Darwin House Limited

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 assessment we rated this key question good. At this assessment, the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider 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.

People and their relatives told us they could tell staff about things that concerned them. They were confident that changes would happen if they did.

There were processes in place to monitor accidents and incidents affecting people’s safety. When an incident occurred, action was taken across the service to ensure lessons were learnt, and staff improved practices to keep people safe. Any safety issues were identified and addressed promptly by the provider’s auditing processes.

Staff told us meetings and handovers kept them up to date with changes made in the service, such as any lessons learned from incidents, accidents and concerns. Staff told us provider promoted a culture of honesty, openness and learning. They were encouraged to raise concerns and were confident they would be listened to and supported.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People and relatives told us they were involved in discussions about their care needs. Staff worked closely with external professionals to ensure people’s needs were suitably met. Staff had made appropriate referrals to other health and social care services were needed to enable people safe continuity of their care. One visiting health professional said, “They are very good at Darwin House at working collaboratively, I have no concerns about Darwin House.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated 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 shared concerns quickly and appropriately.

People and their relatives told us they were happy with the service and felt safe around the staff. One person commented, “Yes, I feel [relative] is very safe there because firstly [relative] is very happy, and I live 2 hours’ drive away, and I feel confident they give them the best possible care to their ability and will always telephone me if anything is wrong.”

Staff protected people from the risk of abuse, discrimination and avoidable harm. Staff completed regular safeguarding training. They knew how to identify and report any concerns. The service had a whistleblowing policy in place and staff were confident to report to outside agencies if required. The registered manager reported safeguarding concerns to the local authority and the Care Quality Commission in line with guidance.

The service had policies and procedures in relation to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). We identified 1 person had fluctuating capacity; however, records did not consistently demonstrate appropriate Mental Capacity Act assessments had been completed or consideration had been given to Deprivation of Liberty Safeguards applications where required. We discussed this with the manager, who took immediate action to address the concern. Following the assessment the manager confirmed they had submitted the necessary applications and completed the necessary mental capacity assessments and associated best interest decisions.

The provider 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.

There were systems in place to minimise risks to people. Care plans included assessments which identified potential risks and how these should be managed. These covered a range of areas, including medicines management, nutrition, moving and handling and skin integrity. Risk assessments were detailed, and we observed staff delivering care and support in line with them.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Environmental risk assessments considered all aspects of the home, both internally and externally to ensure people lived freely within a safe environment. The provider undertook regular health and safety checks of the premises and equipment.

A recent visit from the fire service identified that improvements were required to strengthen fire safety arrangements, including a review of the current fire risk assessment. The provider completed all identified actions; however, the fire risk assessment still required reviewing to ensure it reflected the updated measures in place.The provider was in the process of doing this.

We identified that the staircase was easily accessible to people who were at risk of falls and those who may wander. This increased the potential for harm, and appropriate measures to reduce the risk were not always in place. This was important as one person was identified as high risk of falls and had at times accessed the stairs unsupervised. We raised this with the registered manager and asked them to review and mitigate the risks identified. The manager was responsive to our feedback and agreed to review the risk and take action to ensure appropriate measures were in place.

The home was spacious and there were comfortable chairs and spaces where people could sit quietly away from the main sitting room. Furniture and equipment was well maintained. Care equipment, such as hoists and wheelchairs were subject to regular safety checks.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The provider had a system in place to safely recruit staff. This included pre-employment checks such as Disclosure and Barring Service checks (DBS). DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

Staff worked well as a team to make sure tasks were completed, and they interacted with people in an appropriate way. On the day of our visit staff were visible and available in communal areas and people did not wait long for their support. Staff did not appear rushed. They engaged with people, asking how they were and whether they needed support.

Staff received training and support which assisted them to carry out their roles and responsibilities in an effective way. Staff received supervision at regular intervals. Annual staff appraisals identified any concerns, what they have done particularly well and any goals for the coming year, such as training requirements. Staff told us they found these sessions valuable and supportive.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. The home was clean, and people were protected from the risk and spread of infections. One person told us, “It’s homely and clean.” Staff knew how to protect people from the risk of infection. They had training in infection prevention and control (IPC), hand hygiene and the use of personal protective equipment (PPE) such as gloves and aprons.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Medicines were received, stored, administered and disposed of safely. People received their medicines as prescribed by their GP. Staff were trained to administer medicines and their competency to do so was checked. We found PRN (‘as required’) medicine protocols were not always in place. This meant staff did not have clear guidance on when these medicines should be given, which may lead to inconsistent administration. We discussed this with the manager who took immediate action to address this concern.