Wood Hill Lodge

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 requires improvement. At this assessment the rating has remained requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

This service scored 59 (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. However, although further progress had been made since our last visit there were a number of areas we identified at this visit where further improvements were still needed. Although systems were now in place to ensure lessons were learnt including a root cause analysis to identify themes and trends these still needed to be consistently applied and embedded throughout the service. Some areas were still work in progress and new ways of working needed to be fully integrated and sustained over the longer term.

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. We saw evidence in care plans of visits and referrals when required and information was shared and reviewed to ensure people’s needs were met. The care planning system was able to produce an emergency pack which would be used to pass on relevant information to healthcare professionals when required.

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 registered manager shared concerns quickly and appropriately. Staff understood safeguarding procedures and reported incidents immediately to management. Staff were confident the registered manager would respond appropriately. All people we spoke with told us they felt safe and had no concerns. When asked if they felt safe one person said, “Absolutely.”We identified 2 concerns during our assessment, which the registered manager acted on immediately following correct procedures.The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People's capacity was assessed in line with MCA and decisions were made, where people did not have capacity, in their best interest. People had Deprivation of Liberty Safeguards (DoLS) in place to protect their rights and the service complied with these.

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 which mattered to them. Risks associated with people's care were identified and managed effectively. Staff knew people well and their risks were manged safely. However, we found care plans were not consistent and there were discrepancies between care plans, risk assessments, and diet sheets, which could potentially lead to confusion. One person was also assessed as requiring a specialist diet, the person was refusing the diet so was given food that could cause choking, valid reasons were given for this, however, the care plan lacked detail to guide staff on how to manage the risk. The registered manager addressed this immediately, and assured us all care plans and risk assessments would be reviewed and updated. The systems were in place to monitor care plans effectively, they required embedding into practice.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. All relevant safety checks were regularly carried out including fire, electrics, gas and moving and handling equipment. The provider had a redecoration plan in place and upgrades, and redecoration of some areas were already completed. However, we found areas of the home that required attention to ensure people’s safety. For example, floor coverings were damaged and uneven, outside planters were collapsing, fire doors were wedged open, external safety lights were not working, there were gaps around electrical sockets and a fire exit external gate had a padlock attached. The registered manager explained they had been without a maintenance person for some time and this had impacted on progress of works. Following our visit the provider addressed the areas, new floor coverings were provided, redecoration and replacement and repair of various items of equipment. They have assured us the improvements would continue.

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 which met people’s individual needs. Staffing levels were determined by the needs of the people who used the service. Staff told us, there were predominantly enough staff on duty. One staff member said, “In my experience, the staffing levels are the best compared with other homes I have worked in. The staffing ratio enables us [staff] to deliver a high quality care to our residents.” Staff said they told us they received effective training and support. One staff member said, “The training is very good.” Although a number of staff mentioned that face to face training was sometimes at short notice, which caused some issues and would like more notice. The registered manager assured us notice was given but agreed to look at ways to better communicate this. Members of staff were predominantly recruited safely. However, we found some staff files did not contain all the required information. The provider assured us this had been identified and was being rectified.

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 found the service was clean. However, some areas of the environment were not well maintained so were not able to be effectively cleaned. These included kitchenette units, seals at back of sinks, work tops, refrigerators, and microwaves. The provider replaced the fridges and microwaves on the day of our site visit and has assured us the kitchenettes will be repaired and work tops replaced. Staff had access to appropriate stores of personal protective equipment (PPE). Members of staff had access to infection prevention and control policies. Audits we reviewed, identified areas for improvement and the provider had an environmental action plan that was being followed to make improvements.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Controlled drugs, which are medicines at high risk of misuse, and associated stationery and records, were stored safely and securely. Controlled drug checks were undertaken by two staff members; however, a recording error was noted in the controlled drug waste record register. Medicine protocols and care plans lacked personal information to guide and support staff to meet resident's needs. We found that people received their medicines including time sensitive medicines on time. When people were being given their medicines staff treated them with respect, kindness and dignity. Medicines were stored securely, at the correct temperature and within their expiry date. Staff received medicines training and were assessed as competent to provide medicines support. Staff reported Medicines-related incidents promptly, with documented actions and shared learning. Two medicines incidents identified during the inspection were managed and escalated appropriately. The provider carried out weekly and monthly medicines audits, ensuring good oversight of medicines processes.