Ringway Mews 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.

The provider was in breach of regulations regarding safe care and treatment.

This is the first assessment for this newly registered service since Springcare became the provider of Ringway Mews. This key question has been rated requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

This service scored 59 (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.

Where people had an accident or incident, this was recorded in their care plan, monitored and action taken to address concerns. The management team regularly analysed accidents and incidents to identify any emerging themes or patterns in order to improve the care provided. These findings were then shared with the staff team.

Staff confirmed they were informed of any actions following an accident or incident through daily meetings that took place. Any concerns about a person’s safety could be discussed during staff handovers.

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 was a safeguarding policy and procedure in place which was in date and provided an overview about what people could do if they experienced any abuse. A safeguarding log was maintained, with details about any incidents reported to the local authority for further review.

Staff had completed safeguarding training, which was documented on the training matrix and understood how to report concerns. A member of staff said, “If somebody has an unwitnessed fall, this could be a safeguarding, as well as unexplained bruising.”

People living at the home and their relatives said the home was safe. One relative said, “I feel just as confident when I leave as I do when I am visiting. I know they look after (person) just as well.” Another relative said, “(Person) is very safe if I call to take them out for a walk a member of staff always comes with us.”

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 was a safeguarding policy and procedure in place which was in date and provided an overview about what people could do if they experienced any abuse. A safeguarding log was maintained, with details about any incidents reported to the local authority for further review.

Staff had completed safeguarding training, which was documented on the training matrix and understood how to report concerns. A member of staff said, “If somebody has an unwitnessed fall, this could be a safeguarding, as well as unexplained bruising.”

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. People’s care plans were not always updated to reflect current risks presented to them.

Within the home’s electronic care planning system was series of risk assessments which covered skin integrity, choking, falls and nutrition/hydration. However, we found the completion of these to be inconsistent and not everybody had these in place. Staff understood about risks presented to people however when we spoke with them.

Where people were at risk of skin breakdown, some people’s care plans stated their skin should be checked daily, however records did not show this had taken place. Where people required specialist equipment to protect their skin, this was not clearly recorded in their care plan for staff to refer too. The electronic care planning system did not always demonstrate when people had been supported to re-position by staff in order to give them adequate pressure relief.

Not all people had risk assessments in place for choking and where people required thickened fluids, it was not always clearly documented when this had been provided.

Some people were at risk of falls, although didn’t have mobility or moving and handling risk assessments in place. Some people weren’t wearing appropriate footwear which could increase the risk of falls. Staff said these people often refused to wear appropriate footwear, although this information wasn’t clearly recorded in their care plan.

Other risks were managed effectively. For example, we saw people using mobility equipment if this was required. We saw staff using hoists correctly and providing people with the correct consistency of food. One relative told us, “(Person) has been there for 9 months after coming out of hospital. (Person) had bed sores but they seem to be on top of them now. Another relative added, “(Person) was skin and bone on arrival at Ringway Mews, but they have managed to get him to start to put on weight again. They give (person) build up drinks.”

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

The building was safe, for example we saw windows were fitted with appropriate restrictors to prevent any unauthorized access. Radiator temperatures were controlled with a thermostat to prevent the risk of burns and scalds. We looked at maintenance certificates which showed work completed within the home.

One of the units at the home had recently been refurbished with new flooring, chairs, cabinets, photos on the wall and a fish tank. We were told plans were in place for other units to be modernised also. People’s bedrooms were personalised with items of their choice, although we saw some were relatively bland.

The environment had been adapted to help to meet people's needs, in particular people living with dementia to promote their independence. We observed clear dementia friendly pictorial signage to communal areas and bathroom facilities, aswell as pictures of the local area for people to relate too.

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.

Staffing rotas were in place and this demonstrated how many staff were available to care for people. A dependency tool was used to determine how many staff were required.

Relatives said there were enough staff, although people living at the home didn’t provide any feedback in this area. One relative said, “I don’t think they are short of staff there. There is also a nurse on each unit, a cleaning lady aswell as an entertainment person.”

Staff told us they felt numbers were sufficient to care for people safely. One member of staff said, “We have enough staff at night and we have extra staff for those on one to one care. The staff seem happy.” Another member of staff said, “We do have some sickness but most of the time staffing is okay. We are able to meet people’s needs.”

Staff were recruited safely with the necessary pre-employment checks carried out. NMC (Nursing Midwifery Council) pin checks were caried out for nurses working at the home. A pin check ensures nurses have the relevant registration to practice safely. Staff told us they received enough training to support them in their role, with a training matrix in place showing which courses had been completed. Staff supervisions took place where staff could discuss their work in a confidential way.

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.

Appropriate systems were not always in place regarding infection control. We found some areas of the home to be unclean, including fixtures and fittings around toilet areas, as well as bins and washing machines. Some areas of the home were dusty which appeared like they hadn’t been cleaned for some time This presented the risk of the spread of infections.

An infection control policy and procedure and cleaning schedules were in place and we observed domestic staff carrying out their work during the assessment. Areas such as bedrooms, communal areas and corridors were seen to be clean and tidy and any odours were diminished quickly. Staff had completed infection control training, which was recorded on the home training matrix.

Systems were in place to ensure regular medicines were given as prescribed and recorded accurately, including controlled drugs. Medicines that were required to be given at specific times were given at the right time. Person-centred information was in place to support staff to safely give ‘when required’ medicines.

Correct processes were followed for people who were having their medicines given covertly, hidden in food or drink. Creams stored in people’s rooms were not always risk assessed to prevent inappropriate access. However, the service implemented a new safe storage system immediately post-assessment.

Robust processes for applying and recording creams were not always in place. Overall, staff demonstrated good knowledge of people’s medicines needs. However, care plans did not always have up to date, personalised information about how to support people with their medicines. Managers told us that staff had completed medicines training and had been assessed to ensure that they gave medicines safely. We were shown evidence of training records to confirm this.

Audits were completed at regular intervals to identify medicines-related issues and to drive improvement. Medicines incidents were recorded, analysed and learnt from. Following the assessment, we received a detailed action plan addressing the shortfalls we had identified.