Nodens Manor 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 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 66 (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 recorded, there was a culture of openness and honesty to look for improvements.There were processes to record, monitor and learn from accidents and incidents. Lessons learnt were shared through meetings, one to one’s and themed supervisions. Staff were encouraged to report concerns. They felt supported to do so.

Professionals working with the service told us staff were proactive in adopting different advice where needed. One professional told us, “For quite a while we had weekly catch-up calls to discuss problems that may have arisen from either side and to pass on any concerns that needed to be communicated with the GP. These were very useful especially in the early days of the care home setting up.”

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.

Many people came to the service on a respite basis initially to see how the service met their needs before making a permanent decision to stay at the home. Information was shared with agencies to ensure continuity of care. Visiting professionals told us communication systems with health professionals had greatly improved since the service opened 2 years ago. People were accepted into the service safely. One relative told us, “We came to look round before it opened and then came back to see the manager and do paperwork. It looks lovely but wanted to know about staff. All the initial reactions were good”.

The provider did not always share concerns quickly and appropriately. There were systems, processes and practices to protect people from abuse, neglect, harassment and breaches of their dignity. These were communicated with people, staff and visitors to the service. However, during our assessment, we identified 2 concerns that had not been reported as a safeguarding concern or notified to CQC. The registered manager had acted on the concerns through internal processes and following our feedback took measures to report to the statutory authorities.

Staff we spoke with understood their responsibilities in relation to safeguarding people. One staff member told us, “I have completed safeguarding training and feel confident to raise anything. There are always seniors about if there is anything I am not happy with.”

Where people lacked capacity to make their own decisions, we found appropriate legal authorisations for Deprivation of Liberty Safeguards (DoLS) were in place and referrals were made and monitored.

The provider did not always work well with people to understand and manage risks. Risk assessments were of mixed quality. Some risk assessments were missing and lacked detail whilst others demonstrated a good comprehension of the risks to the person and how staff should support them. For example, we saw a detailed risk assessment for one person who presented with distressed emotions. However, one person with a diagnosis of diabetes did not have a risk assessment which identified the risk associated with this for staff. We did not find anyone had come to harm because of this. The registered manager acted on our feedback during the assessment. One professional working with the service told us, “Staff not always aware what food and drink to give a diabetic person.” Another professional said, “The care home are good at referring into the District Nurses promptly when there is a concern regarding skin integrity.”

People and their relatives told us they felt safe, and risks were managed well in practice. One relative told us, “After they had the fall, they set up a pressure pad as a safety measure. They have a wrist one (call bell), they are always happy, well fed, warm and dry. They are safe.” Another relative told us, “I was sat with her and moved my chair onto the crash mat, they were there in an instant.”

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

Facilities, equipment and technology were well-maintained and used for their intended purpose. Effective arrangements were in place to monitor the safety and upkeep of the premises, bringing in professionally qualified people to complete the necessary environmental and equipment checks.

People’s bedrooms contained safety features including window restrictors, furniture that was affixed to the wall and sensor lighting in bathrooms. Rooms were of a good size and allowed people to move freely and for assistive equipment to be used if required.

Fire safety measures were in place. This included an equipped grab bag with people’s evacuation plans, regular fire alarm testing and fire drills completed twice a month which alternated between day and night staff. There were plans to complete fire marshal training for all senior day and night staff in June 2025. Assistive equipment was available and secured in stairwells to support people downstairs in an emergency.

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.

People were supported by sufficient levels of staffing. One person told us, “When they have new recruits, they introduce them and then they train them.” A relative told us “There are always people around when I’m there. They have their radios and can call another for assistance. From what I can see they have more staff than required.”

Staffing levels in the service were safe. One staff member commented, “We work all over but I am more downstairs. There is enough staff to get it all done and we can cover each other well, we work together.” The registered manager confirmed the staff team was stable.

Throughout the inspection staff were visible and observed supporting people when needed.

Staff were recruited safely; regular supervisions took place. Staff had yearly appraisals with their line manager. Staff had the opportunity to develop their skills, knowledge and career with the provider.

Training was in place and staff had their competencies checked. Training had been completed online. The provider had a plan to introduce more face-to-face training. However this had not started at the time of our assessment. This is important because the service supports a number of people living with a dementia.

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.

Infection Prevention Control was well managed within the home. The home looked visibly clean. People and relatives told us infection prevention control was managed well. One relative told us, “I’ve seen them with gloves and aprons when seeing to residents. On the trolley there are special bins, colour coded.”

Staff had access to appropriate levels of cleaning materials and Personal Protective Equipment. One staff member told us, “Cleaning supplies are ordered and we never run out.” Staff understood the importance of maintaining a high level of cleanliness and how to prevent the spread of infection. This included extra cleaning of high touch point areas and working in ways to contain an outbreak from the rest of the home.

The service did not always make sure medicines were administered in accordance with the prescriber instructions. Errors were identified by the service however, errors were reoccurring. The provider was responsive and took immediate action to resolve issues found by inspectors. Covert medicine plans lacked details for staff to follow. However, the service required more input from health professionals to complete the plans fully. Following our assessment the service engaged the local GP practice in developing these plans in more detail.

People who could not say they were in pain all had individualised care plans.

One person told us, “I have a lot of medication including morphine. I check the medication with staff.” A relative said, “staff do all their medications, we have organised an optician, but they do the rest”.