William Wood House

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 requires improvement. At this assessment the rating has changed to 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.

The provider tracked incidents, complaints, and safeguarding concerns to identify clear risk trends. To proactively prevent similar events from happening again, the registered manager had introduced a new falls tracker that improved root cause analysis and risk mitigation. Supported by a transparent culture promoted by leadership, the team ensured all accident reporting met regulatory standards.

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 maintained people’s safety by proactively sharing healthcare concerns and responding swiftly to changing needs. They followed expert guidance and worked in close partnership with health professionals, including GPs, district nurses, and occupational therapists, to ensure high-quality care. A relative told us, “The carers liaise with the local pharmacy and order and manage [family member’s] medication.”

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.

Overall, people reported feeling safe and comfortable in the presence of care staff. However, they expressed a preference for permanent staff members who knew them well, highlighting a contrast with temporary agency workers. One person shared, “Although the agency staff are kind, I just don’t feel as comfortable with them. They are more difficult to understand, and this causes me some anxiety.” The registered manager actively took steps through ongoing recruitment to expand the permanent staffing team, reduce the reliance on agency staff, and used a preferred agency to supply temporary staff who were familiar with the service to support continuity.

Staff had completed safeguarding training and knew how to report any concerns within the service and to external organisations where needed. One member of staff shared, “Depending on who was involved and the abuse involved, I would go to the team leaders first, then I would go to the [registered] manager and if it was that serious, I would go to [local authority] safeguarding if I felt I couldn’t go to those previously mentioned, or CQC, the police if it was severe enough.”

Records showed that the registered manager had reported safeguarding concerns to the relevant authorities and where applicable had cooperated with investigations and conducted lessons learnt to prevent reoccurrence. Outcomes of these were cascaded to staff to support best practice.

There were occasions where opportunities to work with people to better understand and manage risks had not been fully realised. This meant people did not always receive care and support that consistently balanced their safety and individual needs.

People underwent initial assessments to establish their specific care and support needs, and risk management plans were in place to safely manage potential hazards. However, we found inconsistencies within care documentation; while risk assessments had been updated following changes in people's needs, corresponding sections of their care records had not been updated promptly, creating a risk of incorrect care delivery.

The registered manager acknowledged the discrepancies and took immediate corrective action by initiating a comprehensive review. They identified that staff had not fully adhered to the provider's documentation protocols, which had prevented updated information from syncing across all sections of the records. To address this, additional training was provided to the leadership The registered manager confirmed that the provider had identified the limitations of the current framework and was transitioning to a new digital system. They explained that the upgraded platform featured enhanced monitoring, advanced reporting, and anti-duplication capabilities designed to support the ongoing accuracy of individualised care records. To safeguard the quality of care during that transition period, the registered manager established a new protocol that required weekly care plan update requests.

There were occasions where opportunities to identify and address potential risks within the premises could have been strengthened. The landlord had not always ensured that equipment, facilities and building systems consistently supported a safe and dignified environment for people. Both internal and external areas, including soft furnishings and armchairs, showed notable wear and tear.

External surfaces had peeling paint, stains, and marks. The registered manager recognised that these environmental issues compromised people's safety and dignity and was actively engaging with the landlord—who holds primary responsibility—to resolve them. The registered manager also confirmed that an updated risk assessment for the communal staircases was in progress, and that a replacement part for the clinical weigh chair scales had been ordered following staff feedback.

There were occasions where staffing arrangements and staff support processes could have been strengthened to better promote the delivery of safe and individualised care. Further opportunities were available to enhance supervision, professional development and team working.

People and their relatives reported that the quality of care varied when agency staff were deployed. One person shared, “The main snag is the agency folk, the care is not as good.” A relative added, “Some of the agency staff are quite sweet but the care is just not consistent.” Another relative stated, “[Family member] has dementia and can get confused so continuity of staff is important, and this doesn’t happen.” To resolve this, the registered manager was actively recruiting permanent staff, with new team members scheduled to start.

Staff highlighted significant pressures regarding rota deployment, daily schedules, and unplanned calls, which occasionally prevented them from taking breaks. Rota schedules lacked flexibility for ad-hoc calls, forcing staff to adjust visit times. The leadership team altered preferred call times without informing people, occasionally causing friction when staff arrived early or late. One staff member explained, “We are still expected to answer the call bells and attend to whatever needs to be done for the [person] involved and this can mean that we do not get a break. Also, on the rotas there is no allowance made for calls that can go off at any time during your shift so it this then up to staff to make the necessary adjustments to other people’s times to try and fit these in. [People] have specific times that they like, however these are changed by the office without informing the [person] to when we arrive earlier or later than normal, we are left to explain why it isn’t the time they would like or normally have, this can cause some conflict between [people] and the carers due to the time differences.”

The registered manager was receptive to our feedback regarding the staffing arrangements, advising they would review the rotas and were committed to addressing this matter. They also acknowledged that the provider's existing systems did not track late calls which would assist with planning of calls. To address this shortfall, they implemented an interim manual process to capture the necessary information and adjust schedules accordingly. They confirmed that the incoming electronic system would provide this data alongside other enhanced features to improve the wider rostering system.

While safe recruitment processes were in place and staff received ongoing supervision, appraisals, and training, some employees felt they would benefit from further specialised support in care for people living with dementia, medication and moving and repositioning. One staff member stated, “Extra training should be given especially on manual handling and equipment as we are getting more [people] that require this.” Additionally, some staff requested further support to pursue professional qualifications in the sector. A staff member shared, “I would like to be offered level 3 in health and social care in order to progress my career. At the moment, only level 2 is offered.”

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.

Effective systems to help prevent and control infection were in place. Staff had received relevant infection control and food hygiene training and had access to resources and equipment to help them reduce the risk of infections spreading. People told us staff followed good hygiene practices and used personal protective equipment (PPE) when needed. Staff reported they had consistent access to enough PPE.

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

The leadership team conducted routine audits to monitor the quality of medicine administration. Staff confirmed they received relevant training and underwent regular competency checks to ensure safe practices.

Administration was documented using electronic Medication Administration Records (MARs). The system required staff to complete the MAR before logging out of a care call, which significantly reduced errors. Any administration errors that did occur were promptly investigated, and staff received targeted training. Immediate system alerts for missed medicines allowed staff to quickly investigate and resolve non-administration issues.

Care plans and risk assessments guided staff on safe practices, including clear protocols for administering 'as required' (PRN) medicines for pain management. Feedback indicated that medicine support was delivered safely. One relative noted, “My [family member] has a complex medication regime. There is a MARs sheet that clearly lists the medication and time of administration. The carers liaise with the local pharmacy to manage the medications.”