Summerville Care Home

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

The provider had systems in place to keep people safe from abuse and avoidable harm. The provider worked with other healthcare professionals to establish and maintain safe systems of care. Accidents and incidents were investigated and lessons learned. People told us they had to wait up to 20 minutes for help from staff when they needed assistance, however, regular management reviews demonstrated an improvement in call bell response times. Staff used safe moving and handling techniques when assisting people Staff deployment was not always effective at mealtimes. The service was clean and tidy, and staff had been trained in IPC. Some improvements were needed around the safe management of medicines. This was addressed immediately by the registered manager by implementing more robust procedures. Staff had been recruited safely.

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.

Relatives told us people received safe care. When events occurred, relatives said they were kept up to date and actions were made to mitigate further risk to their loved one. One relative told us, “They [staff] are on the phone straight away and let me know what’s going on, I can’t fault that.”

Staff were able to describe the process for reporting and recording accidents and incidents. Staff were able to describe how lessons learned were discussed through daily meetings to embed learning from incidents to prevent recurrence.

The provider had systems in place to ensure staff followed procedures in relation to reporting events which occurred. They had a focus on analysing and learning from these to prevent future occurrences.

Relatives described how the provider worked in partnership with other agencies to support safe care and treatment. Relatives told us how they made people transitioning into the home feel welcome. One relative told us, “It was brilliant, the room was made, the TV was on, and the room was warm.” Relatives were kept informed of medical appointments made by staff for people. One relative told us, “I get told straight away of any appointments.”

The registered manager was able to explain the pre-admission process with us. Staff told us they would get to know the needs of new admissions through care plans, via their handover system and by speaking with the person directly.

We sought feedback from partners about how the provider worked effectively with other agencies through periods of transition. We did not receive any information of concern with respect to this.

The provider had systems in place and liaised with other professionals to ensure people experienced a safe transition between services. For example, a person returning to the home required additional equipment and did not return from hospital until this was in place.

People told us they felt safe. This was supported by the views of relatives. Comments included, “I cannot see how [relative] can be any safer” and “I have no concerns around safety.” Relatives told us they felt confident raising concerns.

Staff told us they received relevant training and understood the actions they must take to safeguard people.

The people we observed seemed content in the communal areas. We observed staff treating people respectfully and spoke with them in a kind manner.

Systems, processes and practices were in place to protect people from abuse and neglect. The registered manager ensured safeguarding concerns were appropriately reported, with any further actions required and outcomes being recorded. Staff had received safeguarding training.

Most people felt they received safe care and were supported effectively to manage risk. However, this view was not shared by one person, and this was fed back to the registered manager.

The registered manager described how they reviewed risk daily through meetings and updating care plans.

Staff were able to explain how they responded to risk situations.

Kitchen staff told us how they understood and catered for people receiving a modified diet.

We observed staff using safe moving and handling techniques when assisting people.

Peoples’ changing needs were consistently risk assessed. Care plans and risk assessments were updated appropriately. Care plans contained relevant risk assessments.

Some people required the use of equipment to keep them safe. These were always available for people and safely maintained. However, several pressure mattress settings did not always match the information in the persons care plans. We raised this with the management team who acted and implemented a new monitoring system.

Where risk had been identified in peoples’ care records, daily care records did not always evidence they had been managed and mitigated. For example, one person, on regular changes of position to help maintain their skin integrity, records did not demonstrate this care had been carried out as instructed in their care plan. Which placed them at greater risk of their skin breaking down. We fed this back to the registered manager.

People and their relatives felt the home was safe and suitable for their needs.

All staff told us they have been trained in using equipment. Staff had no concerns regarding the environment; one staff member told us, “Things get fixed quickly.” Staff confirmed the fire alarm was tested weekly.

We saw one room being re-painted as someone had recently changed rooms.

Furnishings were appropriate for the people’s surroundings. There were plenty of chairs for people to sit within the home, however, equipment was stored in communal bathrooms demonstrating a lack of storage.

Fire doors were in working order, escape routes and exits were clear, however, combustible items were stored on top of a tumble drier. Storerooms and bin areas were found to be unlocked. These issues were immediately resolved when raised with the registered manager.

Routine safety checks on the environment and equipment were up to date and certificates were in place to demonstrate this.

People had access to equipment to meet their needs. Maintenance tasks were carried out promptly.

The registered manager conducted daily walk rounds to identify any improvements needed, however the areas for improvement that we raised were not identified.

Most people and relatives acknowledged staff to be skilled and compassionate in providing care to people. However, people told us they had to wait for support. One person told us, “It can be 15-20 minutes.” However, the management team was already aware of these ongoing concerns and continued to review people who required monitoring throughout the day.

Relatives told us staffing levels could be improved. Comments included, “I think there could be more [staff],” “There are not enough staff” and “They are less staff at a weekend.”

Staff told us there were not enough staff to provide safe and effective care. Comments included, “It’s hard, we don’t have enough staff, mornings are a struggle getting people up” and “Not enough staff to support them all [people].” Whilst another staff member said, “We have some vocal residents who want to get up in the morning and it takes time.”

Staff told they did receive group supervisions, some staff told us they would prefer supervisions on their own. We shared this feedback with the registered manager who booked individual supervisions.

Whilst we observed staff present on the ground floor and in the communal areas, staff presence was lacking on the first floor which impacted on peoples’ care.

We observed people waiting for assistance when they pressed the call bell from their own rooms. For example, during breakfast time one person was distressed, we raised this with a staff member who replied, “All the staff are serving breakfast in the lounge.”

The registered manager was already aware of some of these concerns, and they continued to monitor staff deployment for effectiveness.

We reviewed 6 recruitment files and found staff had been recruited safely. Checks had been carried out on staff before they started employment.

Staff received regular group supervisions, and the registered manager had recently implemented individual supervisions.

The provider had a process in place for managing deployment of staff across the home

People told us staff wore appropriate protective personal equipment (PPE) when providing care. This was supported by the views of most relatives.

Staff confirmed they had received training regarding infection prevention and control. Staff knew the actions to take in the event of an infectious outbreak. They confirmed how they would adapt their practice. For example, frequency of cleaning and wearing full PPE.

We observed the home was generally clean and tidy, however, some areas needed improvement. For example, walls had flaking paint, damaged floor in the communal area, pull cords were not wipeable. The registered manager was addressing these issues.

Staff had access to PPE.

Systems in place were not always effective in protecting people from the risk of infection. Staff received training and spot checks were undertaken by the management team on staff practice.

People were appropriately supported with their medicines.

Staff told us they had completed training in medicines management and had their competency checked.

Systems were not robust in managing medication.

Staff had not followed safe practices when administering medication. We found one person was prescribed eye drops; however, staff were administering this medicine after the expiry date.

We were not assured people were receiving topical creams that were effective due to staff not recording the dates of opening.

Some instructions were not always clear. For example, when one medication had changed from prescribed to an ‘as required’ medicine, the label did not match the medication administration record.

We raised these issues with the registered manager who took immediate action to address feedback received.