Roebuck Nursing 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

Risks to people’s health, wellbeing and safety were identified and assessed. Frequent reviews were completed to ensure appropriate mitigation was in place. Where concerns were raised, the registered manager responded positively and took immediate action. Actions were routinely shared with staff to ensure practice was improved. Safeguarding processes in place were effective. There were robust systems in place to record, analyse and share learning from any untoward events that might occur. Where referrals were needed to outside agencies, including the local authority, these were completed in a timely manner. Staff numbers were consistent. Systems were in place to ensure staffing levels remained sufficient including assessment, observations and feedback from people. Safe recruitment processes were followed, and staff received a range of training. Infection prevention and control measures were in place, alongside and up to date policy. The environment was clean, safe and well maintained. Medicines were managed safely and administered in accordance with the prescriber’s instructions. Checks and audits were in place.

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.

People told us they felt they could speak up. They shared they had no concerns for their safety and felt informed about all aspects of their care.

Staff were informed of any events, incidents or concerns that occurred at the service and learning from these was shared. A staff member said, “Management always update us monthly on policies and legislation. We discuss about complaints, safeguarding or accident and incidents.”

When accidents, incidents or untoward events occurred at the service there was a robust system in place to review these. The registered manager analysed events to identify learning and ensured that this was shared with staff, people and other stakeholders where needed.

People felt their move into the service went well. A person said, “The move in was good, staff are nice, and I had enough information.”

Leaders confirmed that people were involved in their assessments as much as they were able to and wanted to be. Staff told us there was a handover and effective communication in place to ensure people received the right care and support. A staff member said, “We have proper handover. During the handover they cover all the residents, their health condition, skin integrity, food and fluids, any changes in their medication, and hospital appointments.”

Feedback we received from partners was positive. We saw that the provider had recently sought feedback from partner services and responses were also positive. One professional commented, “The care staff that I have spoken to are very knowledgeable about the services users in DTA beds, they have a caring attitude and always follow any advice or guidance offered to them. They also show initiative and contact relevant professionals when they identify a specific need.”

Multi-disciplinary meetings were regularly held. We saw that discussions were focused on people and that action was taken to shape the service provided to ensure positive outcomes for people. The provider had a system in place to ensure communication with partners was maintained and strong working relationships were developed.

People told us they felt safe. One person said, “I feel safe here, staff are kind.” However, two people did tell us that there had been occasions in the morning that a staff member could be not so kind and rushed them. We shared this with the registered manager to follow up.

Staff knew how to recognise, and respond to, signs of potential abuse. A staff member said, “Speak to the resident, report it and follow the whistle blowing and safeguarding policies.” Another staff member said, “Our resident’s health and safety comes first, any concerns I report to the management. Thank God I haven't seen or experienced any abuse to our residents.”

Information about safeguarding people from abuse was displayed. We saw staff working safely and noted that people were relaxed and happy in the presence of staff.

The provider had a system in place to report any safeguarding concerns. The registered manager maintained an accurate log of any referrals made to the local authority and the outcome, once received. This process was supported by an up-to-date policy. We reviewed records relating to minor injuries such skin tears and bruises and found, where these had happened, there was a reason or occurrence noted with an explanation and, if needed, an investigation had been completed.

People told us they felt staff supported them safely in all aspects of their care and support.

Staff were familiar with people’s individual risks and were able to tell us the ways in which they worked to reduce these risks. They confirmed they were aware of the risk assessments in place and knew how to escalate any concerns they might have with regards to changes in people’s needs.

We saw staff working in accordance with assessed risks. However, when we reviewed 6 pressure relieving mattresses that required being set to people’s weights, we found all 6 were set incorrectly. For example, one person weighed 57.1kg however their mattress was set to 180kg. We raised this with the registered manager who immediately took action to resolve the inaccurate settings.

People had individual risk assessments. These were detailed, clear and reviewed regularly. Checks were completed by the registered manager and senior staff during each shift to ensure tasks were completed and guidance was being adhered to. We noted that a check on pressure relieving mattresses was completed daily however, these records were not completed in full, and people’s weights were omitted from the check sheet. Despite this, all the forms we reviewed were completed indicating that the mattresses were working and set correctly. This was in contradiction to our observations. We raised this with the registered manager. At the feedback call held they confirmed that, since our visit, changes had been made to the completion of the check sheet and stringent checks were being completed to ensure that practice was improved and embedded.

People told us they felt safe and comfortable living at the service. They raised no concerns with us about the environment and had access to all the equipment they needed.

Staff were aware of potential hazards in the environment and how to reduce the impact of these. Staff had attended fire drills and practiced evacuation in the event of an emergency. A staff member said, “I have been trained to evacuate residents safely to the assembly point. We are taught about the difference and uses of fire extinguishers, where fire exits are and how to use the fire alarms.”

The environment was free from hazards and fire safety equipment was in place. We saw that people had access to call bells and the service was well maintained.

The provider had an effective system in place to ensure that equipment and facilities were routinely serviced and maintained. Regular audits were completed, with action taken when identified as needed.

People told us staff were available to support them when needed. A person said, “They come when I need them.”

Staff told us they felt there were enough of them to meet people’s needs in a timely way. They told us there was good training and support in place for them. A staff member said, “We have enough staff, and care is given to our residents in a timely manner.” Another staff member said, “There is enough training and support from the home manager and a regular supervision every 2 months.”

Staff were visible and prompt when people requested support. We saw regular checks were completed on people who were unable to use their call bells.

Staff recruitment was safe and all essential pre-employment checks were completed prior to a staff member starting work. There were consistent checks on the staffing level by the registered manager to ensure it remained sufficient. This included comparison of deployment with a staff dependency tool, checks on the responsiveness of staff to call bells, observations during shifts and seeking feedback from people about their experiences. Systems were in place to ensure staff received the training, support and supervision needed for their roles.

People’s bedrooms and communal areas were kept clean for people to enjoy. People raised no concerns or issues when asked about hygiene or IPC.

Staff knew how to perform good infection prevention and control practices. A staff member said, “Specific COVID-19 training was given and it is very useful in daily life and in work. We all know to wash our hands, but this training is helping to do it properly including different stages of wash. It is also helpful in donning and doffing of PPE, cleaning of touch points, all infection control and prevention.”

Staff were practicing good IPC whilst delivering care and completing tasks. We observed correct handwashing and the appropriate use of personal protective equipment (PPE). The environment was clean and hygienic. We saw housekeeping staff completed a wide variety of tasks in their daily routine.

IPC audits were completed regularly, with an up-to-date policy and guidance in place for all staff. Infection prevention and control was a consistent agenda item for discussion at team meetings and lessons learnt were completed and shared following any outbreak.

People received their medicines in accordance with their needs and as the prescriber intended.

Staff responsible for managing medicines were aware of safe practice. They confirmed they had received training and competency checks.

Robust systems were in place to ensure safe management of medicines. These included daily counts and a staff signature list. We saw that medicine records were completed fully, and audits were completed regularly. We checked quantities of medicines against records held and found these to be correct.