Archived: Woodlands Ridge 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 75 (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. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The provider had effective systems to ensure learning always occurred following incidents and accidents. Where incidents had occurred, we found these were documented, reviewed and acted on by leaders. Care plans we looked at had been updated to reflect additional support needs following an incident.

We saw minutes of meetings which showed lessons learned were regularly discussed with staff and staff we spoke with confirmed this. One staff member said, “After one incident the manager said about making sure we put the sensor mat in the right position, making sure the buzzer is in place, and reviewed equipment in use. They explained everything that was happening.” The registered manager told us, “We have done lots of work with staff to ensure they understand what an incident is and what an accident is. Everything is discussed at the daily meeting. We reflect, reflect, reflect.”

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 assessed prior to moving to the service to ensure their needs could be safely met. Records showed people were referred to other healthcare professionals when needed. There was a weekly GP review and nurses told us it was easy to contact a health professional for advice between weekly visits. People’s relatives told us people were supported to attend appointments.

Staff told us they worked well with health and social care professionals and had developed good working relationships. There were clear processes to ensure people’s current information was safely shared and we saw records of this during the inspection. One health professional told us, “I’m doing a review of someone. The team have already referred the person to the GP who has prescribed medicines, so I’m reviewing how well that is working.”

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, although we identified one incident when a notification had not been made to the Care Quality Commission (CQC). The registered manager rectified this after the inspection.

People and relatives, we spoke with did not have any safeguarding concerns. One person’s relative said, “I have no concerns as to [name’s] safety or wellbeing.”

Staff had received safeguarding training and knew how and when to report concerns. One staff member said, “We’ve had training on this. Safeguarding is about protecting the residents from abuse, keep them safe and doing as much as I can to help them.”

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 been assessed for risks such as skin integrity, choking, falls and malnutrition. When risks were identified, the care plans informed staff how to reduce the risks and how to keep people safe. Examples included how to reduce the risk of people choking by ensuring people were in the correct position when eating and drinking, and following any advice provided by healthcare professionals.

However, not all care plans informed staff how to keep people safe when people experienced periods of anxiety or agitation. We fed this back to the management team during the inspection, and they assured us this would be rectified. Despite this, staff we spoke with told us they had received training on how to manage challenging behaviour and felt confident to do so. They described scenarios which demonstrated they knew people well and knew how to keep people safe.

Pressure relieving equipment we looked at was set correctly and records showed staff changed or supported people to reposition regularly and in line with care plan guidance.

The registered manager had oversight of the risks to people. When people’s needs changed, they told us how care plans were reviewed to ensure the risk of harm was reduced. One person’s relative said, “[Relative] has become much frailer in the last six months and had a couple of falls, but the staff called us and informed the doctor, and there is now a falls mat by the bed. It was well managed.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

We noted there was no dementia friendly signage within the home. This signage helps people living with dementia to orientate themselves. The registered manager told us the signs had mistakenly not been replaced following some recent painting but that they would action this immediately.

Equipment such as lifts, hoists and those related to fire and gas safety had been inspected in line with requirements. Equipment staff used to support people such as beds, call bell systems, wheelchairs and walking aids, were assessed for safety monthly.

Personal evacuation plans were in place. These had been regularly reviewed to reflect people’s support needs in the event of needing to evacuate the building in an emergency. Staff told us they had received fire training in person and on-line.

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 service used a dependency tool to calculate staffing levels. The staff rota showed that staffing levels were maintained in accordance with the dependency tool. We saw people had call bells close by and for those people who were unable to use the call bell, staff checked on people regularly throughout the day.

People’s relatives told us they felt there were enough staff on duty. For example, one person’s relative said, “There always appears to be enough staff and if I ring the call bell they [staff] always come quickly.” Overall, staff told us they felt there were enough of them on duty.

We observed that call bells were answered in a timely manner. The service audited call bell response times to ensure that appropriate numbers of staff were in place and to identify any trends around when people might use the bell more than usual.

Safe recruitment processes were followed. Training records showed staff had completed training. Although annual staff appraisals were carried out, staff told us and records we looked at showed that supervisions took place when the staff member or the supervisor had something to discuss, rather than as an opportunity of one-to-one time with a senior member of staff to discuss general well-being. The registered manager told us they were reviewing how staff supervisions were carried out.

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.

We observed the environment was clean and generally smelt fresh. There were systems in place to ensure visitors were not feeling unwell when they arrived.

There were housekeeping staff on duty. Regular infection prevention and control audits took place. When issues were identified, there were action plans in place, and these were shared with staff.

Staff had been trained in infection prevention and control. Staff understood when and why they should utilise personal protective equipment (PPE) and we saw this was readily available throughout the building.

People’s relatives raised no concerns about the overall cleanliness. One person’s relative said, “The environment is clean, tidy and safe. The staff are very particular about wearing PPE; they are very careful.”

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.

Staff responsible for managing medicines were aware of safe practice, had completed training and had their competence assessed and regularly reviewed. Staff were confident and knowledgeable regarding safe medicines management, and we observed one staff member demonstrating a calm and skilled approach when supporting people with their medicines, by not rushing them and making sure they had a drink.

Medicines were stored, administered, recorded and disposed of safely. Robust processes were in place to ensure people received their medicines in line with their prescriptions. Regular stock balance checks were carried out.

Some people were prescribed additional medicines on an as required (PRN) basis. However, not all the PRN protocols we looked at were personalised and did not always inform staff of alternative steps to take prior to resorting to the use of medicines. The management team told us that as part of the implementation of the new electronic medicines system, all PRN protocols were being reviewed and that this issue would therefore be resolved.

Regular medicine audits were carried out. When issues were identified, action plans were put in place. We saw that actions had been completed in a timely manner.

People and their relatives raised no concerns about medicines management. One person’s relative said, “No problem with the medication. They [staff] are very good and keep a close eye on it. They have upped [name’s] meds a bit due to pain.”