Risby Park Nursing 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 remained good. This meant people were safe and protected from avoidable harm.

This service scored 69 (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 had a proactive and positive culture of safety, based on openness and honesty. Relatives told us they were informed regarding any incidents and changes in the health and wellbeing of their loved ones.

Staff listened to people’s concerns and understood their responsibility to report concerns about safety. Staff told us what they would do if they had concerns about people’s health, welfare and safety. Incident forms were reviewed by the management team and learning documented and shared with staff.

Staff were confident the manager and provider would listen to concerns and act upon these. The provider shared information through daily handovers, staff meetings and communication diaries/logs.

Risks were identified, with very detailed, robust risk management plans in place for the majority of people. However, one person who had multiple health conditions, and where incident records detailed challenges with their behaviour, there was a lack of care and risk management planning in place. This was despite this person having been resident in the service for 6 weeks. The manager took immediate action to address this shortfall to reduce any risks of harm.

Improvement was also needed in the recording of care and support provided on a daily basis. We noted daily records which showed significant gaps of several hours after personal care and support had been provided and gaps in the recording of monitoring checks including repositioning to avoid skin damage. This meant there was not always an up to date, contemporaneous record made of care and support provided at the point of delivery. The provider told us they had recognised this as an area of improvement since the implementation of a new electronic care recording system and how in the interim both paper and electronic records were being used resulting in confusion for staff as to where to record. The provider had recognised these shortfalls and told us of the plans they had in place to improve this.

The provider worked with people, healthcare agencies and stakeholders to understand what being safe meant to them and the best way to achieve that. The provider investigated safeguarding incidents and shared concerns quickly and appropriately with the relevant authorities.

Staff had received safeguarding training. Staff told us they felt comfortable to whistle-blow on poor practice if they witnessed it.

Where people needed to be deprived of their liberty to keep them safe, the provider ensured a deprivation of liberty safeguard (DoLS) was applied for through the relevant local authority.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People had up to date risk assessments and associated care plans in place. This included where people were at risk of choking, falls and malnutrition. Any shortfalls identified were addressed immediately.

Monitoring was in place to keep people safe, including monitoring people's weights, mobility and during mealtimes. We observed people supported to eat appropriately and offered food and fluids in line with their assessed needs. Information was available to staff in care records to ensure they knew about people’s support requirements.

Where people were at risk of pressure wounds, equipment, repositioning and monitoring was in place, to reduce risks to people developing these.

There were effective systems in place to ensure the environment was safe, however, some people told us they felt the environment was in need of updating. One relative said, “If you ask me what they could do to improve I would say, the place could do with some money spent on updating it, the environment it is looking tired.”

We found the service was clean and well maintained. Routine testing took place in relation to testing of fire alarms, fire equipment, water temperature testing including tests to protect people from the risk of Legionella.

Environmental risk assessments were in place such as fire safety, gas safety and water safety. These were up-to-date and where issues were identified, these had been addressed or there was a plan in place to address them. We noted a lack of risk assessment in place to address risks to people from their access to an open staircase. In response to our feedback the provider took prompt action to address this and provide a written risk assessment with guidance for staff.

Environmental audits took place to monitor the safety of the premises and equipment.

There were grab rails and specialist equipment available to support people who needed these. People were provided with specialist beds, hoists, and other equipment to keep them safe. There were coded doors to help restrict access to non-communal areas to keep people safe.

The provider made sure there were sufficient 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.

We observed enough staff on duty to meet people's needs. We observed staff to use their skills and knowledge when supporting people living with dementia in a kind and dignified manner.

Staff told us they received the training required to undertake their roles safely. One staff member told us, “The training here is very good. It is mostly face to face with only some you have to do on-line.”

There was a variety of training provided. Team meetings, one-to-one meetings and daily handovers were in place to support staff to provide safe care to people.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Staff were provided with personal protective equipment (PPE) and were observed wearing and removing this appropriately. There were handwashing facilities throughout the building and also access to hand sanitising gel.

People told us staff wore personal protective equipment (PPE) during personal care. Staff understood the need to wear PPE and how to manage the risk of infection.

Staff had received training to support with minimising the risk of infection and information about safe infection prevention and control practices was displayed throughout the service. Training included in-depth face to face training in recognising the symptoms of sepsis and the staff response needed to protect people from the risk of harm.

We found topical medicines were not all dated when opened and were not being stored securely to ensure people could not access them and potentially cause themselves harm.

Where care staff administered topical medicines, these had not always been signed for with gaps. We found external and internal medicines stored together in medicines cupboards. These shortfalls had not been identified in management audits.

We informed the homes manager during our site visit of an incident involving incorrect administration of covert medication for one person. In response the manager took immediate, appropriate action. In response to our feedback the manager took immediate action to address these shortfalls.

People told us they received timely responses to requests for pain relief when needed. Care plans contained detailed information as to how people chose to have their medicines administered.