Chester 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

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last inspection we rated this key question requires improvement. At this inspection the rating has changed to good.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Any incidents about people's safety were discussed with staff in a timely way, with action taken to mitigate further risks. A staff member told us, “Learning is shared. For example, a cardiac de-brief was very beneficial to discuss learning after a health incident.”

The service 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. Professionals’ comments included, “The staff seem to go above and beyond to support the residents and are brilliant in reporting any concerns and bringing professionals together in terms of MDT (multi-disciplinary team) working” and “Assessment referrals have been appropriate, and any equipment recommended by myself, is the homes responsibility to fund, and has been provided in a timely manner.” A relative told us, “We provided lots of information before [Name] moved in and we had a book to fill in.”

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They 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 service shared concerns quickly and appropriately. People and relatives told us they felt safe, they would speak with staff if they were worried, and they always felt listened to. Their comments included, “[Name] is safe and comfortable. The staff are absolutely smashing, and the nursing is excellent.” A professional told us, “Safeguarding issues are raised with transparency and in a timely manner and the manager will always check re outcome and that any actions are completed.”

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Risks to people had been assessed and risk assessments had been put in place to help mitigate risks. Staff supported people safely and appropriate equipment was available if people needed assistance. A relative told us, “The hoist is always there when [Name] needs it.”

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Environmental risks were assessed and addressed. A relative commented, “Safety, that is what [Name] gets from being here.” A staff member told us, “Equipment is replaced as soon as it is needed” and “When someone is at risk of falls, staff do hourly observation checks, and we have sensor equipment to alert us.”

The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. Staff member’s comments included, “Colleagues are supportive” and “There are opportunities for career progression, with good support in learning.” Staff worked together well to provide safe care that met people’s individual needs. However, we received mixed feedback about staffing levels and staff deployment. People told us they felt safe with staff support, but not all people and relatives thought there were sufficient staff. For example, there were times people had to wait for their care. Their comments included, “There are plenty of staff, there is always someone around”, “The staff are there for you”, “There are not enough staff at times, especially at meal times, [Name] is waiting”, “There are enough staff during the week, at the weekend it is lacking” and “Every time I just want to go to my room, I wait a long time to get undressed.”

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Staff told us personal protective equipment (PPE) and all cleaning materials needed were available. They confirmed they had received infection control training.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened. Some improvements had been made to medicines management since the last inspection. However further improvements were needed to medicine records, which were discussed during our inspection. The registered manager took immediate action and introduced a list of medicine checks that they reviewed on a daily basis. Records for cleaning and managing percutaneous endoscopic gastronomy PEG tubes (a tube to receive nutrition through the stomach) had improved, and some other issues regarding PEG management identified at inspection, such as a medicine that was not on the guidance list for crushing, was checked with the relevant health professionals and was rectified on the day.