Warrengate 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

People received care from staff that were suitably trained and supervised in their role. Any risks associated with people’s care was managed well by staff who understood how to ensure people were kept safe. Staff understood what constituted abuse and how to report any concerns. Accidents and incidents were recorded with actions taken to reduce further risks to people. There were sufficient staff to meet the needs of people. The majority of the service was clean and tidy. Where we did find concerns with some aspects of infection, prevention control including in the sluice room and laundry, this was rectified immediately.

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.

Relatives told us when there had been incidents involving their loved ones, steps were taken by staff to reduce further risks. One relative told us, “If there’s any sort of incident, they’ll ring me straight away, if [person] has bruises or if the doctor has been and prescribed something.” Prior to the assessment we found there had been a high level of incidents particularly around people at a heightened state of anxiety. The provider had taken steps to address this and acknowledged this was a result of admitting people into the service without fully knowing understanding their needs and triggers with anxiety. We saw as a result of the interventions the provider had taken since; the incidents had reduced.

Staff were aware of how to report incidents and accidents. They told us any learning from these would be discussed at meetings. One member of staff told us, “They will talk about accidents and incidents, and they will ask for ideas.” The registered manager told us, “Incidents are reducing now than from previous months. The dependency level now we are carefully considering the residents. We were doing telephone reviews before and couldn’t see their behaviours.”

Incidents and accidents were recorded, and action taken to reduce the risks of incidents reoccurring. These were analysed to look for themes and trends. For example, one person’s anxieties were triggered by another person who they were frequently walking past. A decision was made, with the involvement of the family, to move the person to a different part of the home to avoid the risks of the people seeing each other as often.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

There was a safeguarding adults policy and staff had received training in safeguarding people. Safeguarding was also discussed at staff meetings.

Staff understood safeguarding adults procedures and what to do if they suspected any type of abuse. One member of staff told us, “We have Safeguarding training. We have this training online. Every six months they ask us to do this training. They also have one to one training for safeguarding.” Another told us, “We have to inform to the nurse in charge, if they don’t take action then go to the manager, and if the manager doesn’t, then we go to the safeguarding.”

People told us that they felt safe living at the service. One person told us, “It’s safe here. They’re [staff] very nice.” Relatives felt assured when they left the service their family members were safe. Comments included, “They [staff] never seem to lose their patience. It’s very safe”, “I leave here, and I know [person] is safe” and “The staff are wonderful, loving and affectionate. I don’t worry about [person] being here.”

Staff were knowledgeable around the risks associated with people’s care and regularly reviewed the risk assessments. One member of staff told us in relation to a person’s skin integrity, “There is a machine by the legside of the bed and there are measures and we check that. We press the mattress and check if there is air.” They said, “We have a lot of people with repositioning, and we have to reposition regularly to reduce the risks of pressure sores.” Staff were aware that each person had a personal evacuation plan in place in the event there was an emergency.

People told us risks relating to their care was managed well. They told us they were involved in their planning of care and assessments of risk. One person told us, “I have issues with my mobility, but staff are always there to support me.” One relative told us in relation to their family members health condition, “Staff manage it very well.” Another said in relation to their loved one’s risk assessments, “It seems pretty fair and accurate what they’ve put in here.”

We saw where people had mobility aids, these were left within reach of them. Calls bells were also left within reach of people in the event they required support from staff. Where people were on modified diets, the meals were being provided appropriately. When people were moving around the service, staff were there to support when needed.

Assessments were undertaken to identify risks to people. For example, in relation to people’s nutrition, mobility, behaviours, skin integrity, choking and people’s heightened anxiety. The care plans identified the potential risks to people and gave instructions and guidelines to staff to manage those risks. We did find the guidance contained a lot of clinical language that some staff may find difficult to understand. However, staff were aware of the risk associated with people’s care and how to keep them safe. The registered manager told us, “We have three steps of admission process. We do a telephone assessment and then we will go and do a face-to-face assessment and then a risk management meeting. Sometimes the nurses will participate and the family, myself and clinical director. The purpose of the meeting was to look at the most current risk and future plans.”

People and relatives fed back the service was accessible, and people had all the equipment needed to ensure their safety. One person said, “I’ve got an air [flow] mattress but they check it. I’ve not had any trouble with it.” A relative told us, “They have their own maintenance [team] so things get fixed pretty good.”

Internal and external audits were completed with actions plans with time scales on how any areas could be improved. Areas that we found needed improvement including the maintenance of the service had already been identified by the provider and included on their action plan. The registered manager had a Health and Safety audit where areas that had been identified were constantly reviewed. This included infection control and the improvement to the environment.

We saw most of the service was in a good state of repair. Where we found some areas that required improvement this had already been identified by the provider and they had tight timescales to action this.

Staff told us they had the necessary equipment to ensure they were able to do their jobs in a safe way. They told us if they had any concerns with the equipment, they would report this to the maintenance team.

People and relatives told us there were sufficient numbers of staff but had concerns about the levels of agency staff used. The provider had already taken steps to recruit more permanent staff. Comments from people and relatives included, “They [staff] come quickly, the staff are very good” and “There’s usually enough [staff], If there’s anyone in the lounge who tries to get up, there’s a staff member there to help them and they’ll be straight there.”

Staff fed back there were enough of them to ensure people’s safety. One member of staff told us, “There is enough staff.” They told us there were always sufficient staff to ensure where people required a member of staff to be with them through the day, this was always in place. The registered manager told us they regularly reviewed the needs of people to ensure there were sufficient staff. They said, “Last minute sickness is covered by the floating staff member. We do use agency but we prefer to use the team.”

Staff received training in relation to their role and were competency assessed to ensure the training was effective. People were protected from being cared for by unsuitable staff because robust recruitment was in place. The provider ensured all agency staff had appropriate background checks and were suitably trained.

When people used their call bells these were responded to quickly by staff. Where people required to always have a member of staff with them, this was in place. There were sufficient staff to support people during mealtimes.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.