Royal Garden Hotel

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

Systems and policies were in place to keep people safe. People were protected from the risk of harm and abuse. Risks were managed, positive risks were encouraged and care plans provided guidance to staff to keep people safe. There were enough trained staff to support people. People told us they felt safe and we saw positive and friendly interactions between people and staff. People had input in their care and were able to live independently. Staff encouraged people to take positive risks. There were enough trained staff to support people safely and in a relaxed way.

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.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

There were policies in place to ensure people were safe. The policies focused on empowering people, and positive risk to ensure people kept their independence while remaining safe at the home. Safeguarding training was provided for staff and formed part of mandatory refresher training, it was also covered in staff supervisions.

Staff were fully trained, had completed National Vocational Qualifications, and often had a history of working in care. Induction training included safeguarding to ensure staff recognised how to prevent and recognise harm, abuse or discrimination. The registered manager said they had an office on site and people were able to come and raise any concerns or issues with them at any time. People were also able to talk to staff while care was being provided. The registered manager had a good knowledge of local authorities safeguarding protocol and what was expected of her. She knew how to report concerns to the local authority and police and sent notifications to CQC. The registered manager said unexplained injuries would be reported but this was rare. The registered manager said staff would question bruising if they saw it. We spoke with staff, who had a good knowledge of safeguarding.

People told us they felt safe at the home. People said the home was peaceful and well managed. One person said they understood safeguarding and felt it was managed well at the home. Another person said they knew they could speak to the registered manager about concerns or call the police if there was a crime. One person said, “[I am] Very comfortable here, not sure what else to say. I choose to be here, if I didn’t like it, I would find somewhere else to live”.

We saw people being supported in a safe way. People were treated with respect. Physical care interactions were minimal, mainly verbal prompts and these were delivered in a compassionate way. No one was observed to be fearful of staff or each other. Positive interactions were observed throughout the inspection.

The deputy manager told us how risk assessments were part of the care plan, and we looked at these. Risks about nutrition, skin integrity, and mobility were clearly recorded along with reminders for staff ask for consent when providing care. On a care plan for a person with diabetes there was clear guidance for staff on how to manage hypoglycaemia or hyperglycaemia, including signs to watch for and actions to take.

People told us they managed certain aspects of their care, but understood their own abilities and limitations, and would ask for help when needed. A person told us they liked to use the stairs to keep their mobility ‘in good shape’. People said they had participated in their care planning needs and met with the manager to update these as needed.

Staff knew people well and understood any risks, how to reduce them, and which things people could manage on their own. Staff had training in recognising infections and knew when to report concerns to senior staff.

People mobilised independently around the care home. The care home was on three floors and people were able to independently access the lift to reach each floor. Some people used the stairs. We saw staff encourage people to use mobility aids in safe ways.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

People at the home needed minimal support with personal care. Staff had time to sit and speak with people and when necessary staff accompanied people out of the home, for example to assist them with shopping. People said they never really had to use the call bell but if they did staff would answer very quickly. People told us it was positive that agency staff were never used. When we asked about staff skills a person said, ““No concerns in that area, they all seem pretty competent”.

There were enough staff to support people safely. We saw staff were available to help people when needed and we looked at staff rotas to confirm there were always adequate numbers of trained staff. People had call bells in their rooms and at various points around the service including bathrooms. During the inspection call bells were not heard. Staff and people told us it was very rare a call bell was used.

We looked at two staff files for evidence of safe staff recruitment. We saw safe recruitment processes, Disclosure and Barring Service (DBS) checks, two references, and full employment history. The registered manager said that staff were able to shadow experienced care staff before their DBS was returned however, they were not able to work alone or provide personal care. We looked at several weekly rotas for the home and saw safe staffing levels and a clear policy that the registered manager needed to approve any changes to staff hours or shifts. Staff were fully trained in aspects of care and had National Vocational Qualifications (NVQs) at appropriate levels.

We spoke to staff at the home. Staff told us the induction process was good and they felt well supported by the registered manager. Staff knew people well and told us they knew how to record any incidents and accidents, although these were rare. Staff said people needed minimal assistance but there were enough staff to help people if the need arose. Staff told us there was never a need for agency staff as the core team was always available to cover shifts if needed. The registered manager and the provider were in the home most days if people needed to talk to them.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.