Roxburgh House 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

People were kept safe and protected from harm. Staff had a comprehensive understanding of abuse and knew what to do to make sure people were protected. People felt comfortable to raise concerns about their safety. Staff gave people information about risks to their safety and supported people to manage risk so they had as much control and independence as possible. However, not all risk assessments contained the required level of detail to guide staff in reducing the risk of harm. The environment and equipment was well maintained and action was taken to continually assess and reduce environmental hazards. There were enough competent staff deployed to meet the needs of the people living at the home. However, the tools used to calculate the staffing levels did not provide a clear rationale for how the number of staff had been determined. Overall, staff were safely recruited and recruitment checks were carried out as standard practice. Staff had the right mix of skills to make sure that practice was safe. However, we identified improvements were needed to ensure staff received training in line with best practice guidance.

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.

People told us they were safe and protected at Roxburgh House Care Home. They confirmed staff treated them well and understood how to support them effectively. Relatives told us staff shared any concerns about their loved ones in a timely way. A relative told us, “[Person] is safe here. I always know staff will call me if there is ever any concerns.” People and relatives were aware of the process for reporting their concerns, if they had any.

Processes were in place to ensure safeguarding incidents were recorded and reported. We found evidence that lessons were learnt following safeguarding investigations. For example, a concern identified in relation to medicines administration had led to improved training and oversight to reduce the risk of recurring incidents. All staff had completed safeguarding training however, the provider scheduled refresher training every two years instead of annually. We shared our findings with the registered manager who committed to ensuring training schedules were updated in line with best practice guidance. A safeguarding policy was in place to guide staff on the types and indicators of abuse. We found the policy could be improved to include contact details for the local authority and other agencies staff could escalate their concerns to.

Staff clearly described the course of action they would take if they felt someone was being harmed or abused. This included escalating their concerns to the registered manager, the local authority, or contacting the police if required. Staff explained the different categories of abuse, and described the emotional and physical signs and symptoms of abuse they looked for as part of their role. The registered manager understood the importance of their role in ensuring safeguarding concerns were reported to the safeguarding authority when required.

Our observations found staff practice was safe and action was taken to ensure people were protected from potential risk.

People told us staff had a good knowledge of their needs and took the necessary action to mitigate risk. People were aware of their individual risks such as falls and felt the staff supported them safely to manage these risks. Comments included, “Staff make me feel safe, they will walk with me” and “staff completely understand risk and how this effects [Person].”

Staff described how they supported people to manage risk. This included informing the registered manager if they felt people’s needs had changed and their risk assessments needed to be reviewed.

Overall, people’s individual risks were assessed, monitored and mitigated. However, not all risk assessments contained the required level of detail to guide staff in reducing the risk of harm. For example, the risk assessments for 1 person lacked detail about their health needs, and some were out of date and not scored. We shared our findings with the registered manager who took action to update the records. Accidents and incidents were recorded and appropriate action was taken to implement risk reduction measures. However, the analysis of incidents was not always completed robustly as we identified potential trends were not identified. For example, trends were not always identified when a number of accidents occurred within the same timeframe.

Our observations found people were supported safely by staff. Staff understood people’s individual needs and took action to reduce the risk of harm. For people who had risks in relation to their skin, we saw equipment was in place to reduce the risk of the development of pressure related injuries. Staff ensured people's mobility equipment was in place before they started to mobilise to reduce the risk of falls.

People felt the home was safe and secure. People told us the communal areas in the home were nicely decorated and felt the home was kept clean. Comments included, “The place is lovely and the room is nice. Staff fix things quickly” and “clean and tidy, never a thing out of place.”

Staff told the us repairs were always dealt with quicky. A staff member provided an example of when they needed a new kitchen appliance and how this was ordered straight away. The registered manager understood the importance of maintaining the home to ensure the safety of the environment. They were honest about any repairs that were outstanding such as a replacement boiler. However, we were assured the outstanding repairs had little to no impact on people.

We observed the environment to be safe. The necessary adaptations and equipment were in place to enable people to safely access all areas of the home. All communal areas and people’s bedrooms were clean and free from any hazards.

Processes were in place to ensure the safety of the environment. Records showed equipment was regularly serviced and well maintained to ensure the delivery of safe care. Essential checks on areas such as gas safety, fire safety and electrical safety were carried out in accordance with health and safety best practice guidance.

Staff spoke positively about the staffing levels within the home and told us there were enough staff to provide a safe and effective service. Staff explained how they all worked together to ensure staffing shortfalls were covered, and how there was always enough of them to be able to sit and engage meaningfully with people as well as deliver care.

We observed a sufficient number of staff were deployed to meet people's needs. When staff were not providing hands on support, they spent time in pleasant conversation with people. We observed staff were engaged in meaningful activities with people. For example, we observed people having their nails painted, engaging in one on one games and taking part in quizzes. We found call bells were answered promptly and people were never left unsupervised in the communal areas of the home.

Staff completed a range of training the provider considered mandatory. However, we found the full range of training provided was not in keeping with the requirements outlined in best practice guidance. For example, best practice guidance states staff should complete training in communication every three years. We found staff had not received this training. We shared our findings with the registered manager who confirmed additional training would be provided to staff. The registered manager understood the importance of a familiar and experienced staff team. Rota's showed people were supported by consistent staff and we were assured staff were deployed in sufficient numbers to meet the needs of the people living at the home. However, the tools used to calculate the staffing levels did not provide a clear rationale for how the number of staff had been determined. We shared our concerns with the registered manager who committed to reviewing their current system. Overall, staff were safely recruited. However, we found some missing information in a staff members recruitment file. Following our feedback, the registered manager took action to ensure they obtained all the relevant information.

People and their relatives told us there was always enough staff around to be able to help them when they needed it, and they felt staff always had time to sit and talk with them. Comments included, “Oh yes there are loads of staff around here. [Person] is never left alone for long periods of time”, “They are always here if I need to speak to someone” and “A few times I have woken up in the night if I have had a nightmare, staff will come and make me feel better.” A relative told us they always saw the same staff at the home and this consistency had helped their loved one settle in.

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.