202 Weston Road

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 were safely supported and were protected from the risk of harm and abuse. The registered manager had made significant improvements to ensure people's risks were well managed. Staff knew people and knew how to meet their individual risks and needs. The culture across the service had improved which promoted this practice allowing staff to support people in the most effective way. The environment was clean and free from potential hazards. The provider had effective infection control processes in place and were in the process of making further required refurbishments. People were supported by enough staff who were well trained to meet people’s needs. Since our last inspection, the registered manager had worked to ensure people were supported by a consistent staff group who met people’s needs safely and effectively. Staff were recruited safely. People’s care records had been reviewed and updated since our last inspection, and now ensured staff had up to date accurate information about people’s risks and needs with specific detail for staff to follow. The processes in place to manage people’s medicines had been reviewed to ensure they were safely administered, in line with prescribing instructions. Protocols had been updated for people’s ‘as and when required’ medicines.

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 were kept safe by staff sharing a culture of reporting concerns and taking required action, as necessary. We observed people moving around their home freely and as they wished, demonstrating a sense of familiarity and comfort within the environment and among the staff group. One relative told us, “I feel [Person’s name] is safe here, there was a time when it was a worry, but that has subsided now.”

Since our previous inspection a new registered manager had been appointed, who demonstrated a passionate approach to supporting people living at 202 Weston Road. They had worked to significantly improve the culture of the home to ensure there was a positive environment which achieved good outcomes and experiences for people living there. We observed staff mirror the values and delivery of care demonstrated by the registered manager, which provided people with a comfortable and safe home environment. One staff member told us, “[Registered manager’s name] is really approachable, I can go and talk to them and raise anything, they always follow it up.” A senior member of staff told us, “We [Staff] have worked really hard over the last 8 months to improve, we have come a long way, the staff team have worked really well to achieve what we have.”

The registered manager had adopted a positive learning culture which encouraged staff to be open and honest as concerns were investigated. Staff completed training and received guidance and support to meet people’s individual needs. They reviewed policies and signed them, to confirm they had read and understood the content. The registered manager had systems in place for staff to raise and report any concerns and a designated member of staff reviewed incident and accident forms each day to ensure the required initial action was taken. This included sending the form to the registered manager who reviewed and took any required further action and identified lessons learnt.

Staff ensured people had access to services as and when they needed. The registered manager made referrals and initiated external reviews when required to ensure people’s needs and preferences were monitored and responded to.

The registered manager and staff members demonstrated positive interactions with people living at 202 Weston Road. We observed staff working together to support people and ensure people received consistent and effective care. One staff member told us, “People’s communication levels have really improved, the whole house is calmer, so people feel safer, each person has an individual rapport with staff now.” The member of staff also confirmed, “Risk assessments and care plans are up to date, following every review we are being updated of the changes, we all read and sign to show we understand.”

Professionals who worked in partnership with the service provided positive feedback about the service and the staff members. External agencies confirmed safe systems, pathways and transitions were in place for people living at 202 Weston Road. External professionals agreed staff members sought advice and guidance when required. One professional told us, “There is effective communication between staff and us, as the external agency, I have no concerns.”

The registered manager had made improvements since our last inspection to review and update people’s care records to ensure they held accurate information reflective of people’s current needs. People’s care records contained documentation of partner agency input to help effectively meet people’s individual needs and preferences. This information was accessible to staff to ensure they delivered care to people in line with their care plan.

People’s relatives confirmed they felt people were safe living at 202 Weston Road. People’s relatives told us they had previous concerns, however, since the registered manager has been in post, they had seen an improvement in people’s wellbeing and safety. One relative told us, “[Person’s name] is safe there, the staff are definitely aware of their needs and risks and how to support them safely.”

Staff confirmed the process they followed when recognising and responding to potential harm or abuse. Staff understanding and responsiveness to report concerns had improved since our last inspection. This included escalating concerns to a senior member of staff or directly to the registered manager. Staff we spoke with confirmed the required action was taken following raising any concerns. One staff member told us, “People are safe, the structure and culture of the home has improved to suit the needs of the service users. There has been a massive impact on them, the environment is calmer, there are less incidents compared to before. People feel comfortable being supported by the staff group, so they are communicating more effectively. The whole house is calmer, so people feel safer.” Another member of staff confirmed, “If we raise anything [Registered Manager’s name] follows it up, we work really well together.” Staff received training in safeguarding and confirmed access to safeguarding policies and procedures if required. Since our last inspection, staff now followed the principles of the Mental Capacity Act 2005 and showed their understanding of the importance of people’s consent and choice.

Since our last inspection, the delivery of care and language staff used when supporting people had significantly improved. We observed staff spoke with people kindly and respectfully, they supported people in a safe and effective way, and in line with their needs and preferences. We observed staff responded to people’s needs and gave them time to communicate in their preferred way. Staff ensured people were listened to and their daily routines were followed to keep them safe.

The registered manager had made improvements to the service to ensure effective systems and processes were now in place to protect people from abuse and harm. Action was taken to ensure safeguarding referrals were made to the local authority as and when required. The registered manager reviewed accident and incident records to ensure required action was taken and themes and trends were identified. We found one incident where restrictive practice was used to keep the person and members of the public safe, the registered manager took the required action in making a safeguarding referral, and ensured debriefs were undertaken with staff members involved. Following our prompt, the registered manager arranged for staff to complete specific training around this use of restrictive practice, and they updated the person’s care records to inform staff of the process to follow if a similar situation occurred.

People’s risks were assessed and well managed. Staff knew people well and supported their individual needs. One relative told us, “The staff are definitely aware of [Person’s name] needs and risks and know how to support them safely.”

Staff knew people well and incorporated their likes and dislikes into their delivery of care which ensured their individual risks and needs were met. Staff understood their role in monitoring and managing people’s needs to help keep them safe. Staff we spoke with confirmed they supported people to be involved in their care. One staff member told us, “People make a lot of choices for themselves, we have a plan set out for them, but we bring choices to them through pictures, if they can’t decide, for meals for example, we show them the content of the fridge, we can go to the shop with them to pick want they want to eat.”

We observed staff supporting people in a safe way in line with their needs and preferences. For example, one person returned home with a staff member, and their routine was followed by staff to ensure consistency for the person and to keep them safe.

People’s care plans had been updated since our last inspection to include clear information about specific needs in line with their choices and preferences. Staff had also completed required training to ensure they followed up to date practices when supporting people. The registered manager had effective oversight of people’s risks due to effective incident reporting processes in place.

People and their relatives did not have any concerns with the environment or premises of 202 Weston Road, they felt people were safe and well supported within the home.

The registered manager had ensured significant improvements had been made to the environment since our last inspection. They had an action plan which detailed some refurbishments were still in process, however updates had been made to ensure the safety of the people living at 202 Weston Road. Staff members took required action to control risks within the environment and safety checks were completed.

We reviewed processes in place to promote the safety of the environment. People moved safely around the home and staff followed clear guidance for required observations of people and the environment to ensure everyone’s safety.

Since our last inspection improvements had been made to ensure the environment was well maintained for the safety of people living at 202 Weston Road and for staff and visitors entering the home. Building records and checks were completed and kept up to date to show the maintenance and safety of the environment. Whilst some improvements were still required, the registered manager was aware of these, and further improvements were in the process of being completed.

People and their relatives provided positive reviews about the effectiveness of the staff group within the home. People’s relatives confirmed there had been an improvement in the regularity of the staff group. This meant people were supported by consistent staff members who knew them well and met their individual needs. One relative told us, “The staffing levels are a lot better than before; it was a bit of a concern when the staff were not consistent, [Person’s name] needed the consistency, it impacted on their behaviour, it has altered a lot now and we are happy with the care.”

Staff told us they felt there were enough staff to support people safely and effectively. Staff we spoke with provided positive feedback about the training they received and were continuingly put forward to complete further training to increase their skills and knowledge. One member of staff told us, “I know people well and how to support them, one person for example has epilepsy, we have had so much training on this, and how to manage seizures and medication administration. I have had so much training to really strengthen my skills in the role. It is positive now, for people living here.” The registered manager assigned training for staff to complete as and when required, they ensured there were enough staff to provide consistency for the people they supported.

People’s needs were responded to in a timely way and staff were attentive and knowledgeable about people’s needs and wants. We observed examples of positive interactions and delivery of care between people and staff members, including the use of language staff used and their caring approach to meet people’s individual needs.

Staff completed required training courses within specific timeframes to fulfil their role, the registered manager kept a record of any due updates to remind staff. The provider ensured staff were recruited safely, and fully trained before supporting people. Records showed staff received supervision, appraisals and attended meetings where they had the opportunity to discuss and enhance their personal and professional development.

People were assured they were being cared for in the safest way to manage the risk of infection. Staff wore required Personal Protective Equipment (PPE), as needed and kept the environment clean and tidy. Staff encouraged people, where able, to keep areas of the home clean and help with domestic tasks. People’s relatives we spoke with had no concerns for the cleanliness of the environment or any issues with Infection Prevention and Control (IPC). One relative told us, “I have no concerns with infection control, it is a nice house.”

Staff told us they received training in IPC and had access to PPE supplies. Staff were aware of how to keep people safe in line with best practice guidance. One member of staff told us, “The house and the building has improved, our manger changed a lot when they came in including adding a cleaning rota, we complete checks in the morning and these are checked, with teamwork, the team is stronger now, it is positive for the residents.”

The home was visibly clean and well maintained. Staff were working with people to keep their bedrooms clean and tidy and where some people’s bedrooms had a malodour, solutions were being tried and tested to help resolve this.

The registered manager had effective IPC measures in place to keep people safe. Staff followed best practice, and checks were completed to ensure their compliance. Staff had access to policies and procedures as needed and received regular IPC training.

The registered manager had made improvements to the management of people’s medicines, and people now received their medicines safely. People received their medicines as prescribed, and staff showed respect and patience when administering their medicine.

Since our last inspection, staff had received medication training and had regular competency checks to ensure they had up to date skills and knowledge to safely administer people’s medication. One staff member told us, “We have had medication training, and the management of people’s medicines is going well, we have not had any errors recently.”

The registered manager had reviewed and updated the medicines processes in place following our last inspection to ensure these were effectively managed. They moved the location of people’s medicines to one specific room to ensure safe storage and temperature checks were completed. People’s ‘as required’ medicines now had clear protocols in place to inform staff of prescribing instructions. Following our inspection the registered manager worked with an external professional from the medicine optimisation team who supported the service to achieve effective medicine management. We found significant improvements had been made and people received their required medicine as prescribed. Staff were following prescribing instructions for people’s medicines, we found a concern with the instruction provided on one person’s PRN (as required) protocol, we queried this, and the protocol was amended by the prescribing GP. The registered manager confirmed, going forward, they would raise any concerns they had with people’s medicines and prescribing information to ensure people receive required doses of medicine. The registered manager also planned to arrange a multi-disciplinary meeting regarding this person to ensure all required agencies and family members were involved in decisions about their medicines. The registered manager completed regular medicine audits to help ensure medicines were managed safely and to identify themes and trends and lessons learnt.