Royal Windsor 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

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. This is the first assessment for this service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

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.

There was a strong focus on learning and continuous improvement to enhance safety. Staff told us incidents were regularly discussed within the team, supporting shared awareness of risks and helping identify actions to reduce the likelihood of recurrence. This reflected an open approach where practice was reviewed and improved. People and their relatives described appropriate and timely responses when incidents occurred. This demonstrated that staff responded effectively in practice and that people experienced safe and responsive care.

There were effective systems in place to support safe pathways and transitions for people using the service. People and their relatives told us they were kept informed of any changes and felt communication was good. One person said, “Links with medical services are good.” Family members confirmed they were kept updated, with one telling us, “I rely on the staff to tell me if there are any issues.” Staff worked with external professionals to support continuity of care, including community nurses who attended regularly to meet people’s needs. This helped to ensure people received consistent care when moving between services or requiring additional support.

People described being supported appropriately when their needs changed, including following hospital stays or periods of ill health. One person told us they were supported following a fall, and appropriate measures were put in place to reduce further risk. This showed the service adapted care to maintain safety and continuity.

The service had systems in place to safeguard people from the risk of abuse. People and their relatives told us they felt safe and confident in the care provided. One family member said, “I’ve no safety concerns. This is a good home.” Another person said, “I feel safe, this is a good place.” Staff demonstrated a good understanding of safeguarding and were aware of how to recognise and report concerns, which supported people to remain safe.

People gave examples of staff acting promptly following incidents such as falls, and appropriate measures were put in place to reduce further risks. People and relatives told us they were kept informed of any concerns and said communication from staff was prompt when issues arose.

During the inspection we observed staff recognising when people were anxious and responding in a calm and respectful way, which helped reduce distress and supported people to remain safe.

Deprivation of Liberty Safeguards were appropriately applied where required, with authorisations in place and restrictions managed in line with people’s individual needs to ensure their rights were protected.

People were supported to be involved in managing risks and care plans were in place to guide staff. Risk assessments reflected people’s needs and supported safe care. However, some care plans required clearer guidance to ensure support was proportionate. For example, there was not always clear guidance on when increased staff support should be applied, which had the potential to lead to more restrictive approaches that may not always promote dignity and independence.

Staff told us they understood the importance of supporting people in the least restrictive way and said care plans had been reviewed following feedback to better reflect this in practice.

Despite this, people and their relatives were involved in discussions about risk, with conversations taking place about how people wished to be supported. They were given information about potential risks and made informed decisions about how these should be managed, enabling them to maintain choice and control.

There were effective systems in place to ensure the environment was safe and well maintained. Regular checks and audits were completed to identify and manage risks.

Fire safety was well managed. Staff told us they completed regular simulated fire drills, including at night. New staff received fire induction training, and all staff completed fire safety training.

Equipment was regularly serviced and specialist equipment such as hoists and slings were checked internally and through external inspections.

Communication systems such as flash meetings and communication books supported the timely sharing of information about environmental risks.

The maintenance staff member described how they engaged with people and took responsibility for maintaining the environment, including responding promptly to issues and ensuring repairs were completed to keep the service safe and well maintained.

Systems were in place to determine staffing levels and were consistently applied in practice. During the inspection, we observed sufficient staff to meet people’s needs, with call bells responded to promptly and minimal delays.

Some staff described challenges when supporting people who required hoisting or higher levels of care, indicating that staffing could be stretched at times when needs were more complex. However, people and their relatives did not raise concerns about staffing levels and spoke positively about the care provided. This indicated that, despite some pressures, staff were able to respond effectively and people’s needs continued to be met.

Staff received training to support them in their roles and had access to more specialist training such as positive behaviour support and recognising pain in people living with dementia. This supported staff to provide safe care and respond appropriately to people’s needs. However, not all required training had been completed within the provider’s timescales, which meant some staff had out-of-date training, including safeguarding and infection prevention and control.

The provider had processes in place to address this and ensure training was completed. Safe recruitment practices were in place. Checks were completed to ensure staff were suitable for their roles and able to provide safe care to people.

Infection prevention and control was well managed within the service. The environment was clean and well maintained and there were no malodours noted during the inspection.

The head housekeeper demonstrated a good understanding of their role and spoke confidently about cleaning routines and infection control processes. This supported a consistent approach to maintaining hygiene standards across the service.

Staff demonstrated awareness of infection prevention and control practices and appropriate use of personal protective equipment was observed.

Cleaning processes were followed, and communal areas and bathrooms were maintained to a good standard. People and their relatives spoke positively about cleanliness. One relative told us, “[My family member's] room is always clean and tidy.” This reflected our observations. Regular checks and oversight of hygiene and cleanliness were in place, which supported the reduction of infection risks.

The service ensured medicines and treatments were safe, person-centred and met people’s needs and preferences. Staff involved people in decisions about their medicines and administered them in line with prescribing guidance, considering individual routines such as food, sleep and daily preferences.

Medicines administration records (MAR) and electronic medicines administration records (eMAR) were completed accurately. Clear, personalised care plans and ‘as required’ (PRN) protocols supported safe and consistent decision-making, including for complex conditions such as Parkinson’s disease and seizure management.

Staff demonstrated responsive and safe practice, supported by clinical input and clear documentation. People were supported to remain independent with their medicines where appropriate, with risk assessments and care planning in place.

Systems for ordering, storage and administration were well managed, with appropriate oversight. Controlled drugs, which are medicines subject to additional controls due to their potential for misuse, were handled safely in line with national guidance.

Medicines were stored securely, with effective monitoring of stock levels and expiry dates. A positive reporting culture supported learning and continuous improvement, with regular audits and reviews in place.

The service took a proactive approach to medicines optimisation, involving people and families and using systems such as holistic reviews to support safe and effective care. Electronic systems further enhanced safety through alerts and clear documentation.