Ladden View

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 72 (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.

Key information, updates and actions were shared by staff in a brief daily meeting, with risks, changes and priorities also being discussed in staff handovers. This helped ensure staff had the information they needed to deliver safe and effective care.

Staff reported, investigated and analysed accidents and incidents in detail. Managers carried out audits to monitor standards. They identified actions and communicated these across the team to address issues and drive improvement. Staff and relatives told us changes and developments had been evident within the previous few weeks.
 

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 carried out assessments before people moved to the home to ensure their needs could be met. This included gathering information from people and their families to support a smooth transition and help them settle into the service. Managers told us they were clear the service was not designed to support people with complex medical or nursing needs. They described Ladden View as an ‘entry-level care home’. They gave examples of how they had proactively supported families when their relative’s needs had increased beyond what the service could safely meet. This helped manage risks and ensured the person received continuity in their care journey.

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.

People told us they felt safe when they were being supported by staff. Their relatives said they were confident that staff kept their family members safe. One relative said, “[Name] has settled there; she tells me she feels really safe there and really happy there. I have no worries about that.”

Staff received training in safeguarding and were able to describe the action they would take if they had any concerns. Staff told us they were confident that concerns would be managed appropriately. A staff member said, “Any concerns, I would raise with a manager, the GP and report to safeguarding. There is a chain of responsibility for safeguarding. Making sure the residents are safe is the most important thing.” Policies provided guidance, and concerns were reported as necessary and investigated by the management team.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). Staff worked within the principles of the MCA, and DoLS were managed to ensure any restrictions or limits on people were the least restrictive possible and were in the individual’s best interest.

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 had individual risk assessments, which were up to date and available to staff. These included risks relating to falls, medication, choking and the safe use of equipment. Staff regularly reviewed people’s risk assessments and care plans to ensure they continued to reflect people’s needs and preferences. People or their relatives were involved in these reviews.

Staff knew people well, and this helped to keep them safe. Staff received training in subjects such as moving and handling, dementia awareness, food safety and skin health to ensure they were able to safely meet people’s needs. A professional told us staff responded positively when they advised staff about the safest and most effective way to provide support when moving a person.

The provider detected and controlled potential risks in the care environment. they made sure equipment, facilities and technology supported the delivery of safe care to a very high standard.

Ladden View provided a very comfortable and pleasant environment for people. Each floor had lounge areas which were decorated and furnished to an extremely high standard. People were encouraged to personalise their bedrooms with furniture, photos and pictures. All bedrooms had en suite facilities, with accessible bathing facilities on each floor in comfortable and well-designed bathrooms. Other communal facilities included a dedicated quiet space, hair salon, bar, cinema and café area, as well as access to secure outdoor spaces. The home was clean and free from clutter and odours.

The delivery of safe care was supported by regular checks of equipment and building safety. Staff carried these out to detect and control potential risks in the environment. This included checks of mobility equipment, fire equipment and building safety.

Staff received training to keep people safe, such as fire safety, moving and handling and the use of different types of equipment.

Although the provider’s staffing tools and rotas showed there were enough staff to safely meet people’s assessed needs, people, relatives and some staff told us they believed there were not always enough staff available. We shared this feedback with the management team at the time of our inspection. They assured us staffing levels remained under constant review.

Relatives told us they preferred when permanent staff supported their family member and were less positive about the care provided by agency staff. They said, “[Name] likes the staff, but some of them come and go. They are all very nice, but you can tell when agency staff are on because they don’t understand the people like the regular staff. The regular staff know both the people and the families very well.” Staff said, “Some agency staff are better than others” and “It makes the job so much easier when all the staff know people and then we can work together.”

Feedback about staff induction was also mixed, although recent new staff reported positive experiences and other staff told us changes had been made. Staff received regular training and supervision to ensure they had the knowledge and skills for their role, and further training and development opportunities were available to staff. The management team monitored staff compliance to ensure they were up to date with training and received regular supervision.

However, staff described a culture of effective teamwork and told us they worked together well to provide safe care that met people’s individual needs. Staff were positive about working at the service and the care they provided.

Staff were recruited safely by the provider, and relevant checks were carried out before new staff started working at the service. This included criminal record and employment checks to confirm staff were suitable to care for people. At the time of the inspection, managers told us they were only appointing candidates with previous experience of working in care. This helped to ensure new staff had a good understanding of expectations and improve the delivery of safe and effective care.

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.

Housekeeping staff followed effective cleaning routines to maintain a clean, fresh, and hygienic environment. Staff received training in infection prevention and control. People, relatives and staff all gave positive feedback about the cleanliness in the home. Relatives also commented about how well presented their family members were.

Staff understood the importance of food safety and hygiene when preparing or handling food. They followed expected standards and practice, and this was reflected in the service’s 5 star food hygiene rating and the catering team reaching the finals of a national industry award.

Staff were seen to be following the provider’s infection prevention and control policy and used personal protective equipment (PPE) appropriately.

The service had not always made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They did not always involve people in planning.

Medicines care plans were not always in place or person centred. Some care plans did not have the required information to help staff support people with their health needs. For example, we found that one person who came to live at the home recently did not have a medicines care plan. Also, care plans for medicines were not in place for another person who was admitted for respite care. For another person who was prescribed anticipatory medicines for palliative care, the care plans lacked detail about how the staff would assess their health condition and when to contact the palliative care nursing team.

The service had a process for reporting medicines incidents and errors. Reported incidents included medicines not being given as prescribed, incorrect doses being administered, and concerns about medicine stock levels. Staff and people living at the home told us staff shortages and a high reliance on agency staff had contributed to recent medicine errors.

Staff carried out regular audits of medicines management. However, we were not always assured that these audits had identified areas requiring improvement or led to necessary action being taken.

However, staff stored medicines, including controlled drugs (CD), securely and at appropriate temperatures. There was an adequate stock of prescribed medicines.

We observed staff administer medicines. The staff members administered medicines in safe and caring manner. Staff received training and were competency assessed to handle medicine safely.

Some people were prescribed medicines to be administered on a when-required basis for health conditions such as constipation, pain or palliative care. The service had guidance for staff for these medicines to be administered consistently.