Rokewood Court

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 inspection we rated this key question good. At this inspection, the rating has remained 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 service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People were encouraged and supported to raise safety concerns with the provider. Managers and staff understood the importance of reporting safety concerns and learning lessons when things went wrong.

Systems were in place to support staff to report and record safety concerns and events when they arose. Managers investigated safety concerns and events and used the learning from these to support staff to continually improve their practice, reduce risk and keep people safe.

The service 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.

Information was obtained from people, and others involved in their care, about people’s individual needs and risks they might face. This was used to develop individualised care and risk management plans to ensure people received safe and appropriate care and support from the moment they moved into the care home.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They 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 service shared concerns quickly and appropriately.

Managers and staff understood how to safeguard people. They knew how to recognise and report abuse and were able to articulate how they would spot signs if people were at risk of abuse or harm. A member of staff told us, “I have completed my safeguarding training and if I had any concerns about how people were being treated I would speak to my managers about it.” Another added, “I know how to identify abuse. If I were to see someone doing something unethical, I would speak to a manager straight away.”

People told us they felt safe living at the care home. One person said, “I do feel safe living there. “An external care professional added, “I have never had any concerns about the safety of the residents, nor have I ever seen anything untoward. The staff always seem attentive and understanding of the needs of my clients.”

Managers worked proactively with the relevant external health and social care professionals and bodies when a concern was raised and took appropriate action to safeguard people from further risk, when this was required. An external care professional told us, “Where incidents have occurred, the provider has promptly reported these to the person’s family and the Local Authority safeguarding team, and put preventative measures in place.”

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

In the last 6 months, the service has managed to reduce the number of serious injuries people living in the care home experienced due to falls and skin integrity [pressure wounds]. The managers told us they had used an evidenced-based screening tool to conduct a root cause analysis of all the falls and pressure wound incidents that have occurred at the care home in recent years. They concluded the number of care staff working on the 2 higher dependency floors needed to be increased and the number of agency staff reduced. We found steps had been taken by the service to achieve the aim of having an additional care staff work on the first and top floors during the day. In addition, a successful staff recruitment drive now meant the service was no longer reliant on agency staff who were not so familiar with people’s needs.

The managers also told us they had arranged specialist falls and pressure wound prevention and management training for staff. Staff were aware of the potential risks people might face and the steps they needed to take to prevent or safely manage them, including for people living with dementia. For example, we saw staff remained vigilant throughout our inspection and closely monitored people who were at risk of falling so they would be immediately available if their assistance were required. An external care professional told us, “There are appropriate risk assessments and management plans in place to reflect my client’s needs. They [staff] find a good balance between promoting positive risk taking, while not overly restricting a person’s rights to freedom and choice. Risks are well-managed.”

People’s electronic care records contained up to date, sufficiently detailed and accurate information. Staff told us they always followed people’s risk assessments and plans to enable people to take reasonable and acceptable risks. One member of staff said, “I always make sure I read the care and risk management plans of everyone I support and attend shift handovers, so I know if there’s been a changes in a person’s needs.” Systems were in place to ensure risks to people were continually assessed, monitored and reviewed.

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

The premises were kept free of obstacles and hazards which enabled people to move safely around the care home. An external care professional told us, “The care home is a safe and secure environment. Staff walk around the care home with a critical eye to ensure there are no trip hazards to protect residents’ safety and report any issues to management and maintenance.” Another added, “Rokewood Court provides a safe, comfortable and pleasant environment for my clients to live in.”

There were effective arrangements to monitor the safety and upkeep of the premises. Regular checks were completed to help ensure the safety of the home’s physical environment and fire safety equipment. Staff told us they had clear guidelines available to help them deal with emergencies. In relation to fire safety, we saw emergency evacuation plans were in place to help staff evacuate people in an emergency.

General risk assessments were regularly reviewed and updated including, reference to equipment used to support people, such as mobile hoists. This equipment was regularly serviced and maintained. Maintenance records demonstrated the environment was maintained to a good standard. For example, lifting and baths servicing took place regularly and visual checks were completed for bed rails, window restrictors and other equipment.

The service 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.

Staffing levels matched the staff duty rota on the day of our site visit. Staff were visibly present on each of the units throughout this inspection and were quick to respond to people’s questions and requests for support. For example, we saw several instances of staff responding promptly to people who had activated their call bell alarm. People told us the care home was adequately staffed. Typical feedback we received included, “Staff come quickly whenever I use my call bell to ask for help”, “The home used to be too reliant on agency staff who did not know my [family member] so well, but since they recently recruited lots of new staff this is no longer an issue” and “I have never had any concerns about the staff to client ratios when I have visited the care home. Staff are attentive and able to offer support, assistance and reassurance to clients where needed.”

Staff were well-trained to meet people’s individual needs, in line with their choices and preferences and encouraged to continually improve in their role. Staff received a mixture of e-learning and in-person practical and theoretical training, which was routinely refreshed as frequently as staff required it including, competency-based assessments.

Newly employed staff were subject to a probationary review and records showed staff received an induction to their role and ongoing training and support to ensure they could meet the needs of people living in the care home. A member of staff told us, “I had a good induction and lots of opportunities to shadow experienced staff when I first started here. I was not allowed to do anything myself until I had completed the right training.”

An external care professional added, “The staff that I have worked with are always knowledgeable and keen to learn and understand new concepts. They also demonstrate a good understanding of people’s care plans and seem well-trained.” Another said, “I have never had concerns about care team competence.”

Staff had ongoing opportunities to reflect on their working practices and to identify any further training, learning or support they might need. Staff had regular individual and group meetings with their fellow peers and line managers.

The provider continued to operate safe recruitment practices and only fit and suitable staff were employed to work at the care home. Staff files contained evidence of robust recruitment checks including application forms where gaps in employment were explored, professional and personal references, right to work and identity checks. The provider maintained a recruitment tracker to monitor staff recruitment and completed Disclosure and Barring Service (DBS) checks. This helps employers make safer recruitment decisions by processing requests for criminal record checks.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The provider had an in-house domestic team who maintained high standards of cleanliness throughout the care home. We observed this team follow structured cleaning schedules to keep people’s rooms and the communal areas visibly clean and tidy. This was confirmed by people we contacted. An external care professional told us, “Rokewood Court is one of those care homes that is always very clean.”

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 in the care home. We observed staff using correct personal protective equipment [PPE] when they were about to meet peoples intimate personal care needs. A member of staff told us, “PPE is always available. Managers are always sending emails to keep us updated on infection control.” An external care professional added, “The staff always wear PPE when they provide personal care tasks at times when I have been present.” The provider’s infection prevention and control policy was current and reflected national guidance.

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

Medicines systems were well-organised and safely managed. Medicines stocks, balances and records showed people consistently received their prescribed medicines as and when they should. The provider had made improvements since their last inspection by reviewing and updating their partnerships with the GP, pharmacy and out of hours provision, and introducing an electronic medication system to support medicines management. Staff involved people in planning, including when changes happened. People told us staff supported them to take their prescribed medicines as and when they should.

Care plans included detailed guidance for staff about how people needed and preferred their medicines to be administered. Staff received relevant training and their competency to continue managing medicines safely was routinely assessed. This helped staff remain clear about their roles and responsibilities in relation to the safe management and administration of medicines. There were regular audits of medicines at the service. This included regular checks of staff’s practice to ensure they remained competent to administer and manage peoples prescribed medicines safely. In addition, the provider has recently organised an independent audit of the services medicines management, which identified no major concerns.