Larchwood Nursing and Residential 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

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.

This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The service was in breach of legal regulation in relation to safe care and treatment at the service.

This service scored 59 (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 did not always have a proactive and positive culture of safety based on openness and honesty. Staff did not always listen to concerns about safety and did not always investigate and report safety events. Lessons were not always learnt to continually identify and embed good practice. For example, we found an unclean fridge in a kitchenette, which was storing food that was not date labelled when opened. In the servery we found a dish of pasta on our first day of inspection, on our return the following day it was still there. The importance of food safety had been shared by the registered manager at team meetings and documented in meeting minutes. However, good practice had not been embedded, and staff did not action or report the potential food safety risks to people we found. The registered manager was proactive when we shared our concerns and made actions with the involvement of the staff team.

The provider 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.

People were supported in accessing appropriate healthcare professionals for their health needs. For example, people at the service were receiving support from GP’s, District Nurses, falls clinics, dietitians, occupational therapists and speech and language team (SALT). A relative told us, “They have contacted the doctor for [person] when they were unwell.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff 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 provider shared concerns quickly and appropriately.

People told us that they were happy at Larchwood nursing and residential home. A person told us, “I feel 100% safe here. They’re all really good at what they do, and they come quickly if I need them.”

Relatives told us that their loved ones were safe. A relative said, “Oh yes, we have no questions about [person] safety.”

Staff received safeguarding training and demonstrated a clear understanding of the procedures of reporting concerns. Deprivation of Liberty Safeguards (DoLS) authorisations were sought when required to lawfully deprive a person of their liberty for their own safety.

People had care plans and risk assessments describing support and care needs, however, some information needed further review to ensure the right care and mitigation was provided consistently according to risk assessments.

For example, a person’s diabetic care plan reflected that blood sugars were to be completed 4 times daily and the last review stated 2 times daily. Also, a person’s Waterlow assessment which is used to identify a person’s risk of developing skin damage, was not completed using the correct Body Mass Index (BMI). The lack of oversight by the provider increased health risks to people.

The registered manager acted promptly when we raised these concerns and advised us that action had been taken.

The provider did not always detect and control potential risks in the care environment.

During our inspection, we found the courtyard garden had outside decorative lights, which were connected to electricity via an extension lead through a sluice room window. A barbeque gas cylinder was not stored safely; the gas cylinder was leant against the outer wall of the home in the courtyard garden. Staircases leading to and from the first floor of the service did not all have gates or retractable belt barriers, and the service had no risk assessment in place. In a person’s room we found damage to the walls and a non-working radiator without a cover in the person’s bathroom. The concerns we found potentially put people at risk of harm. The registered manager was proactive in addressing and actioning the concerns we raised during our inspection.

The provider 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.

The provider had an effective rota system in place which ensured staffing levels reflected the needs of people.

Staff told us that there were appropriate numbers of staff on duty to meet people’s needs. A staff member told us, “I do think staffing levels are as they should be, we do accommodate people’s needs.”

Relatives told us that they felt there were enough staff to support their loved ones. A relative said, “There is always loads of staff around and someone to ask about anything.”

The provider did not always assess or manage the risk of infection. For example, we found 2 wash bowls which were used to support people having personal care in their room, were stored on people’s toilets. We found disposable hand towel bins were overflowing in numerous rooms.

The registered manager acted upon our concerns when we raised them.

Staff had been trained in infection control, and we observed staff using appropriate Personal Protective Equipment (PPE) when supporting people.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

We found medicines were stored safely and securely. Records showed that people had received their medicines as prescribed. We observed that staff followed safe procedures when giving medicines. The staff had their competencies regularly assessed around medicine management to ensure they managed people’s medicines safely.