Iden Manor 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 72 (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.

Staff and management actively learned from incidents and adverse events. One relative commented, “Relative had an incident a few months ago which resulted in an injury which we raised some questions. Anyway, they did a very thorough investigation, and it was done really properly, everyone took it very seriously which was very reassuring.” The registered manager had an oversight of all occurrences and investigated incidents promptly. A recent event prompted a thorough root cause analysis, resulting in targeted actions to prevent recurrence. Findings and lessons learned were shared with staff and discussed at management meetings, and where appropriate, reported to external bodies such as the local authority safeguarding team and the Care Quality Commission (CQC).

The registered manager routinely analysed incident data to identify trends and recurring issues. For example, proactive measures were introduced to monitor and reduce falls within the home. This included assessing individual factors such as footwear, dietary habits, and fluid intake. Where risks were identified, care plans and risk assessments were reviewed and updated to reflect the necessary changes.

The provider continued to work 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.

Trained and experienced staff carried out assessments to ensure individuals’ needs could be safely met within the home environment. They collaborated with relevant professionals to gain a thorough understanding of each person’s requirements and to plan a smooth, safe transition into the service. For instance, the Home Enteral Nutrition Team was actively involved in coordinating care for individuals receiving enteral tube feeding. They helped ensure appropriate equipment was in place and continued to offer staff training and support.

To facilitate a safe transition between services, staff shared important information such as people’s medical history with other teams when individuals moved across different care settings. One professional told us, “The staff team are really engaging, proactive, patient focussed.” Another professional said, “They are responsive, emailing concerns if required on a daily basis, they produce excellent GP round review sheets that facilitated effective GP medical rounds. … I feel secure that my patients are safe in their care and any notification to me is appropriate.”

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 and their relatives told us they were safe in the home. One person mentioned, “I feel safe always.” A relative commented, “The staff are genuinely interested in the residents. They make us feel very safe.” Another relative stated, “[Relative] is definitely safe there and happy when we go and visit them.” There were systems and processes in place to safeguard people from abuse. Staff had completed training in safeguarding from abuse and knew the signs to recognise abuse and actions to take. They told us they would report any concerns to the registered manager; then to the regional manager and if no action was taken, they would whistle blow to relevant authorities. The registered manager demonstrated they understood their responsibilities to safeguard people from abuse. They had raised safeguarding alerts where there were concerns of abuse, carried out investigation and notified necessary authorities including CQC.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service.

We found that people’s rights and freedom were promoted in the home. People moved around the home freely and could leave the home and return as they wished if. People had valid DOLs in place or a pending application with the local authority. The registered manager understood their responsibility to promote people’s right and to notify CQC of any approved DOLs. Staff had been trained in MCA.

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 and their relatives told us staff supported them in a safe way to reduce risks to them. One relative stated, “My relative is hoisted into their wheelchair, and they do that in a very safe and caring way. Their needs mean they always require 2 carers to support them with all their activities and to get them up every day.” Another relative commented, “[Relative] is a high fall risk, so they do have to keep an eye on them, and staff do so to ensure they are safe.”

Staff carried out risk assessments covering various aspects of individuals’ care and management plans were developed to help staff mitigate any identified risks to individuals. These plans were comprehensive and outlined clear strategies to promote people’s health and well-being. Specific plans were in place for individuals with catheters, those at risk of choking, and those receiving percutaneous endoscopic gastrostomy (PEG) feeding—a method of delivering liquid nutrition, fluids, and medication directly into the stomach via a tube.

Staff told us that risks about people were discussed at handover meetings, so staff were aware. One staff member said, “They tell us at the beginning of the shift if there is something new about a resident we need to know. The nurses in charge of the shift will remind us. The same thing if we are concerned about a resident. We inform the nurses so they can check.”

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

The storage room designated for medical equipment and devices and found it cluttered with items that were no longer required, including expired medical devices. Several boxes were labelled for return or disposal. This presented a potential fire hazard and increased the risk of unsafe equipment being used. The registered manager told us that arrangements had been made for their immediate disposal.

Health and safety checks and risk assessments of the environment were carried out including fire safety, electrical installation, gas safety, portable appliance test (PAT), and water management and legionella. The home's risk assessment was current and up to date.

Each person had a Personal Emergency Evacuation Plan (PEEP) which sets out detailed instructions about the level of support a person would require to evacuate the building in the event of an emergency. Health and safety equipment were checked and serviced regularly, and we saw valid certificates for legionella, gas safety, electrical safety and portable appliance tests.

At the time of our visit, the home was undergoing some planned building and redecoration works.

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.

People and their relatives told us there were always staff around to attend to their calls for assistance. A relative commented, “There is always staff around who know people well and [loved one] know them too. Staff know loved one’s needs as a person and that’s very special. It’s a very personal service; they are very caring. I am in there all the time, so I have a good overview.” Another relative mentioned, “I do think there is enough staff, they always have time for everyone. It’s a good place for loved one as they need extra help, there is always staff around for them when they want to get up and the staff are very attentive.”

We observed staff responded to people’s needs and requests for assistance promptly. Staff were available in communal areas and supported people where needed. Staffing levels were determined based on people’s needs and occupancy level. The rota showed the home was covered 24 hours by a team of care staff deployed around the home. People who required close observation due to their needs were assigned designated staff.

Staff told us staffing levels were enough on each shift to support people. One member of care staff said, “We manage ok, some days we are running nonstop, but we support each other and get through it, and it does not happen every time.” Another staff told us, “Yes, the staffing level is good. The nurses and registered manager are here to support if we need support.”

Robust recruitment checks were conducted before applicants could work with people. These included criminal records checks, references, employment history and right to work in the UK.

Records showed, and staff confirmed, they had regular training and were supported to be effective in their roles. One member of staff told us, “I had induction and training when I started. We get regular training in this place. The registered manager is always reminding us to complete our online training.” Another member of staff commented, “I get support and clinical supervisions from the registered manager. I feel well supported in my role. We get the training we need and can always request for additional training if we need it to help us care for people.”

Registered nurses received support to maintain their professional development and ensure their registration remained current.

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 had been trained in infection control and knew procedures to follow to reduce the risk of infection. The home was clean and free from odour. A monthly infection control audit took place. Clinical waste was managed effectively. We saw staff used personal protective equipment (PPE) and washed their hands as necessary. The catering staff were trained in food hygiene. The environment health agency had awarded the home 5 star for their compliance with food hygiene standards.

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.

People’s medicines were administered and managed safely. Only qualified and trained nurses administered medicines to people. People’s medicines were stored in a locked cabinet in people’s rooms. There were care plans and protocols in place to support with the safe administration and management of people’s medicines. For example, where people had as ‘when required’ medicines and people whose medicines need to be administered in a specific way or form or route. Medicine administration record charts were maintained and were legibly signed to show medicines administered. Controlled drugs (CD) were locked securely in a cupboard. Two nurses administered and signed the CD records and carried out daily checks to ensure record tallied with stock. Regular audits took place to ensure medicines were managed safely.

The provider had a system in place for the safe disposal of unused medicines and medical devises.