Seymour House-Northwood

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 last rating for this key question was good. At this assessment the rating has changed to 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.

We identified breaches of legal regulations relating to safe care and treatment.

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.

There was a culture of learning, where staff were supported to understand how to make improvements when things went wrong. The registered manager discussed safeguarding concerns, complaints, accidents and incidents with staff. This helped to ensure they could learn from these.

Staff told us they knew how to report accidents, incidents and concerns. The registered manager reviewed all adverse events and analysed if there were any common themes or areas of concern. This helped to ensure they could provide training or information for staff when this was needed.

The provider ensured people experienced safe transitions and pathways. The management team assessed people’s needs before they moved to the service. They worked closely with health and social care professionals to make sure they could meet people’s needs and provide a safe move to the service. They had identified when the service could no longer meet people’s needs and had worked with other care homes and hospitals to provide information to enable safe transitions. Relatives told us they had felt people’s moves to the home had been well managed and safe.

Staff did not always have a good understanding of different types of abuse. They were able to tell us about safeguarding processes but were not able to describe their role in recognising and reporting abuse and felt this was more the role of managers. They had undertaken training about this. However, they needed further support and guidance to embed their knowledge. We discussed this with the registered manager who agreed to hold discussions with staff to support their understanding.

The provider had procedures for responding to safeguarding alerts. The registered manager had worked with the local safeguarding authority to investigate and respond to allegations of abuse.

People using the service and their relatives told us they thought the service was safe. One relative commented, “I have nothing but praise for the staff here. [Person] is well looked after and safe.”

The provider had requested legal authorisations where restrictions amounted to a deprivation of liberty for people who did not have the capacity to consent to these. Decisions about people’s care were made in their best interests and for their safety.

Risks to people’s safety had not always been assessed or planned for in a personalised way. For example, risk assessments relating to people falling used generic statements and did not include personalised information. The assessment and plan for 1 person who was considered at high risk of falls, did not include information about their cognitive abilities, sensory impairments or leg pain which they experienced. Some people expressed themselves through physical or verbal anxiety. Risk assessments and plans relating to this were not detailed enough to provide staff with appropriate guidance.

Staff did not always ensure safe care and treatment. During lunch we observed a staff member supporting a person to eat. The person was not fully alert or sitting fully upright. The person was not harmed, but this practice increased the risk of the person choking. We discussed this with the registered manager who agreed to address this with staff.

Staff supported people to move safely around the service. They were careful and allowed people to take their time to feel safe and supported.

The environment did not always reflect best practice for people living with dementia. For example, the seating arrangement in the lounge areas was not designed in a way to encourage interaction or engagement. One lounge was set up to support reminiscence and engagement. However, we did not see people spending time in here. Staff referred to the different lounges representing people’s needs. For example, “a lounge for people with more advanced dementia.” Whilst there was no mandatory assigning of people to spend time in specific areas, the design of the building and staff routines supported a structure where people spent time in areas of the building based on the level of their needs.

There was a well-maintained garden with different seating areas. People had their own bedrooms with en-suite showers and toilets. The home was light, well-ventilated and kept at an appropriate temperature. There was enough equipment to help keep people safe, including hoists and specialist beds. These were regularly serviced and checked to ensure they were in good working order. People told us they liked their rooms. One person told us, “When I wanted to change rooms, they found me a nice room overlooking the garden when it became available.”

The provider ensured fire safety systems were in place. They had organised for an appropriate fire risk assessment. Staff checked fire safety equipment. There were procedures to ensure safe evacuation and regular drills to test these.

There were enough staff to keep people safe and meet their needs. People told us staff were attentive, and they did not have to wait for care. Their comments included, “There are always staff to help you, you just need to ask” and “I think there are quite a few staff about.” Staff told us they felt there were enough of them. Staffing levels were calculated using a system which considered people’s individual dependency needs.

The provider had suitable systems to recruit staff. These included a range of checks. Following recruitment, new staff completed an induction, had further competency assessments and undertook training relevant to their roles. Staff were provided with regular supervision, appraisals of their work and training updates.

Whilst the home was generally clean and there were no unpleasant odours, some of the toilet rooms were cluttered and had areas of peeling paint, making these hard to sufficiently clean. The registered manager told these were being renovated and following our site visit, signage was put in place to prevent these from being used.

People using the service and their relatives told us they were happy with the cleanliness. Their comments included, “Staff are always cleaning” and “They keep my room nice and clean.” There were schedules for everyday and deep cleaning. There were regular audits of cleanliness and infection control. Staff had undertaken relevant training.

Some improvements were needed with medicines management. For example, the provider had not obtained written guidance or agreement from the pharmacist about the administration of 1 person’s medicines covertly (without their knowledge). The registered manager had assessed the person’s mental capacity relating to this, consulted with the person’s family and the doctor. However, the person’s care plan did not give enough detail about when and how staff needed to administer the person’s medicines in this way. Staff recorded the administration of medicines via topical patches. But they did not record where on the person’s body these were applied. We discussed our findings with the registered manager who agreed to make the necessary improvements. Following receipt of the draft report the provider sent us evidence of improvements they had made.

People received their medicines safely and as prescribed. Staff responsible for managing medicines had been trained and their competencies had been assessed. Staff recorded when medicines were administered. Medicines were stored appropriately. The registered manager carried out audits of medicines management.

People told us they were happy with the support they received with their medicines.