Watermead Rose Care 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. This is the first assessment for this service. This key question has been rated 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.

The provider used an incident reporting and management system to enhance and improve safety and outcomes at the service. This was linked to their governance processes and meant managers had an overview of incidents and acted to address any safety concerns.

The system identified trends, for example repeat falls or infections. Managers analysed these and took preventative measures to reduce risk and keep people safe. Staff knew how to record incidents on this system, and how to escalate safety concerns.

The registered manager did a daily walkaround to check people were safe. This meant shortfalls were identified and put right. For example, a person was found without a drink next to them. This went against the service’s practice of ensuring people were hydrated so the registered manager alerted staff and reminded them of their responsibilities.

The provider worked with people and healthcare professionals 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.

Relatives said people had a good transition into the service. A relative told us, “The staff were so thorough. They spoke to the staff in the previous care home to check they could meet [person’s] needs. The day of transfer went smoothly.” Another relative said staff spoke to family members ‘at length’ prior to admitting a person to ensure they had a full understanding of their needs.

The provider employed a public engagement officer to oversee people’s admission and first few weeks at the service. This meant people and relatives had a named person to contact if they had initial queries or concerns.

The provider worked with people and healthcare professionals 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 relatives said the service was a safe place. A person told us, “Yes, I feel safe here. There’s always people moving ‘to and fro’ outside my door.” A relative commented, “[Person] is safe in here. I don’t feel worried.”

Staff were trained in safeguarding and knew what to do if they had concerns about the well-being of any of the people using the service. They said managers would act if a person was at risk of harm and understood the role of the local authority in safeguarding investigations.

The provider had good safeguarding systems, processes and practices. These ensured people’s human rights were upheld and they were protected from discrimination. Safeguarding was regularly discussed in staff supervision sessions, team meetings, and handovers, to remind staff of their ongoing duty to protect people from harm.

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.

Staff knew how to support people safely. A person told us, “If I want to go to the toilet they come and help me, they’ll walk with me.” Another person said, “They’re very good at checking my skin. They’ll want to take a photo if they see any broken areas.”

People had risk assessments for all aspects of their care and support. These were regularly updated as people’s needs changed.

Staff knew when people were at risk and acted to minimise this. For example, one person had recurrent falls. To reduce the risk, the person had one-to-one staffing at the times they were active. The person was also referred to a specialist team to see if there was any physiological reason for them falling. This showed staff proactively managing the risk and taking a holistic approach to why it was occurring in the first place.

Nursing staff were successfully managing people’s skin integrity, involving external tissue viability nurses where necessary. Records showed people’s pressure areas improving at the service. People were regularly re-positioned to reduce risk to their skin. Staff recorded/photographed skin damage but had not always measured pressure areas. We discussed this with the registered manager who said that in future, measurements would always be included.

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

A relative told us how staff used equipment to keep their family member safe when they were restless at night. They said staff lowered the bed, put pressure mats down, and explored the possibility of using bed rails to reduce the risk of an accident occurring.

People’s care plans listed the equipment staff needed to support people safely, for example, slings, profile beds, wheelchairs, and hoists. Equipment was checked and serviced regularly in line with legislation and manufacturers’ instructions.

The provider had effective arrangements in place to monitor the safety and upkeep of the premises, including gas, electrical and fire safety maintenance and checks. Staff were trained in health and safety and understood the importance of ensuring the environment was suitable for people’s needs.

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.

Staff recruitment files were mostly in good order with evidence of the provider following robust and safe recruitment practices. One staff member had an undated reference which did not show the designation/company of the person supplying the reference. The registered manager was able to address this shortfall during our inspection visit and ensure the missing information was added to the record.

Most people and relatives were satisfied with staffing numbers at the service. A relative said, “Oh yes, [person] is safe here. They [staff] come straight away when we press the bell.” A person told us they were able to use their call bell, which was within their reach, and the staff were good at responding. The registered manager audited call bell records to ensure call bells were answered promptly.

Staff were satisfied with staffing levels and said these increased if people’s needs changed. A staff member said that if the service was ever short-staffed, they would report this to the registered manager who ‘will listen and get more staff’. The registered manager had autonomy in deciding staffing levels and based them on the number of people using the service and their individual levels of need.

People and relatives said the staff were knowledgeable and provided good quality care and support. A person told us, “They’ve obviously been trained, they’re very competent.”

New staff completed a comprehensive induction, and all staff had ongoing online and face-to-face training arranged by the provider’s training department. Specialist training was delivered by healthcare professionals including local hospices and community nursing teams. Training records showed staff completing a wide range of courses, both mandatory and specialised, including clinical training for the nurses employed.

Staff had supervision once every 3 months as a minimum, consisting of observations, 1-2-1 and group sessions, and peer supervisions. Supervision was ‘tracked’ so managers could check staff had the support they were entitled to. A staff member said, “We receive supervisions the nurse/senior keeps an eye on what we do. They are both formal and informal. I do feel supported by the leaders.”

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 premises were clean, tidy, and fresh throughout. A person said, “The staff wash their hands, they wear aprons and gloves and change their gloves a lot.” Personal protective equipment (PPE) was available in all areas including people’s bedrooms.

Staff were trained in infection prevention and control (IPC) and understood knew how to prevent people being harmed by avoidable infections. Housekeeping staff had the resources they needed to keep the premises and equipment clean and hygienic. There were ‘donning and doffing posters’ displayed around the premises and handwashing posters next to handwashing basins.

The provider had clear roles and responsibilities around infection prevention and control. The clinical lead and head housekeeper worked together to ensure people’s care and support, and the premises, met IPC guidelines.

Staff carried out regular risk assessments and audits to prevent, detect and control the spread of infection. If infections occurred managers analysed them to determine the type of infection, the frequency, the location within the premises, the severity and the outcome. They used the information gathered to improve practice, guide staff, and identify further preventative measures or training.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

People and relatives were satisfied people had their medicines when they needed them and in line with prescribers’ instructions. A person told us, “I get my medication on time.”

The provider had good systems to ensure medicines were appropriately prescribed, supplied and administered in line with the relevant legislation, current national guidance or best available evidence, and in line with the Mental Capacity Act 2005.

Medicines were stored safely and securely. Temperatures were recorded and monitored in medicines storage areas. We checked medicines supplies and the amounts kept tallied with records kept. The sites of patch medicines were recorded to ensure different areas were used on the body each time patches were changed.

Staff who administered medicines were trained and had regular competency checks to ensure their skills were up to date.

We observed a medicines round and saw people received their medicines safely and staff followed best practice.