Saffron House

The provider had made significant improvements to cleanliness and people's accommodation. Some redecoration was still in progress.

“The provider had taken immediate action to improve cleanliness and the standard of people's living accommodation.” from the report

Staff supported people to see health professionals and included professional advice in care records.

“Throughout our inspection visit, we observed the senior staff on shift communicating with health and social care professionals and ensuring referrals were made to meet people's needs.” from the report

The home carried out DBS checks for all applicants as part of its recruitment process.

“The provider followed safe recruitment practices. A check with the Disclosure and Barring Service (DBS) was carried out on all applicants.” from the report

People had choices of meals and drinks, and records showed support for those at risk of poor nutrition or hydration.

“People were supported to have a choice of meals and provided with a choice of drinks throughout the day.” from the report

Tablets were found in sharps containers without an audit trail. Some topical medicines had not been signed for, and a medicine trolley was left unattended where medicines could be reached.

“Medicines were not stored, returned or disposed of safely.” from the report

Care plans lacked clear strategies about triggers and how staff should respond when people became distressed. Inspectors also saw support during eating that caused distress and presented a possible choking risk.

“There was lack of risk assessment and guidance around the mitigation of risks to keep people safe from harm.” from the report

A potential safeguarding incident was not referred to relevant external agencies, including CQC. The home did not show that risks had been reviewed or that action had been taken to prevent further incidents.

“People were not consistently protected from the risk of harm.” from the report

Audits did not identify important problems, and improvements were not consistently sustained. The manager did not ensure agency staff received enough guidance and oversight.

“The registered manager had failed to have effective oversight of the service to ensure improvements were made and sustained.” from the report

People and relatives reported delays in getting help, especially at busy times. Inspectors also found staff awareness of cross-infection risks needed improvement, including unsafe handling of shared cutlery.

“People, relatives and staff felt the deployment of staff was not always sufficient to meet people's needs in a timely way.” from the report

Some mental capacity assessments and best-interest records did not clearly explain the decisions made or who had been involved.

“Mental capacity assessments were not always undertaken consistently.” from the report