South Wold 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 understood their responsibilities to report safety incidents. The registered manager and management team investigated incidents and looked at ways to learn from them in order to improve the service. All changes at the service were cascaded down to staff via a verbal handover or a WhatsApp group message as well as a handover when they were next on duty.

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.

The registered manager worked with people, their family and other services to ensure all involved had knowledge of the persons care needs to ensure safe transition of care. The service worked closely with teams within hospital settings when people were being transferred from hospital. The registered manager said that if they felt they had not been given enough information, they would also do their own assessment of the person’s needs. People and their relatives told us the service worked well with them to make sure they understood the needs of the person receiving care.

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.

All staff received safeguarding training appropriate to their roles. Staff we spoke with were able to give clear examples of what and when they would report as a safeguarding matter and said they would not hesitate to do so. All people and relatives we spoke with said they felt safe at the service.The service ensure they request Deprivation of Liberty Safeguard (DoLS) assessments when people at the service did not have capacity to consent to care and treatment. Where people lacked capacity and did not have any family to support them, the service contacted the local authority to ask for referrals to be made to the local advocacy service.

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.

The service recorded risk mitigations in people’s care records. Staff were kept informed when peoples risk assessments had been updated. The service worked with people to support them with positive risk taking. For example, 1 person needed bedrails in place for their own safety. However, the person felt uncomfortable with bumpers around the bed rails. The registered manager worked with the person to ensure they recognised the risks of not having the bumpers in place. The person had capacity to make their decisions about their care and their views were respected. The service stated they were monitoring this and would continue to assess the risk to the person.

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

Environmental audits were regularly carried out at the service. Actions from the audit were documented with a date completed.

People and their relatives told us they felt the environment was safe.

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.

Although there were always enough staff to support people at the service, there were times when the registered manager was often on the rota as the nurse on shift. The registered manager would on occasions work a night shift and then also work the following day shift. The registered manager told us they had additional nursing support that was due to start at the service in the upcoming weeks.

People and their relatives all told us there was always enough staff to meet their needs, call bells were always answered in a timely manner.

Staff were recruited safely and had received training, supervision and ongoing support from the service.

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.

The service had an infection prevention control (IPC) lead who audited the service for issues relating to IPC. We observed the service to be visibly clean, with staff cleaning throughout our visit. We observed the kitchen staff at the service to be wearing the same personal protective (PPE) as staff who were giving personal care. We discussed with the registered manager about the importance of changing PPE when doing different tasks within the home. Action was taken on the day of the inspection for staff to wear different coloured PPE.

All people and relatives we spoke with said the service was always clean with one relative saying, “The service is spotless, staff are always cleaning, they also clean and disinfect after meals.”

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

Some people required medicines as and when required. The service did not always have protocols in place for people, to ensure staff had the guidance needed to administer these medicines. This was discussed with the registered manager who made sure the protocols were in place before the end of the inspection.

We observed the registered manager administering medicines, during this time they were interrupted several times in order to deal with other tasks. Guidance’s from both the Care Quality Commission's (CQC) website and NICE (National Institute for Health and Care Excellence) emphasises the importance of minimising distractions and interruptions during medication administration to ensure patient safety and prevent errors. The registered manager said that they would consider the delegation of medicines administration to become part of a senior carer role.