Airedale Residential & Dementia 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 inadequate. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 62 (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 fostered a proactive and transparent safety culture, encouraging openness and honesty. They demonstrated a commitment to continuous improvement by analysing incidents to identify patterns and trends, which supported shared learning and the embedding of best practices. Although staff were generally responsive to safety concerns, we identified one incident involving a person who sustained a bruise that had not been recorded in the incident logs. Nonetheless, measures were in place to monitor the bruise and ensure appropriate follow-up.

The provider worked with people and healthcare partners to establish and maintain safe systems of care. They made sure there was continuity of care, including when people moved between different services. One relative said, “[Name] had a rushed admission 18 months ago. The manager came out to assess [Name] and was very thorough with this assessment to ensure they had everything [Name] needed. I was impressed.”

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.

The provider appropriately reported safeguarding incidents and maintained a log to track both outstanding and completed cases. Risk-reduction measures, such as sensor mats, were in place for individuals identified as being at risk of falls. During the inspection, concerns were raised regarding a resident’s bruising. The Registered Manager confirmed that measures had been implemented to manage and reduce this risk.

People and their relatives told us they were supported by staff who made them feel safe. Comments included, “I feel [Name] is safe which makes me feel comfortable”, “There is always staff in the communal areas. They keep people safe” and “Staff they are always nice and polite. Yes, I feel safe.”

Care plans and risk assessments had been developed for individuals; however, we identified some inconsistencies in the documentation. For instance, one care plan overview stated that a person ate independently, while the corresponding risk assessment indicated they required staff supervision due to a choking risk. In another case, the care plan overview noted the use of a Sara Steady (equipment used to support someone from a seated to a standing position), whereas the mobility care plan specified that the individual required full hoisting with the assistance of two staff members. These discrepancies were promptly addressed by the registered manager.

Staff did not always provide care to meet people’s needs that was safe. For example, during a lunch observation, a person was left unsupervised for a brief period while eating, despite a known choking risk. Although a staff member was initially nearby, they left the room, leaving the individual without monitoring.

Additionally, fire safety procedures were not always robust. A review of records showed no evidence of night-time fire drills being carried out in over 12 months to ensure staff could safely move people in the event of a fire. The registered manager confirmed they were planning to complete these imminently.

Staff moving and handling competency assessments were not always fully completed. Some procedures were discussed and demonstrated but not observed in practice, such as fitting and removing slide sheets and using a carry chair. However, during our assessment we did not identify any unsafe moving and handling practices.

The provider did not always detect and control potential risks in the care environment. During our walk-through, we observed areas that required cleaning and maintenance. For example, one person’s bed rail bumpers were visibly dirty, and the kitchen window had a significant number of flies, indicating it needed cleaning. During our walk around the home we found parts of the environment were outdated. For example, paint coming away from walls, bedrooms with broken furniture and worn carpets. The registered manager advised that a refurbishment programme was underway. A relative commented, “Some rooms are a bit dated and need updating.”Additionally, we noted that the linen cupboard fire door had been propped open with a hot press and iron inside. By the second day of our visit, these issues had been resolved, with cupboards locked and cleaning completed. Equipment checks were carried out regularly, and all required safety certifications were up to date.

Since the previous inspection, the registered manager reported significant improvements in staffing, noting, “The biggest change has been staffing. We were using a lot of agency staff, but we have not used agency in 18 months. The current team are strong, and some have a nursing background. The morale has since improved.” A dependency tool was used to determine appropriate staffing levels based on people’s needs. The registered manager also confirmed they were present on-site during early mornings to provide direct oversight and support.

Recruitment processes ensured appropriate checks were completed to help ensure staff were suitable and safe to work with people using the service.

Staff reported that there were not always sufficient numbers to meet people’s needs effectively. They explained that night staff often had to provide additional support to ensure care was delivered, particularly during busy morning periods when staff felt rushed. Comments included, “Sometimes I do feel we are short of staff,” and “There is not enough—I feel quite rushed. Night staff will change pads, so people are safe and not waiting.”

People living in the home and relatives mainly provided positive feedback about staffing levels. One person said, “I think the staffing levels have improved. I think there are people with less needs now. When [Name] came in there were a lot of people with late-stage dementia and now it seems calmer.” However, one person comments, “Sometimes I have to wait for staff. I can get washed and dressed and then the carer turns up and gets a phone call and has to go and see someone else.” We saw staff were busy during the morning but there was always staff in the communal areas to support people.

Staffing arrangements did not consistently adhere to safe working practices although staff did not raise concerns in relation to this. Some staff members were scheduled for extended shifts of up to 14 hours, with insufficient rest periods between shifts. For example, two staff members did not have an 11-hour rest period in between their shifts. The providers Working Time Regulation policy stated that staff should receive 11 consecutive hours of rest within a 24-hour period. Following our feedback the registered manager confirmed they were in the process of updating this policy.

The provider did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading. During the initial visit, infection control concerns were identified. Some bathrooms lacked hand towels, bed rail bumpers were visibly dirty, and one staff member was not adhering to bare below the elbows, increasing the risk of cross-contamination. Additionally, donning and doffing stations were not appropriately spaced to prevent infection spread. By the second visit, these issues had been addressed. However, further concerns were noted. One person living at the home was found wearing a tight watch, and upon removal, there was a build-up of dirt underneath, with skin breakdown and odour indicating a potential infection risk. The individual's nails also showed significant dirt accumulation, further increasing the risk of infection. Staff immediately addressed the concerns raised on the day.

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.

Medication administration records (MARs) showed no missed doses, with accurate stock levels and secure storage. MAR folders were well-organised, and patch rotation charts were used effectively. Risk assessments relating to medicines were regularly reviewed, and PRN protocols were person-centred, with clear documentation of rationale and use.

Topical creams were stored separately with body maps guiding application, and residents confirmed regular use. Daily temperature checks ensured safe medicine storage. However, the emergency bag lacked a checklist, and several items were out of date. The Registered Manager acknowledged this and committed to improvements.

Controlled drugs were checked daily by two staff, but a recording error went unnoticed, indicating checks were not always thorough. Regular audits were in place, and no recent incidents were reported, which the registered manager attributed to strengthened daily checks.