Worplesdon 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 newly registered 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.

Accidents and incidents were acted upon, recorded, signed off by the registered manager and analysed each month. Any themes and trends were identified and discussions took place around possible reasons for recurrent incidents, such as skin tears or falls. The registered manager shared their monthly report and lessons learnt bulletin in staff meetings and daily handovers so all were aware of outcomes and learning. This included identifying an increase in infections with people who had catheters. Following discussions with the GP, it was determined that dehydration during the current heatwave may be a contributing factor. Staff were reminded to encourage and support people to increase their fluid intake.

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.

The service used a safe admission and discharge policy. This included discussing pre-admission assessments with the registered manager to ensure sufficient information had been obtained about the person through all available sources, such as a person’s GP records or information from the hospital discharge team. Information was shared with the staff team prior to a person moving in. These systems helped ensure that a person did not become overwhelmed with numerous questions and the move into the service was a calm and smooth experience for them. A relative told us their family member’s move from another care service was really positive and they were able to raise any concerns at any time with the registered manager.

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 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). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found DoLS authorisations were appropriately applied for and overseen. These assessments helped to ensure decisions are made lawfully and in the person's best interests when they lack capacity.

People said they felt safe. One person told us, “I do feel safe living here, I have never really thought about it but I do not have any worries.”

Staff received training in how to recognise abuse and understood their need to be vigilant and to report any potential concerns. The service worked with the local authority safeguarding team when any safeguarding concerns were raised to investigate and resolve issues. Staff told us, “We would report to the nurse in charge, make sure they are safe” and “If something is done wrong, I would go to the manager.”

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 told us they felt safe living at Worplesdon View and a relative confirmed their belief that their family member was not only safe but considerably happier and more settled since moving to the home. One person told us, “I am really happy living here, I wouldn’t change a thing everything is very good and I always feel safe here.”

Staff understood people’s individual risks and acted in a way that helped ensure they kept people safe. This included ensuring 2 staff provided personal care to 1 person whose health had deteriorated. This reduced the risk of the person’s skin being damaged. Other people spent time in bed and ate their meals in their bed and there was guidance in their care plan to remind staff to ensure people were sitting fully upright prior to eating. Our observations on the day confirmed this was happening. We also observed staff accompanying people when they were mobilising to their rooms or other parts of the service and equipment was seen being used for people who were unable to transfer or stand unaided.

One person required a particular utensil to eat and we saw during lunchtime that staff had provided them with this. This helped ensure they remained safe when eating. We saw several people wearing call bells or had them close to them when in their rooms.

The provider did not always detect and control potential risks in the care environment. They did not always make sure fire safety processes supported the delivery of safe care.

Although people had individual personal evacuation plans these were stored within the electronic care planning system meaning that in the event of a fire, the emergency service would not have immediate access to a list of people and details of those who may need to be attended to first or those who may require specialist equipment. We raised this with the registered manager on the day who said they would action this straight away.

However, the environment in which people lived was clutter free, tidy and had suitable storage to ensure equipment was not creating a trip hazard to people. The service was checked for its safety through regular monitoring of the facilities which included electrical testing, water tests, lift servicing and fire equipment checks. One person told us, “I know there are fire alarms and I know they train hard on evacuation procedures 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.

There were sufficient staff available to provide care to people and people’s feedback confirmed this. People confirmed their alarms were responded to and although some people felt that staff numbers could be a little higher they said staff worked hard and understood if response times to them were sometimes longer. During mealtimes people were supported by a sufficient number of staff which meant that both people eating in the dining areas and those in their rooms received their food quickly.

People said, “I do use my buzzer and it is always comforting to know that someone will come”, “I think mostly they are about right but they do need a couple more at night times”, “I feel safe- because if I ring someone will always come along and if I ever have a problem” and “I have a Buzzer and I do use it, although not often, and someone always comes along.”

We reviewed the call bell audits carried out by the registered manager and saw that the majority of people’s call bells were answered by staff within the required timescale. Where some had taken a while to be responded to, the registered manager had spoken with staff reminding them of the importance of attending to people promptly.

Staff received induction and training when starting at the service and training was refreshed on an on-going basis. The service had good training compliance levels demonstrating that staff were maintaining their learning and as such, their skills. Staff said, “I’m always happy if I have training and learning. I learnt we should give people (living with dementia) more time and that visual choices are useful to help residents make decisions” and “Very good induction and training. Shadowing for 2 weeks. Always doing refresher training.”

Staff also had the opportunity to meet with their line manager on a one-to-one basis to discuss their role, any concerns or any training needs. A staff member told us, “We talk about the residents and how I am.”

Staff working at the service were recruited safely with staff providing evidence of previous employment, their right to work in the UK and their fitness for the role. Each staff member underwent a Disclosure and Barring Service checklist prior to working independently. This helped ensure they were suitable to work at this type of service.

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. The service was clean, tidy and had no malodours and relatives were complimentary about the cleanliness of the service with 1 relative telling us, “The cleanliness of the home is exceptional.”

We also observed that at lunch time to support infection control measures, staff changed uniform and wore specific attire for this period.

We did find some items in the sluice rooms (areas dedicated to cleaning soiled items or disposing of clinical waste) had not been sufficiently cleaned and we raised this with management. Following our visit, the provider confirmed they had taken action regarding this and had replaced some items.

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 medicines were administered in a timely manner and staff held person centred protocols and care plans around people’s individual medicines. One person told us, “I have a lot of medication because of the pain but they look after all that for me.” In addition, some people had been assessed as being able to self-administer their own medicines, which encouraged and supported their independence.

The service ensured people received the medicines they required. They held adequate stock of medicines which they stored securely and at appropriate temperatures. There was a robust ordering and stock management system in place to support this.

Staff followed good practice and safely administered medicines via Percutaneous Endoscopic Gastrostomy (medicines given through a tube directly into a person’s stomach) or where these were administered covertly (without the person’s knowledge).