Woodbridge House

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 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.

The provider worked with people and staff to establish and maintain safe systems of care, where safety was routinely monitored, reviewed and learned from. Staff described a culture in which incidents were openly discussed, with lessons shared through team meetings and updates to care plans. One staff member said, “(I) report everything on the phone and speak to the manager straight away,” highlighting a shared responsibility for learning.

All incidents were reported on an electronic system. Leaders told us the system was helpful to have oversight of incidents and ensure that actions were completed in a timely manner.

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 provider worked with people and healthcare partners to establish safe systems of care where safety was effectively managed. People experienced well-coordinated transitions, with staff obtaining relevant information from previous services to ensure continuity. Relatives described smooth processes, a relative told us their loved one “Slotted in perfectly” after moving from another service.

Staff understood referral pathways and used them appropriately. This included referrals to SALT (speech and language therapists) and occupational therapists when people’s needs changed. The provider was able to evidence timely professional involvement for swallowing risks, mobility needs and end of life care.

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.

Staff understood their safeguarding responsibilities and followed processes to raise concerns which protected people from the risk of abuse. Staff told us they had received safeguarding training and were confident to escalate issues both within the organisation and to external agencies. Staff told us, “The person might be withdrawn if they exhibit fear. Look for signs of depression. With physical you need to check routinely for any marks.” Staff also told us, “I would report to my managers or I could go to the local authority. They (people) are the reason why we are here. They should be the most priority. They come first.” Relatives told us, “Yes she feels safe, the staff are amazing,” and “I have never seen anything go on that gives me any cause for concern.”

Where applicable, Deprivation of Liberty Safeguards (DoLS) had been completed and notifications had been submitted to the CQC. DoLS are important human rights safeguards; they aim to ensure that such deprivation of liberty only happens when it is necessary, proportionate and in the person’s best interests.

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.

At our last inspection we found that risks to people had not been assessed and mitigated. At this inspection we found improvements had been made.

Care plans and risk assessments contained detailed guidance for staff to follow, including how to support people safely whilst eating, providing personal care and mobility tasks. Staff we spoke with understood risks to people and how to support them to remain safe. Staff understood people with complex health conditions. Staff were able to explain to us what actions they would take if a person choking, and how they would respond to a person experiencing a seizure.

People had been supported to reduce the distress they experienced. One person had experienced high levels of distress when they first moved into the service. Over a period of time staff were able to understand the person’s needs better and implement positive strategies to support them positively. The person was able to expand their world by being able to positively engage in more activities due to their reduced distress.

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

People lived in a safe environment, and staff completed regular checks of equipment and communal areas. People were involved in the upkeep of the service, cleaning and maintaining the environment. One person enjoyed carrying out the fire alarm tests each week with the support of staff.

Although parts of the home required redecoration, the provider had clear improvement plans, and staff kept areas clean and functional. Relatives told us that environmental concerns were addressed promptly. One relative told us, “If the toilet seat is broken it’s sorted as soon as possible… they’re open and honest about everything.”

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 were supported by sufficient numbers of consistent staff with the right skills. Rotas showed consistent staffing levels, and staff described good teamwork and support from the registered manager and leaders. Relatives told us that that people were supported by consistent staff, one relative telling us, “I know them well.” Another relative told us, “I couldn’t speak highly enough of staff, they are wonderful.”

When new staff were recruited they were done so with consideration of their skills and interests to ensure they aligned with the people living at the service. People were supported by staff who had been recruited using safe recruitment processes. This included checking new staff members work histories and ensuring staff had a disclosure and baring service check (DBS) in place before they supported people. A DBS check is used by employers to make safer recruitment decisions.

The provider did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading or share concerns with appropriate agencies promptly.

On the first day of our inspection we noted parts of the service were not clean. Some people had dirty bedspreads which were promptly changed when we highlighted this to the registered manager. Audits and staff meeting minutes showed inconsistent cleanliness checks, gaps in cleaning records and some items incorrectly stored, such as COSHH (Control of Substances Hazardous to Health) products being left out. The registered manager had identified and addressed this through supervision and amending shift allocations to ensure staff understood their responsibilities.

Feedback we received in relation to the cleanliness of the service was positive, one relative telling us the home was always, “very clean and hygienic.”

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.

At our last inspection we found that medicines had not always been managed safely. At this inspection we found improvements had been made.

The provider followed STOMP (stopping over medication of people) principles, with evidence of medicine reductions where appropriate and regular reviews by professionals. One person had been supported to reduce their anti-psychotic medication over a period of time until they no longer needed this prescribed. People received their medicines safely, and audits demonstrated good practice. Records demonstrated that MAR (medicines administration records) had been completed accurately and in line with best practice guidance. Staff were ensured that medicines were stored safely in line with best practice guidance. When medication errors occurred, evidence demonstrated that staff were supported to re-train and be assessed as competent before supporting people with their medication again.