Chiltern Rest Home

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• 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 improved 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 service had a proactive and positive culture of safety, based on openness and honesty. Lessons were learnt to continually identify and embed good practice. The registered manager investigated incidents, accidents and near miss occurrences to see if anything could be done differently. For example, if someone needed to be referred for additional support like a falls assessment or mobility equipment.

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. For example, should a person experience ill health a GP would be contacted for guidance or if necessary treatment.

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. Everyone we spoke with stated they knew how to raise a concern if they were worried about anything and were confident, they would be responded to appropriately. Staff had received training on safeguarding and knew how to raise concerns.

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. People had individual assessments of risk associated with their care and support. These included, but were not limited to, risk of falls diet and nutrition. Staff were aware of these assessments and knew how to keep people safe.

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. One person told us, “We know where the fire exit points are, and we have fire drills.” The provider had made recent improvements to the physical environment including the replacement of hot water pipe cladding and radiator covers to limit the potential for injury.

The service 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. People told us they were supported by enough staff to meet their needs in a timely way. One person said, “They (staff) always come quickly if the buzzer is pressed.” The provider followed safe recruitment checks to ensure only suitable persons were employed to support people.

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. People told us the staff supporting them always wore appropriate personal protection equipment. The home was clean and tidy and regular checks were made to ensure effective infection prevention and control practice was maintained.

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. One person said, “I have my medication when I need it.” A recent quality check identified a greater level of detail was required on peoples medicated creams records. The provider acted immediately, and records were revised and gave staff greater information to safely meet peoples needs. People had protocols in place for the administration of PRN (as and when needed) medication including the prescribed dose, time between administrations and maximum dose within a 24-hour period.