Freeland House Nursing 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

People told us they were safe living at Freeland House. Staff had received training in safeguarding and knew how to report any safeguarding concerns. Risk assessments and management plans were in place and reviewed regularly. Equipment was used appropriately to support people and was checked to ensure it was safe to use. There were systems and processes for staff to follow and incidents and accidents were analysed. Improvements were made in response to learning from incidents. The provider had a positive culture of safety in which concerns about safety were listened to. We saw evidence that safety events were reported and thoroughly investigated with lessons learnt to continually embed good practices. The provider met their responsibilities in relation to duty of candour. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. There were enough staff to support people’s needs and the service was fully recruited. Staff had access to supervisions and appraisals which were used to develop and review their practices and focused on professional development. The provider had safe recruitment processes in place. The provider had an up-to-date infection prevention and control (IPC) policy which staff followed. They ensured infection outbreaks were effectively prevented or managed.

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 in which concerns about safety were listened to. We saw evidence that safety events were reported and thoroughly investigated with lessons learnt to continually embed good practices. The registered manager facilitated clinical governance meetings which enabled wholistic strategies for safety improvement utilising healthcare professionals’ input. For example, poor communication had resulted in delayed referral for medical support. With support from healthcare professionals, they introduced referral tools which captured all the information required for remote decision making. Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses; they were fully supported when they did so.

The provider met their responsibilities in relation to duty of candour. Duty of candour requires that providers are open and transparent with people who use services and other people acting lawfully on their behalf in relation to care and treatment. They had effective procedures in place which facilitated their honest and transparent information sharing and communication. The registered manager ensured they reflected on where things could have been improved and used this as an opportunity to improve the service for people and staff. Records of staff meetings also highlighted where learning and change had been implemented.

People and their relatives told us they were informed and apologised to when things went wrong. Relatives said, “I visit regularly and always get calls with any updates on medication, and even when [person] just tripped over. I get calls after Dr visits to advise on medication and weight” and “If they have any medical issues they always ring and leave a message if we do not answer, this can be anytime of the day or night. On one occasion, the staff called the paramedics, and they rang straight away. They also update us weekly with [person's] progress.”

The provider told us they had safe referral systems in place which ensured continuity of care. There was effective partnership with other services and healthcare professionals. Staff told us they had systems to guide them when supporting people during transitions. There were enough staff to support with these processes.

People told us they could easily access other services with staff who knew their needs available to support them with visits. Records showed there was clear planning to ensure continuity of care.

Healthcare professionals who often worked with the service were positive about the collaboration with the home and the referral systems which enabled people to access care and support when they needed it. One healthcare professional said, “I have a meeting with the nursing team at my visit each week, and we have a clinical governance meeting twice a year. I believe it is a good home and I don’t have any specific concerns.”

The provider’s referral and communication processes enabled safety and continuity of care. These processes were often reviewed to ensure they were fit for purpose.

Staff were trained in safeguarding and were able to identify the common signs of abuse. Staff demonstrated that they knew who to report any potential safeguarding to and where to escalate this if necessary. One member of staff said, “I can report any concerns to manager or deputy. Also, CQC, Safeguarding, police.” Staff told us people were supported in line with the principles of the Mental Capacity Act (MCA). Staff had received training about the MCA and understood how to support people in line with the principles of the Act. One staff member told us, “We support residents in their best interest and to make their own choices.”

The provider had a detailed safeguarding policy and procedure for staff to follow. This noted current information on what to do if anyone suspected a person was at risk of harm. Care plans contained consent to use photographs and documents were signed by people or their legal representatives. Where people were thought to not have capacity to make certain decisions, capacity assessments had been carried out. Where capacity was not evident to make specific decisions, best interest decisions had been made and management and staff followed the correct process to do so.

People told us they felt safe living at Freeland House. They said, “Yes, I do feel safe. I have a fall mat and the girls help me and walk by my side when I go about, just in case I have falls” and “Oh yes I feel safe because I haven’t come across anything that makes me feel unsafe.” People’s relatives were equally positive about safety. They commented, “Safe, yes, we know we will always get a phone call if there are ever any problems and because we trust the staff here” and “Extremely safe, there is always multiple staff around checking on mum.”

We saw people engaged with staff in a relaxed manner and they looked comfortable in their presence. There was a relaxed atmosphere which enabled staff to focus on people’s individual needs.

Staff told us and records showed they regularly assessed risks associated with people’s care and well-being and took appropriate action to ensure these risks were managed and that people were safe. The provider’s electronic recording system effectively interlinked people’s risks, allowing personalised planning of care.

People’s risk assessments included areas such as falls, skin integrity and choking. Where people had been assessed as requiring regular checks, records seen indicated that these had been completed.

The provider had procedures in place which gave them oversight of the recording and monitoring of the risks people faced in their lives. This included monitoring falls and pressure ulcer risks. Staff considered patterns and trends in order to minimize the risks to people and inform staff how to support people safely. Staff met with healthcare professionals on a regular basis to share best practice, review people’s presenting risks and take action to ensure people were cared for appropriately.

We saw people were supported in line with their risk management plans. For example, where equipment was required to support with mobility, staff followed guidance and ensured people were safe.

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

There were enough staff to meet people’s needs. Where people required support, we saw staff were quickly available and anticipated people's needs. We saw calls bells were responded to quickly. Staff looked relaxed and not rushed.

People told us there were enough staff to meet their needs and they did not have to wait for support. They said, “I think that there are probably enough staff and I think they are well trained”, “The carers come whenever I call for help. I see them around all the time.” Relatives were equally positive about the staffing levels. They told us, “There appears to be plenty of staff, there is always someone there to help”, “Yes there is always plenty of staff when I have been, if I require any help or support someone is always there” and “Staff always seem to be available and within view at all times, I’m sure as with everywhere they would like even more staff but they certainly appear to have enough.”

Records of staff rotas showed planned staffing levels were always met. The registered manager told us they were fully recruited and only used agency staff to cover short notice absences. Records showed the provider followed safe staff recruitment processes which included disclosure and barring service checks (DBS).

Staff told us that there was enough staff to meet people’s needs. Staff found each other to be supportive and commented that they worked well together. Comments included, “We have enough staff, and we work well as a team” and “We have enough staff. We only use agency to cover unplanned absences.” New staff completed a comprehensive induction and did not work unsupervised until they and their line manager were confident, they could do so. The induction included the provider’s own mandatory training as well shadowing opportunities of experienced members of staff. Staff had access to supervisions and appraisals which were used to develop and review their practices and focused on professional development. Staff told us they felt supported and that these meetings provided an opportunity for them to meet with their line managers and agree objectives as well as discuss their performance.

The provider had an up-to-date policy which staff followed. They ensured infection outbreaks were effectively prevented or managed. We were assured that the provider had effective systems and processes in place to prevent and control infections.

People were positive of the cleanliness of the home and acknowledged that it always smelt fresh. They told us staff wore PPE and were always cleaning and the home always smelt fresh. People’s equipment was clean and had been serviced.

The environment was clean and free from malodours. We saw staff had access to personal protective equipment (PPE) and were using it correctly.

Staff told us they received training in infection prevention and control and often had their practice checked. The provider had a policy which staff followed.

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