Warren 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 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.

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 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 attended team meetings which were held on a regular basis and provided them with the opportunity for discussion about the service, care they provided to meet people’s needs and learning opportunities. Staff told us they felt supported by management and within their roles. One staff member commented, “There’s lots of appreciation which is nice and makes you want to do your job." The registered manager was the safeguarding lead for the service. They were knowledgeable about safeguarding, the importance of learning from events, and their responsibilities and their Duty of Candor.

The provider worked with people and health and social care partners to establish and maintain safe systems of care, in which safety was managed or monitored. They ensured there was continuity of care, including when people moved between different services.

People’s care, and support needs were assessed before they moved into the service. Assessments covered various aspects of individuals care and support such as; mobility, nutrition and hydration, personal care, communication, mental health and medicines management amongst others. Records showed that referrals to health and social care professionals were made in a timely manner to ensure people received the support they required maintaining a safe system of care and support. A GP visited the service on a weekly basis and any specific health needs were raised to the GP by staff ensuring any risks were reviewed and addressed. The registered manager and senior care staff informed us that there was good access to the GP and a good working relationship with the GP that visited.

Staff worked with health and social care professionals to ensure people were supported to remain safe. Staff focused 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 the service. One person said, “I feel safe here, I have no concerns about the service.” Another person commented, “Staff are very friendly, I feel safe.” Staff received safeguarding training and were aware of their responsibilities to report and respond to concerns. Staff understood the different types of abuse, the signs to look for and actions to take. A staff member told us, ‘I had training on safeguarding. I know about the different types of abuse. I would report any concerns I had to the registered manager, to the local authorities safeguarding team and CQC if I thought I had to.’ The registered manager had systems in place to assist with the monitoring, reviewing and learning of safeguarding concerns raised. Records of safeguarding concerns showed the registered manager and provider worked with health and social care professionals to address any concerns raised.

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. We checked whether the service was working within the principles of the MCA. People were consulted and supported to make choices and decisions for themselves. Staff promoted people's rights and worked within the principles of the MCA.

Risks to people were assessed, planned for and reviewed to ensure their safety and well-being. People’s care records included risk assessments for areas of their care such as, choking, moving and handling, nutrition and hydration and diabetes. Risk assessments included information for staff about actions to be taken to minimise accidents occurring. Where people had been assessed as being at risk of choking, we saw advice had been received from appropriate health care professionals and their care plans recorded the support they needed from staff to ensure they could eat and drink safely.

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. The chef was knowledgeable about people’s dietary needs. They showed us records which detailed people’s individual dietary needs, for example, some people had modified textured diets where they were at risk of choking. 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.

People had individual emergency evacuation plans which highlighted the level of support they required to evacuate the building safely in the event of an emergency. Staff had received training in fire safety.

The provider detected and controlled potential risks in the service environment. They made sure equipment, facilities and technology supported the delivery of safe care.

People had access to equipment that enabled their independence and ensured their physical and emotional needs were met. For example, hoists, walking aids and wheelchairs. Health care professionals had assessed people’s needs and supplied equipment that met their needs. We saw appropriate signage throughout the service for example, people’s bedroom doors included pictures of things that were important to them to aid them with orientation. There were large gardens at the front and to the rear of the service for people to enjoy in warmer weather. The provider told us new garden furniture had been ordered for the rear garden.

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.

The provider used a dependency tool to determine the staffing levels required to meet people’s needs safely. We observed there were enough staff deployed throughout the service to ensure people's needs were met when required.

Processes were in place to ensure staff were safely recruited. Staff files showed the provider completed all the necessary pre-employment checks before staff commenced employment. These include DBS checks, employment history and references from previous employers. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. All staff were trained in core areas such as safeguarding, fire safety, first aid and person-centred care, they also received training on other topics relevant to the needs of people using the service for example, moving and handling. New staff completed a structured induction and shadowed experienced members of the team. Staff told us they had regular supervision and a yearly appraisal to reflect on their performance and identify support that they may need.

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. The service employed domestic staff. A domestic staff member told us they worked from 7am to 13:30pm every day. The service was clean, free from odours and had infection control procedures in place. We saw hand wash and paper towels in communal toilets and staff had access personal protective equipment (PPE) such as gloves and aprons when they needed them. Training records confirmed that staff had completed training on infection control and food hygiene.

The provider carried out regular monthly infection prevention and control audits. Staff told us they had access to PPE when they needed it. Staff were observed using PPE appropriately and when required.

The provider made sure that medicines administration was safe and met people’s needs, capacities and preferences. People told us there were never any problems with their medicines, they received their medicines at the same times when required.

Medicines were administered by senior staff who were appropriately trained to do so. We observed the medicines administration rounds. Senior staff ensured the medicines trolley was secure and Medicines Administration Records [MAR] were completed according to administration. Medicines were stored correctly, and fridge temperatures were recorded daily and were within safe boundaries. Protocols for ordering, storage and disposal of medicines were in place and medicines audits were completed and fed back to the registered manager to ensure continued safe practice.

Where covert medicines (given to people without their knowledge) were recommended by health care professionals, the GP and pharmacy had provided advice about administration. Where people lacked mental capacity to manage or give consent to others managing their medicines this was assessed and decisions recorded for their best interests. People were told about the medicines they were offered, and this was done in a friendly, respectful way. People were asked about their symptoms in relation to ‘as required’ [PRN] pain medication, before being asked if they needed the medicine.