Royal Leamington Spa Nursing 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. 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 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.

Incidents, accidents and other events were recorded, reviewed and used to identify opportunities to improve care and reduce the risk of recurrence.

Falls, accidents, safeguarding concerns, complaints and other incidents were monitored and analysed to identify trends, themes and lessons learned.

Learning was shared with staff through handovers, daily meetings and other team discussions. Staff were able to describe changes that had been made to practice as a result, demonstrating that lessons were understood and embedded in day-to-day care.

The registered manager had introduced a new daily audit to help identify emerging risks. Staff had also received training to recognise potential safety concerns and understood how to escalate these appropriately.

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.

People's needs were assessed before they moved into the home. The registered manager or deputy manager completed pre-admission assessments to identify risks and ensure the service could safely meet people's needs. Care plans were developed promptly following admission, providing staff with the information they needed to deliver safe and effective care.

Staff supported people to access healthcare services and worked with other professionals to ensure continuity of care. During our assessment, staff supported a person to attend a hospital appointment and shared relevant information with healthcare teams. Care records were accurate and up to date, enabling information to be transferred quickly and effectively when required.

The registered manager demonstrated learning from a previous incident to improve safe transitions and had created ‘an emergency information’ template. This provided staff with key information to share with emergency services, helping to support safe and coordinated care during unplanned events.

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 living at the home. Comments included, “I do feel safe, the carers make me feel safe” and “I’m safe alright, nothing has happened to me here. I have less fear now.”

Staff were able to describe what events might need to be referred to safeguarding agencies and knew the processes to follow. The registered manager demonstrated safeguarding events were appropriately documented, investigated, reported and used to inform learning.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In a care home, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. When people were identified as potentially being deprived of their liberty, applications were made to the authorising body as required. Processes were in place to ensure Deprivation of Liberty Safeguards (DoLS) were managed in accordance with legislative requirements.

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 risk assessments and care plans in place which were accurate and contained detailed information that informed staff how to safely manage known risks. Assessments were thorough, informative and written in an accessible way which meant all staff could be clear on how to safely support people. Risk assessments were regularly reviewed and updated.

People told us they were involved in planning their care and knew what information their care plans contained. One person told us, “They ask if we want any changes to our care plan monthly. I review my care needs with them then.” Another person said, “I have a care plan. They ask me if there’s anything I want updated.”

When people moving into the home had more complex medical conditions, the registered manager organised bespoke training to ensure staff had the skills and confidence to support people’s needs.

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

Since our last assessment there had been an ongoing refurbishment programme at the home including a detailed fire risk assessment, a new kitchen ceiling and new fire doors. Staff received regular training on how to react in the event of a fire, and regular drills ensured staff were responding as expected in the event of an emergency.

The provider sought specialist advice and support when required to help maintain a safe environment. For example, external specialists were commissioned to assess ageing windows and identify those that required repair or replacement.

Learning had been implemented since our last assessment, and daily checks had been introduced to ensure the security of the building, pressure relieving mattresses were on the correct settings, and chemicals that could be hazardous to people were safely locked away.

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 told us there were enough staff available to meet their needs and provide support when required. Comments included, “There is enough of them… there’s never not enough. They are very good at allocating help,” and “I’ve no problem with the staff being trained, they all seem to be.”

The provider had systems to recruit staff safely and ensure they had the skills and knowledge needed to support people effectively. The registered manager had recently reintroduced competency checks to ensure staff had understood their training and could follow it in practice.

There was a stable and established staff team, many of whom had worked at the home for a considerable number of years. When sickness or holiday cover was needed, staff covered shifts between them, which helped people receive consistent care from staff who knew them well.

Staff received regular supervision to support their professional development and reflect on their practice. This helped to identify learning opportunities and ensure staff continued to provide care in line with people's needs and best practice.

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.

People and their relatives told us the home was clean and they had no concerns about hygiene standards. Personal protective equipment (PPE) was readily available throughout the home, and staff were observed using and disposing of it appropriately to help prevent the spread of infection.

People who were at increased risk of infection had detailed care plans in place. These provided staff with clear guidance on the precautions and practices required to reduce and manage identified risks.

A member of the housekeeping team had recently taken on the role of COSHH (Control of substances hazardous to health) champion and had developed clear, accessible guidance for staff. This included information on the appropriate use of cleaning chemicals, safe storage arrangements and first aid measures, supported by photographs to promote understanding and consistency.

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.

People told us they received their medicines when needed and were supported by staff who understood how to administer them safely. Medicines were stored securely, and there was an adequate supply available to meet people's needs.

Where people were prescribed medicines to be taken only when required, such as pain relief or laxatives, staff had clear guidance in place to support safe and consistent administration. This helped to ensure people received these medicines appropriately and in line with their assessed needs.

Staff worked with healthcare professionals to review medicines and respond to changes in people's health. For example, 1 person had experienced an adverse reaction to a prescribed medicine, Staff advocated on the person’s behalf and worked with healthcare professionals to explore suitable alternatives. This helped to ensure the person's symptoms continued to be managed effectively while reducing the risk of further harm.