Wood Cottage

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 people were protected from abuse and avoidable harm. This is the first assessment for this registered service. This key question has been rated 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. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Accidents and incidents were reported by staff, and action was taken to mitigate the risk of events happening again. The provider had robust management structures to assess safety risks This included a positive behaviour support team who were skilled in reviewing any events and provided support to people, if required, and the staff team. People had access to professionals, family and friends outside of the service. There was a clear process inplace for raising concerns and complaints, debriefing sessions with staff and opportunities to learn and share in meetings.

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.

Continuity of care was maintained by ensuring staff had access to clear records. People had hospital passports in an accessible format, which meant if they needed medical support, important information about their health and support needs was available to other professionals. The staff team worked proactively with people to ensure reasonable adjustments were in place when they needed to attend planned health appointments. There were good links with the local GP. People were consistently supported if they were distressed. Care plans were in place to support people to have a good day, and strategies were in place to prevent distress.

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.

There were clear processes in place to manage safeguarding events and the registered manager and service manager worked collaboratively with the local authority to support people safely. Staff had received safeguarding training and understood how to recognise and report poor care and abuse. Where people were subject to Deprivation of Liberty safeguards (DoLS) the provider had made applications to the local authority and there was clear monitoring in place. DoLS ensure if a person is restricted in a way which deprives them of their liberty in a care home, it is only done when it is in their best interests, is necessary for their safety, and all other options have been considered. Where restrictive practices were being used, they were legally justified and proportionate. There was a clearcommitment to minimising restrictions for people and they were regularly reviewed to promote people’s choice and independence. Relatives told us they felt their family members were safe. Comments included, “[Person] feels safe, you can tell in their presentation I would know if they felt otherwise.” And “You can tell he is happy and content, he seems more settled in this service.”

The provider worked with the positive behavioural support team to understand and manage risks. Staff provided care to meet people’s needs which was safe, supportive and enabled people to do the things which mattered to them. This was evidenced by the reduction in periods of distress in the service and a reduction of incidents. However, risk assessments and plans, were reviewed annually and staff frequency of reading risk assessments, care plans and positive behavioural support plans required strengthening.

Key risks such as activity, complex behaviours and nutrition and hydration were assessed and monitored. Staff told us they were kept up to date about any changes in people’s needs through good communication. Staff knew people well and understood there were times when people became distressed and took steps to understand why a person was distressed and what support they needed to express their emotions. We observed care being delivered in line with people’s care plans, which promoted their independence and choice. People were supported and empowered to take risks in areas they wanted to and to enhance their lives.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, and facilities supported the delivery of safe care. A bathroom floor and drain had damage and needed repairing. We did not find any evidence of harm to people. We discussed this with the service manager, and they took immediate action. Evidence was provided regarding the damage to the floor in the bathroom during the assessment, quotes for repair were being sought. The service was quite spacious and had an accessible garden with activities to choose from.

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.

Safe staffing levels were in place, and this was confirmed by staff, people and relatives. Comments included, “There is always enough staff, and they support in the home and community. This makes [Person] feel safe and secure.” Recruitment was managed safely and all the required checks were carried out before people commenced in their role. Where people needed one to one support this was clearly recorded on rotas. Staff had the induction, support and training to be able to carry out their role. Training was coordinated to ensure it was flexible and met the specific needs of the people who were living at Wood Cottage. Staff had received regular effective supervisions and annual appraisals.

The provider did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading or share concerns with appropriate agencies promptly. The laundry room and kitchen required a deep clean. During the on-site assessment, on the third day, the service manager ensured the kitchen and the laundry room was cleaned and organised with ongoing monitoring in place to ensure cleaning schedules were being adhered to.

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

The provider evidenced good outcomes for people using the national health service programme ‘Stopping over medication of people with a learning disability and autistic people or both’ (STOMP). Staff received training to administer medicines, and their competency was regularly assessed. However, we found medication was being disposed, not undertaken and stored in line with national guidelines. The service manager had organised for this to be rectified and evidenced this during the on-site assessment.