Ruislip 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

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 inspection the rating has changed to good. This meant people were safe and protected from avoidable harm. People received safe care and treatment. Risks to their safety and wellbeing were assessed and planned for. The provider worked with people using the service, staff and others to learn when things went wrong and to improve the service for them. The environment and equipment were safe to use and well-maintained. Staff had training to understand about safe care and using equipment. There were systems for ensuring infection prevention and control and these were operated effectively. The provider worked in partnership with external professionals to help people access other services and get the safe care they needed. There were enough staff deployed to meet people’s needs. There were robust systems for recruiting and selecting staff; as well as training them and making sure they were competent and knowledgeable. People’s medicines were managed in a safe way.

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.

There were well managed systems for responding to and learning from things that went wrong. Staff recorded and reported any accidents, incidents or adverse events. These were investigated by the management team. There was evidence that the provider had informed and involved the person and/or their representatives in the investigation, apologised when things went wrong and worked with them to develop improvements. People using the service and their relatives confirmed they had been given information about this. We looked at a number of records which showed examples of a proactive response to incidents. Information within care plans and risk assessments had been updated, staff had received additional training and guidance when needed and external professionals had been consulted to make sure best practice was implemented.

There were systems to help ensure people’s transition between services was well managed and safe. The provider worked with external partners to make sure information about people’s needs was clear and communicated to all professionals involved. People were informed about what was happening to them. The staff made timely referrals when people needed additional treatment. People told us they were happy with the support they received to access different services.

Systems helped to ensure people were safeguarded from abuse. There were appropriate policies and procedures, and the staff were familiar with these. Staff were able to tell us how to recognise and report abuse. There was information displayed and shared with people using the service and their relatives about this. The provider maintained clear records of safeguarding concerns and their response to these. We could see they had investigated these and worked with the local safeguarding authority and others to put in place protection plans to keep people safe from further harm. The provider had shared learning from safeguarding concerns with staff. People using the service and their relatives told us they felt safe and knew how to speak up if they had concerns about abuse. The provider had applied for Deprivation of Liberty Safeguards for people when they lacked the mental capacity to consent to their care and treatment. There were systems to monitor these and any conditions of these to make sure they were relevant, and people’s rights were not being unfairly restricted.

Risks to people’s safety and wellbeing had been assessed and planned for. The risk assessments were detailed and included guidance for staff about how to monitor risk and keep people safe. People were supported to take risks and make informed choices about these. For example, some people went into the community independently. The provider had put in place safety checks which people had agreed to. This enabled them to be independent whilst having assurances that the staff would quickly respond if something went wrong. Risk assessments were regularly reviewed and updated with people and their representatives. People using the service and their relatives told us risks were appropriately managed.

People lived in a safe and well-maintained environment. At our last inspection, we identified risks to health and safety within the environment. At this assessment, we found improvements had been made. The provider had robust systems for monitoring the safety of the environment and equipment, including fire safety. There were regular checks, and action was taken when problems were identified. The staff knew how to support people to use the equipment they needed to stay safe. This equipment was regularly checked to make sure it was in good condition.

There were enough staff deployed to keep people safe and meet their needs. People using the service told us they felt there were enough staff, and they did not have to wait for care. We observed staff were available and attentive to people’s needs. There were suitable systems for recruiting and selecting staff. Staff were supported to work towards promotion and to learn new skills. There were comprehensive inductions and training schedules for staff. Additional training courses were provided when there was an identified need. This meant the staff had the skills and information required to support people in a safe way and to understand their needs. The management team carried out checks on staff knowledge and competencies. Staff told us they felt supported and had the information they needed.

There were appropriate systems for managing infection prevention and control. There were up to date policies and procedures. Staff had training in these and understood their responsibilities. The environment and equipment were clean. People confirmed they were happy with cleanliness and the laundry facilities. There was enough personal protective equipment (PPE) for staff. Staff carried out audits and checks on cleanliness and infection prevention and control. They took appropriate steps to rectify any concerns identified through audits.

People’s medicines were managed safely. Staff administering medicines had received training; and competency assessments had been completed to ensure they were administering medicines appropriately. Medicines records were clear and accurate including Medicines Administration Records (MARs) to record when medicines had been administered. We observed medicines being given and saw these were administered in a safe and caring way. There were suitable arrangements for the storage of medicines. Temperatures were recorded to ensure medicines were stored at correct temperatures. When creams, eye drops, and liquid medicines were opened the dates were recorded to ensure they were discarded within the required time range. There were suitable arrangements for the ordering and disposal of medicines. There were suitable procedures to ensure medicines which had to be given at specific times would be managed safely. Protocols were available to guide staff on when it would be appropriate to administer medicines which were prescribed to be taken ‘when required’. When medicines were given covertly (disguised in food or drink without people’s knowledge) we saw that people’s mental capacity had been assessed and decisions made in their best interests. Pharmacy advice was recorded on how to administer medicines safely in this way. Medicines incidents had been recorded and investigated. We saw that actions were put in place to prevent them from re-occurring and that changes had been made following a recently reported error.