The Flowers Care Home Limited

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. Risks to people’s health, safety and welfare were assessed and the environment was maintained safely. Medicines were managed safely. There were enough trained and skilled staff to support people. Processes were in place to learn lessons when things went wrong.

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 provider had a positive approach to learning, with a culture based on openness and willingness to learn. People and relatives told us they knew how to raise concerns and felt confident appropriate action would be taken to address them.

Accidents and incidents were recorded and there was evidence action had been taken to mitigate the risks of events happening again. Staff knew how to report events and documentation was well completed and indicated immediate and follow up actions taken to keep people safe. This included ‘near miss’ events which were also reported and acted upon. There was a process for raising complaints and concerns and action was taken to resolve any issues.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, maintaining continuity of care when moving between services. The provider had a pre-assessment process in place which enabled them to gather relevant information prior to care being provided.

Staff understood their role in supporting people to access appointments. Records showed people had access to a range of health and social care professionals when needed. People were assessed before they moved into the home and this information was used to develop care plans. The provider had been proactive in seeking other professionals’ views via a survey and feedback about staff communication and responsiveness was good.

Relatives gave us positive feedback about how the home supported their loved ones. Comments included, “[Name of relative’s] health and wellbeing has improved a lot since their admission due to staff’s commitment and care.”

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. We found the provider shared concerns quickly and appropriately. Where people lacked capacity, and restrictions were in place, the provider had applied to the local authority in line with their legal responsibilities, and this was clearly recorded.

Safeguarding logs were in place and there was evidence of close communication with the relevant authorities and people’s families. Staff received training in safeguarding and they understood how to recognise and report abuse and poor care.

People and relatives told us they felt safe. Comments included, “Yes I do feel [name of relative] is safe by the experience of care we witness and they receive.”

The provider worked with people to understand and manage risks. Staff 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’s health, safety and welfare had been assessed. They covered all key areas, including falls, nutrition, and skin integrity, along with individual identified risks. We found there had been improvements in people’s care plans but this was not always reflected in the quality of the risk assessments. Some risk assessments required more detail to ensure they fully reflected the risks. However, staff knew people well and understood the risks people were exposed to and told us they were kept up to date with changes in people’s needs. We observed people being supported safely. Where people experienced periods of distressed behaviour, improvements were required in how their behaviour was monitored to ensure records were detailed and used effectively to inform updates to risk assessments.

Relatives told us risks were managed well, which had led to good outcomes for people. Comments included, “[Name of person] is very happy and settled; a different person these days, has put much needed weight on and needed new clothes. Staff have turned their health around, no falls, it’s saved their life [being] in there.”

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

The provider had systems in place to ensure the building was maintained safely, including regular checks and audits. Systems were in place to promote good fire safety, including dedicated training from qualified professionals. We noted further work was required to ensure scenarios relating to night-time evacuations were more detailed, but we were assured the provider was taking action to resolve this.

The home décor and furnishings were well maintained and there was an ongoing refurbishment plan. People lived in a homely and comfortable environment which included an accessible outdoor patio and ‘pub’ style snug area. People’s bedrooms were personalised. There was good signage around the home to support people to orientate.

The provider made sure there were enough qualified, skilled, and experienced staff. They worked together well to provide safe care that met people’s individual needs.

The provider followed safe processes to ensure staff were recruited and inducted into their role safely. Staff received support, training, and supervision to be able to carry out their roles. The provider used a dependency tool as part of their processes for identifying the number of staff needed. This was not a recognised tool and did not provide a consistent overview of people’s needs. We discussed this with the provider and they confirmed they would review this. We observed there were enough staff to support people safely, although staff were sometimes stretched at mealtimes as the provider did not employ a cook. The provider told us there were plans to change how mealtimes were coordinated by involving the whole staff team, including the registered manager and ancillary staff, with a view to enhancing people’s support and dining experience.

Staff, people, and relatives told us there were enough staff to support people safely. Comments included, “There are good staffing numbers, well trained and we see familiar faces which my relative likes, staff treat them very well.”

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 home was clean and tidy and free from malodours. Staff followed safe infection, prevention, and control measures, including hand washing and wearing the correct level of personal protective equipment.

Relatives and people gave good feedback. Comments included, “The home is very clean and tidy, no smell, always smells lovely.”

Medicines were managed safely; however, some improvements were required.

Overall, we concluded medicines were managed safely and people received their prescribed medication on time. Some medication administration records (MARs) were handwritten and best practice guidance was not being followed. Handwritten MARs should be an exception and be checked by 2 suitably qualified staff. On the first day of the inspection MARs had only been checked by 1 staff member. On the second day of the inspection this had been rectified, and the majority of MARs had been printed by the pharmacy. Where handwritten MARs were in place they had been checked and signed by 2 staff.

Where people were prescribed ‘as and when required’ medicines protocols were in place. However, staff were not always fully detailing if the medication had been effective on the back of the MAR, in line with good practice.

The provider had made improvements to how people’s topical medicines were administered, including easy read guidance for care staff and lockable facilities in people’s bedrooms.

Staff had medication training and their knowledge and competency were regularly assessed.

We received good feedback from relatives. Comments included, “All medication is in their care plan, any changes or additions we are kept fully informed.”