Wollaton View Care 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 remained 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.

During our last assessment of the service, we found the provider was in breach of regulations in relation to safe care and treatment and staffing. Improvements were found at this inspection, and the provider was no longer in breach of regulations.

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.

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. However, the processes in place to ensure lessons were learnt to continually improve practice; required embedding to be fully effective.

The management team were open and transparent where incidents had occurred, ensuring these were promptly reported. Audits from falls were reviewed, showing they prompted the management team to ensure a safeguarding referral had been made. However, we found a lack of detail for safeguarding inquiry outcomes recorded. This impacted upon the ability of the management team to look at key themes and put lessons learned in place.

The management team were responsive to reviewing this process when we raised these shortfalls with them. They submitted an updated version of their incident review form, which we were assured by.

The provider worked in partnership with external healthcare partners to establish safe systems of care. However, the processes in place did not always ensure there was continuity of care, including when people moved between different services.

We found some shortfalls in the admission processes in place for the commissioned reablement beds. Some people and their relatives had raised concerns around their expectations not being fully met and not always feeling involved in discussions around their care planning. One person said, “I’ve had no involvement myself, but my relative comes in and talks to the office staff.”

The management team were aware of the challenges these quality concerns presented. We saw the management team had responded appropriately when any concerns were raised directly with them. They worked hard to improve the relationships and communication, senior staff attended regular handover meetings with the external health provider team. The service had display boards throughout the service, which detailed the reablement process. One relative told us, “We’re lucky that it seems a good choice after my family members hospital discharge. It feels safe enough here.”

The provider did not always work effectively with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. However, the service was focussed on improving people’s lives while protecting their right to live in safety, free from abuse, discrimination, avoidable harm and neglect.

People were safeguarded from abuse and avoidable harm, with the management team making prompt referrals to the local authority. However, there was limited evidence to show lessons were learned following incidents. The safeguarding records lacked documented outcomes of safeguarding inquiries, so the service was unable to show how they had changed their procedures as a result.

People told us they felt safe and were able to speak out if they thought they or others were at risk. One person told us, "I’ve had a few minor things I’ve made them aware of, and they were all easily sorted.” Staff had received safeguarding vulnerable adults training and staff we spoke with understood their role in safeguarding people, and who to report concerns to.

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 and their relatives we spoke with told us they felt safe living at Wollaton View and with the support provided from staff. Feedback we received was positive. One person said, “I feel really safe. I’ve got a lovely room; no strangers can get in and my family can visit.” A relative told us, “100% my family member is safe - it’s the staff, they’re brilliant. All the doors have security too.”

We observed people living on the ground floor; some of whom required staff supervision when in communal areas, due to their identified risks. We saw people were receiving the correct level of support from staff. One person said, “They use a stand-aid to move me, and I feel safe enough. I’ve got my own wheelchair so staff will take me around in that.” Staff we spoke with were aware of how to minimise known risks to people's safety. For example, we saw people who had experienced falls had appropriate equipment in place to help reduce any further risk to them.

Risk assessments were in place for each identified need people had. For example, where a person was at risk of choking; the service ensured appropriate actions were in place for staff to follow to reduce this risk.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

We found a significant number of people’s bedrooms where there was an overstock of incontinence products. These boxes created a potential hazard for people if they should knock them over and reduced the floor space available for equipment used to assist with moving people safely, for example a hoist. The placement of the boxes in people’s personal space, also lacked dignity. We raised this with the management team to address with the supplier and to source more appropriate storage. We were assured by their response.

Communal adapted bathrooms were found to contain laundry trolleys and unused manual handling equipment. We raised this with the management team, who agreed to source alternative storage space for these items. This reduced any risk to people and would ensure peoples’ bathing preferences could be respected.

Risk assessments relating to the environment were centrally located for accessible use in the event of an emergency. They included Personal Emergency Evacuation Plans (PEEPs) and documents relating to the fire floor plan of the building.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. The staff team worked well together and showed a positive approach.

Staffing levels were set according to people's care dependency needs, to help ensure that people were supported safely. We found however, that the deployment of the staff across the service could be improved, in order to more effectively meet people’s individual needs. For example, the activity coordinator was observed to be alone with groups of people, in the communal dining space for extended periods. At these times, other staff members were supporting people with personal care needs. We raised this with the management team to review, and they were responsive to this. The service planned to employ extra staff to have an additional staff member downstairs during the day. This would provide an extra staff member at lunchtime. Only 1 staff member will be allocated to document food and fluid records at this time, so there would be more staff available to enhance the mealtime experience for people.

People and their relatives gave a mixed response regarding the availability of staff to support them. One person said, “Now and then they seem short of staff and we have to wait longer to be helped, and it seems worse in the summer with holidays. It all seems quieter at weekends too as there’s less going on and staff are kept busy.” Another person said, “I find the staff very capable. But I think they’re a bit short at times; some seem quite stressed and so busy.” A relative told us, “It definitely feels like my family member is safe here and there’s good staff interaction.”

The staff training matrix showed some shortfalls in subjects which the provider had identified as essential. We discussed the gaps in staff training with the management team, who provided an updated training planner and completion matrix. We were assured by their response.

The provider followed a robust recruitment process. Staff had been safely recruited with appropriate references and Disclosure and Barring checks (DBS) in place prior to their appointment. This meant the registered manager could be assured that people were protected from the risk of potential abuse from unsafe staff. The information helps employers make safer recruitment decisions.

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 had improved their infection prevention and control processes, to reduce any risks to people. The service was kept clean and well maintained, by an experienced domestic and maintenance team.

People and their relatives gave positive feedback about the cleanliness of the building and their personal spaces. One person said, “I can have a shower whenever I want, with a bit of help. The cleaners are lovely, and the laundry team do a good job.” A relative told us, “We’re totally happy with my family members bedroom and the way their clothes are laundered. They’re very good here. My family member and their bedroom always look clean and fresh.”

The management team had action plans and audits in place to ensure a robust approach to infection, prevention and control. Staff we spoke with understood the importance of maintaining high standards and ensuring the risk of infection was reduced.

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.

Medicines were stored and managed safely. The clinic room was clean and tidy, with space for the safe storage of medicines deliveries and those being returned. Staff involved in handling medicines followed best practice for the administration, recording and storage of medicines.

People and their relatives had no concerns regarding medicines, which they told us were given correctly, as people preferred and on time. One person said, “I take 3 tablets and know what they’re for and the staff always wait with me. I can ask for an extra painkiller if my leg is painful.” Another person said, “I take 4-5 tablets every day and the staff always wait with me while I take them.” A relative told us, “Amazingly, my family member is only on paracetamol and I’ve seen staff wait with them whilst they take them.”

Photographs of people and any allergies were clearly recorded at the front of their medicines administration records. ‘As required' medicines protocols, and body maps for pain relief patch application medicines, were well documented.