the following day. The laundry followed safe systems to ensure soiled, dirty and clean clothes were separated and washed at the correct temperatures to prevent cross contamination. There was an infection control policy in place which highlighted the correct action to take should concerns arise.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. People and their relatives told us they had no concerns regarding how medicines were managed in the home. One person told us, “The carers are very good and keep track of it all.” Systems were in place to ensure people received their medicines safely. Medicine Administration records (MAR) were completed following each administration and stock levels were monitored to ensure people had access to their medicines. We found some protocols for as and when required (PRN) an emergency medicines lacked detail regarding when or how they should be used. The registered manager ensured these were changed immediately and gave assurances a full review would be completed. Where people required support to apply topical creams this was clearly recorded in line with their prescriptions. Medicines were securely stored and unused medicines were disposed of safely. Staff received training in the administration of medicines and their competency was assessed prior to them administering medicines without supervision. The registered manager confirmed that in addition to regular audits being completed they checked one or two people’s medicines records each day to look for any concerns or themes in relation to staff practice.