Standon House

Improvements were still required to ensure the physical environment was safe for people. For example, we saw some pieces of equipment had visible rust which hampered effective cleaning. The main corridor between parts of the building had a poorly defined slope putting people at the risk of trips and falls. Door frames in communal bathrooms needed to be treated to ensure they could be effectively cleaned.

Some assessments needed to be updated to include the most relevant information. For example, following a review by a GP the recommended daily fluid intake for one person had decreased but the care plan had not changed to reflect this.

Some staff were wearing nail polish and acrylic nails. This created a potential infection risk especially when supporting people with personal hygiene. One person's walking frame still had the cardboard packaging still attached. This prevented effective cleaning.

There were no specific guidelines for staff on when to administer 'as required' medicines (PRN protocols). The care manager told us they would develop these with people as a matter of priority.

When staff had made historical disclosures the provider needed to assess any potential risk to ensure the staff member was safe to work with people.

Improvements were noted since the last inspection but these needed to be reviewed to ensure they were effective and embedded into the management teams' practice. For example, the infection prevention reviews failed to address and correct staff members practice for wearing nail varnish. The checks failed to identify or remove cardboard on people's mobility equipment. Environmental checks didn't address the issues with bare wood or rusted equipment. Although regular checks were made to medicines they failed to identify there was a lack of PRN protocols or missing risk assessments on staff files when they were needed.

The care manager told us they were looking at ways to make these conversations more formal and to provide more feedback to people.