Rowanweald Residential and 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.

An effective system was in place to report, record and monitor incidents and accidents to help support people safely. There was a record of lessons learnt to help reduce reoccurrence. Lessons learnt were discussed in regular meetings and staff were encouraged to openly discuss and learn from one another.

Senior staff promoted a positive learning culture at the service through their monitoring and engagement with staff. There was a focus on learning and improving the service wherever possible. Staff were able to raise concerns outside of the management team to help prevent the development of a closed culture. A member of staff told us, “I feel able to raise any concerns, and I know they’ll be taken seriously.

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.

Staff worked in partnership with other professionals such as GPs, dietitians and speech and language therapists (SALT) to support people to access healthcare when they needed it.

When people moved into the service, or were coming to the home for respite care, the management team carried out a detailed assessment of their needs. This was reviewed regularly to help ensure the information about people’s care and support was current. People and their relatives were involved in the assessment process so that their views and wishes were taken into account when planning their care and support. This approach was confirmed by people and relatives. A relative said, “The transition from hospital was good and everything seems to be going well and we felt involved. We are impressed so far. We chose [the service] because it’s local to us, we live round the corner, and we can visit anytime.” Another relative told us, “The transition from the hospital to the home was smooth. The staff were doing the assessment and yes, we have been involved all the way.”

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.

Procedures were in place to help safeguard people from abuse and improper treatment. Staff were able to recognise signs and symptoms of abuse and received training to help ensure they were up to date with best practice guidance. Staff said they would report concerns and wouldn’t hesitate to do so.

Feedback from people and relatives indicated that people felt safe in the home and in the presence of care staff. A person said, “Mainly everything runs smoothly and I am in safe hands.” Another person said, “[Staff] look after you pretty well.” A relative said, “I am very happy with the care. [My family member] is well looked after. [They] are safe in the home.”

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 were involved in decisions about their care and risk management. People's care records included risk assessments such as falls, moving and handling, eating and drinking and catheter care. Malnutrition Universal Screening Tool (MUST) risk assessments were in place where necessary. These are used to assess people with a history of weight loss or poor appetite. Risk assessments included information for staff about actions to be taken to keep people safe. They contained clear instructions about how to support people to minimise and manage risks to help keep people safe.

People who had pressure wounds or who were at risk of developing them had appropriate risk assessments in place. Staff recorded the actions taken. There was documented evidence that wounds were reassessed and dressed regularly. Wound assessment body maps were in place, and we saw that tissue viability nurses had been involved with people's care.

Personal Emergency Evacuation Plans (PEEPS) were in place for people. These provided details about people's mobility and medical conditions that could impact on their ability to leave the premises in the event of an emergency and guidance on how staff should safely support them.

Staff told us they felt they had sufficient information to support people safely and were able to seek advice or guidance when required.

The provider identified and controlled potential risks in the care environment. They helped to ensure equipment, facilities and technology supported the delivery of safe care.

The home was bright, welcoming and homely. A relative told us, “The home is nice and was refurbished last year. We can visit anytime, we don’t have to ring ahead.”

We did not identify concerns around the environment during the site visit. The maintenance team worked closely with the management team to help ensure the internal and external environment was safe and well maintained. The provider made sure that the appropriate health and safety checks were being carried out such as fire safety checks. Equipment was serviced at regular intervals. Appropriate arrangements were in place to manage emergencies.

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.

Systems were in place to help ensure staff received training suitable for their role and that they had the required qualifications. Staff received supervisions and their practice and competencies were checked. This enabled management to monitor and discuss care staff’s role, performance and development.

Staff told us they felt they had the right training to effectively carry out their role. A member of staff told us, “All the training helps me feel confident in my job.” Another member of staff said, “We have regular training and updates, which helps keep us confident in our work and makes sure we’re following the latest guidelines.”

Policies and procedures were in place to help recruit staff safely. Checks on the suitability of potential staff were completed. This included obtaining references and checks with the Disclosure and Barring Service (DBS). The DBS helps employers make safer recruitment decisions and help prevent unsuitable people from working in care services.

Staffing levels were sufficient to meet people’s needs. This was confirmed by staff we spoke with. Staffing rotas were planned to ensure continuity and consistency of care. Staffing levels were assessed according to people's needs and occupancy levels. The provider used their own dependency tool which monitored the dependency of people in the home and calculated the appropriate numbers of staff to safely meet people's needs. Management reviewed staffing numbers and people's dependency monthly to ensure there were sufficient staff.

During the site visits, we observed that staff were not rushed and were able to spend time speaking with people in the home whilst carrying out duties. People were supported by a consistent team of staff.

The provider assessed and managed the risk of infection. Staff detected and controlled the risk of it spreading and were aware of the procedures to follow if any concerns had to be shared.

Communal and private spaces in the home were clean and tidy. Personal protective equipment, for example, gloves and aprons, were available and all staff were trained to understand infection prevention and control. Feedback from people and relatives regarding the cleanliness of the home was positive. A relative said, “The staff are nice and [the home] is clean.” Another relative told us, “The home is clean.”

The service had a policy and procedures in place for infection prevention and control, and regular audits were completed by staff.

People were well presented and supported appropriately to maintain their personal hygiene.

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

Medicines were safely managed. Systems were in place for ordering, administering and monitoring of medicines. Staff were trained and deemed competent before they administered medicines. Medicines were safely secured and records were appropriately kept. We found that room and fridge temperatures were monitored.

The provider had a system to monitor and audit people’s medicines on a regular basis and used these to make improvements. For example, an audit identified that stocks of thickeners were not appropriately monitored in communal areas. The provider responded to this and implemented an action plan to help ensure that stocks were stored in locked medicines trolleys.

We were assured that medicines related incidents were investigated properly with appropriate action plans. Processes were in place to help ensure staff learned from these incidents to prevent reoccurrence.

People received their medicines as prescribed. People’s medicines records were accurate and we found no discrepancies. There were separate charts in place for people who had medicines such as patches, ointments and creams prescribed to them (such as pain relief patches).

Where people were prescribed PRN (as required) medicines, there were associated PRN protocols in place. This meant we had overall assurance that staff were able to administer these types of medicines effectively to people in line with clinical guidance.

Where people received medicines in a covert manner, appropriate authorisations were in place.