Yew Tree 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 and relatives told us people were safe. We found improvements had been made to how risks were identified and addressed and this had a positive impact on the safety of people in the service. There were sufficient staff to keep people safe and medicines were managed safely. There were no concerns raised by people or their relatives relating to the safety of the environment. There were safe recruitment practices and staff received supervision to ensure safe practice. There were robust safeguarding procedures and staff understood their responsibilities to keep people safe. Improvements had been made since the last inspection and the provider was no longer in breach of regulations.

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.

People were positive about their experiences of care in the service. People and relatives told us they felt feedback and concerns were listened and responded to by the manager and staff team.

The manager and staff told us there was a culture of openness to share concerns and to learn and implement improvements to reduce further risks.

There were systems and processes to support a culture of learning and improvement. An example of where improvements had been made was falls management. At previous inspections we had identified risks around how falls were recorded and a failure to take necessary actions to reduce falls risks around the service. Now the registered manager and the provider were able to identify where there had been an increase in falls and the actions that needed to be taken to manage the risk.

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.

We spoke with people who lived at Yew Tree and they told us they felt safe. One person told us "Everything is ok and I feel completely safe."

Staff were able to tell us about how they safeguarded people from abuse. Staff were aware of the whistleblowing policy and felt that any concerns they raised were listened to and acted upon. One staff member said "I have no doubt that any staff who are worried about people would raise the concerns and we are all committed to keeping people safe."

During our visits we saw that staff were attentive and mindful of keeping people safe. We saw examples where staff ensured people were comfortable and aware of what was happening before being hoisted, we also saw when people appeared anxious and upset staff took the time to provide comfort and support.

There were clear policies and procedures to safeguard people. Where concerns were raised they were reviewed and appropriate actions taken. There were processes to enable staff and people to raise concerns and action was taken swiftly to ensure people were safe. The provider had a whistleblowing policy, and this provided guidance to staff on how they could raise concerns about any unsafe practice. A whistle blower is a person who exposes any kind of information or activity that is deemed illegal, unethical, or not correct within an organisation. The registered manager had ensured that where concerns or safeguarding had been raised CQC notifications were completed as required.

People and relatives told us they were involved in the assessing of care needs and risks. One relative told us how quickly there loved one had improved in their mobility and how staff were enabling the person to move move independently. Where people's care was reviewed efforts were made to involve the person and relatives and loved ones.

Staff were able to tell us how they managed risks to people and the importance of involving people in their care. Staff told us about people''s needs and measures they took to manage risk. However, one person's records indicated that bed rails (to keep someone safe in bed) were not to be used due to the risk of climbing over them. Staff were not clear if bed rails were to be used, or what additional measures were taken to manage the risk when they were in bed. The risk assessment provided conflicting information and when we looked at this person's bed bed rails were fitted and it was not clear if they were being used or not. We raised this with the management team and they were taking steps to clarify the measures to manage the risk for this person.

We saw that staff were attentive and mindful of risks. We saw where people needed support with mobility this support was provided safely. We saw where one person had slipped down in a chair to the floor. Staff were quick to respond and made sure there were no injuries before safely hoisting the person back into position.

The provider had made improvements since the last inspection and was no longer in breach of regulations. Systems and processes to support effective oversight of risks had improved for example the falls management had improved and there was a clear system to record and then investigate where falls had occurred and implement measures to reduce the risk. However, we did find that information relating to the use of bed rails for one person did not match what staff told us. It was not clear how the information regarding this person had been shared with staff.

People and relatives told us they had no concerns regarding the home environment. Relatives told us they found the environment safe and well maintained.

Staff could tell us about where potential risks may be present in the home environment. We found staff had the knowledge and training to be able to use equipment safely.

We found the environment clean and well maintained. There was a clear schedule of maintenance lists and we found that where repairs had been identified as being needed, work was scheduled and carried out in a timely manner. Communal areas where generally free from clutter, however we did find some wheelchairs in corridors and communal areas, when we spoke with staff they told us it was due to the limitations of space in the building. We raised this with the management team and the first day and when we returned on the second day storage of equipment had improved.

There were processes for ensuring equipment was maintained in good working order. The systems and processes to support oversight and management of the environment had improved since the last inspection. For example, there was more oversight of maintenance and taking action to reduce the risk of falls.

People and relatives told us they felt there were enough staff to meet their needs. One person said "If I call they always come." another person said "We do have to wait sometimes, but not too long. It is not a problem."

Staff told us that there were enough staff to keep people safe, but felt that more staff would mean more opportunities for promoting activities. The registered manager shared the staff dependency tool that is used to assess how many staff are required based on occupancy and need. This was kept under review to ensure staffing levels remained safe.

We saw that where people requested assistance this was provided in a timely manner. We found that where people were able they had access to call bells.

We checked staff recruitment files and found all staff had checks and references to ensure they were appropriately recruited to ensure new staff were suitable for their roles.

People and relatives told us the home was clean and maintained and didn’t feel there were any infection control issues.

Staff were aware of the location of Personal Protective Equipment (PPE) and how and when to us it. Staff were aware of the providers infection control policy and also aware of the measures to be taken in the event of an outbreak.

We found the service to be clean and saw that staff were attentive to their responsibilities to take infection precautions, for example the use of gloves and aprons.

There was a comprehensive Infection Prevention and Control policy (IPC) and this detailed steps to be taken to prevent an outbreak. There were cleaning and maintenance schedules to ensure areas of the service were kept clean and in good order.

People and relatives felt that medicines were managed safely. One person told us how when they have pain they ask and staff make sure they have pain relief. One relative said the registered manager and staff had been working to reduce the medicines their loved one was prescribed.

Staff were able to tell us about the medicines people were on. Staff told us they had frequent medicines training and felt confident in their knowledge and practice of safe medicine administration.

Medicines were stored safely and securely. People had risk assessments around medicines to assess the level of support they needed to ensure they had their medicines safely. Where people were prescribed medicine to be taken on an ‘as required’ basis (PRN) risk assessments and protocols were in place. People received their medicines in line with the prescription.