Wilford View Care 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

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last inspection we rated this key question requires improvement. At this assessment the rating has improved to good. This meant people were safe and protected from avoidable harm. The provider was previously in breach of the legal regulation in relation to safe care and treatment. Improvements were found at this inspection and the provider was no longer in breach of this regulation.

This service scored 81 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The management team 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. Audits completed by the management team following incidents showed an exploration of themes and trends, with detailed actions the service would take to reduce the potential risk for people. For example, we found robust analysis of incidents had led to service improvement measures following an adverse event.

The management team always worked in partnership with people and healthcare partners to design, establish and maintain safe systems of care. Safety was always well managed and monitored. They made sure there was always continuity of care, including when people moved between different services. We found the service worked collaboratively with external partners to ensure people had a safe admission to the service or when people experienced a hospital admission. People had personalised admission care plans in place, detailing their clinical needs, medicines, allergies, contact details for people important to them and their communication needs. These documents had been regularly reviewed and updated when a person’s needs had changed. We saw people had been involved in regular care plan feedback. This gave them the opportunity to ensure they received care and support tailored to their needs. Staff we spoke with showed an understanding of these documents, and where to access these in the event of an emergency.

Ensuring people were safe and free from the risk of abuse was a priority at Wilford View. The majority of people and relatives we spoke with told us they felt safe and well supported by staff. One person said, “I feel safe, as it comes down to the quality of life. The constant care gives me peace of mind.” Whilst a relative told us, “We feel [Name] is safe and it gives us peace of mind when we’re not visiting.” The service had created the role of ‘champions’ across all areas of care. This ensured quality improvement was driven by staff, alongside the management team. A staff champion for safeguarding understood the importance of supporting staff to put into practice the provider policies and processes to ensure people were protected from the risk of harm or abuse.

The management team consistently worked well with people and healthcare partners to fully understand what being safe meant to them and the best way to achieve that. Staff had a clear focus 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 always shared concerns quickly and appropriately and reviewed outcomes and recommendations from partner agencies to improve care quality.

The management team 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. The service supported people to effectively manage known risks. All areas of risks identified for people were clearly assessed and planned for. We found care plans contained best practice guidance for staff to follow. People we spoke with did not recall any concerns with being unsafely handled by staff. We observed examples of people being transferred from a walking frame into a chair, which were carried out by staff in a caring and safe manner. One person said, “I’m hoisted into my wheelchair and never had a problem with that. I’ve got all the equipment I need.” Some people and their relatives told us about falls they had experienced when not being supervised with mobilising or toileting. We discussed these with the management team, who showed they had analysed incidents where people had potentially been left unsupported. These incident analysis records had led to improvement measures being implemented. The management team ensured they actively listened to feedback or concerns from people and their relatives to improve care quality.

The management team detected and controlled potential risks in the service. They made sure equipment, facilities and technology supported the delivery of safe care. Feedback on call bell responses was mixed, with some people feeling they had not always received a timely response. We shared this with the management team, who spoke to people individually to provide assurance and review of staffing if this was needed. We observed some bedrooms where sensor and call bell equipment had trailing wires, which posed a risk to people. The management team promptly reviewed these and submitted evidence of reconfiguring the equipment, to reduce any potential risk of harm for people. The service employed a full-time maintenance person to oversee the safety of the environment at the service. The service had a robust maintenance schedule, which ensured required environmental checks were all completed. We saw there had been regular checks to ensure the home was safe in the event of a fire. Staff had allocated roles during an emergency evacuation, each considered the unique needs of people. People had Personal Emergency Evacuation Plans in place, specific to their identified needs. The management team had included flash cards in the fire grab bag, to support people living with communication challenges. This showed a person centred approach to safety. Windows were fitted with restrictors by the provider, so they were unable to be opened wide. This safety feature prevents people from falling or climbing out and was in line with guidance from the health and safety executive (HSE). Furniture was secured to walls to prevent any risk of this falling over and injuring people. Where people required specialist equipment, for example, falls sensors or air mattresses, these were in place and well maintained. The kitchen was managed in a hygienic way to ensure people did not get food borne infections. The most recent rating from the food standards agency was 5 stars in July 2024.

The management team ensured there were always enough qualified, skilled and experienced staff, who received supervision and development opportunities. They worked together well to provide safe care that met people’s individual needs. Rotas showed the management team had carried out regular review of dependency and allocation tools within the service. Where people’s needs had changed, staff were redeployed to enable timely support. Staff exhibited a high level of understanding of people’s needs along with a person-centred approach to care delivery. The clinical staff competency was regularly assessed, with peer support available amongst the registered professionals. The majority of people and their visitors told us there were enough staff, and their needs were responded to. However, some people and relatives expressed that on occasion, they experienced a shortage of staff. They described these as being at peak times, and felt this had impacted on their care routine and call bell response times. One person said, “There are more people staying here now but the staffing is not enough. There’s definitely less at night as you have to wait more.” A relative told us, “We personally have never had a worry about staffing.” Whilst one person said, “The numbers [staff], could be better as some residents are more demanding so we may have to wait. It’s not had a real impact on me. They work very hard.” When people required modified diets, the catering team used moulds and focussed on presentation to maintain dignity and respect. Different coloured napkins were used to discreetly indicate which people required additional support with their meals. The staff training matrix showed staff had completed training in the subjects which the provider deemed as essential, along with extra subjects to enhance people’s care experience. Staff displayed a high level of competence and understanding and were able to demonstrate their skills and knowledge to improve care outcomes for people.

The management team thoroughly assessed and managed the risk of infection. They always quickly detected and controlled the risk of it spreading and always shared concerns with appropriate agencies promptly. The service was clean and well maintained, which enabled the domestic team to be able to deep clean effectively. People told us they were supported by staff to maintain their personal hygiene. One person said, “I can have a shower every day if I want. They support to keep me clean.” While another person said, “I have a bed bath every day, which is what I ask for.” A relative told us, “The whole place is kept nice and clean, and they do their best with showering and shaving my family member. Their laundry is handled well too.” There were clear processes and policies in place to ensure the environment was kept clean and hygienic. This protected people from the spread of infection. If an infection outbreak occurred (for example diarrhoea and vomiting), there were clear processes in place to reduce the risk of this spreading to other people at the service. Staff had received training in infection control, how to put on protective equipment, correct disposal processes and how to keep people safe in the event of an infection outbreak.

The management team made sure that medicines and treatments were safe and met people’s needs. Staff kept clear records of when they had given prescribed medicines. Medicines were given as prescribed. We observed a delay to the morning medicine round, which could have a potential impact for people. We discussed this with the management team, who reviewed processes to improve outcomes for people. People told us they were well supported by staff with their medicines. One person said, “I’m always supervised with any of my medication.” Another person said, “I know what medication I’m on so will check the pill pot and staff wait with me.” Suitable medicine stock levels were in place, so more could be ordered from the pharmacist as needed. Some people required ‘as needed’ medicines, staff had clear guidance on how these should be administered. One person required a specific medicine when they experienced periods of agitation. Staff had guidance on symptoms the person may show, what dose should be offered, steps to take prior to administering the medicine and the person’s preferred way to receive the medicine. Where people were prescribed medicines to be administered covertly, we saw appropriate decisions were in place. Covert medicines are given when staff administer a person’s medicine without their knowledge or consent, usually by mixing medicine into food or drink. Staff knew where to report medicine concerns, if they felt a person’s medicine was no longer effective, they documented this and knew who to contact. Where medicines needed to be stored at a certain temperature, this had been done. Staff checked the fridge temperatures regularly to ensure it was working as expected. Where people were prescribed creams for healthy skin management, there were body maps in place & instructions regarding application sites and frequency. Staff received training on administering medicines safely. Staff competency was regularly assessed, to ensure best practice was followed.