Wilbury

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 75 (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, investigated and reported safety events, and shared learning to support safe care delivery. Lessons were learnt and used to promote consistent practice and reduce the risk of avoidable harm. People were supported by the provider in a way that promoted safety. Staff demonstrated a clear understanding of how to recognise risks and respond appropriately when concerns were identified. Staff were able to explain how they raised concerns and how these were acted upon, which helped to ensure people received care safely. Learning from incidents and concerns was shared within the staff team. One staff member told us, “Learning from incidents was discussed and used to support safe practice.”. This learning was most evident in day-to-day practice at staff level, where staff reflected on people’s needs and adjusted care to reduce risks. These arrangements supported a culture where safety concerns were listened to and addressed within the service. Staff learning from incidents and concerns helped to promote consistent and safe practice and reduced the risk of avoidable harm to people using the service.

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 were supported by the provider through arrangements that helped ensure care was delivered safely and consistently. Staff demonstrated an understanding of people’s needs and explained how information was shared to support continuity of care. Staff described how they worked with other health care professionals involved in people’s care to support safe transitions and respond appropriately when people’s needs changed. A professional told us they, “Felt the team listened to the guidance provided and that people were cared for very well.” This supported coordinated care and continuity for people using the service.

The provider worked with people 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. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act 2005 (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. People were supported by the provider in a way that promoted their safety. Staff demonstrated an understanding of safeguarding and were able to explain how they would recognise concerns and take appropriate action if people were at risk of harm. Staff supported people to receive care that protected them from abuse and avoidable harm.

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. The provider supported people to manage risks in ways that reflected their individual needs and preferences. Staff demonstrated an understanding of the risks people faced, including risks associated with daily living and medicines, and were able to explain how they supported people safely while promoting choice and independence. Staff described how they supported people to take positive risks as part of everyday care and how they escalated concerns when risks changed. This helped ensure risks were managed appropriately while people were supported to live their lives safely.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People were supported in surroundings that were arranged and maintained with their safety in mind. The environment was organised and well presented, which supported people to move around the service safely. A lift was available to support people who were unable to use the stairs, helping them to access different areas of the home. Clear signage was in place to support people’s orientation within the home. Staff and people demonstrated an understanding of how safety concerns could be raised, which supported prompt action when issues were identified.

The provider made sure there were enough qualified, skilled and experienced staff to keep people safe. They made sure staff received effective support, supervision and development. People were supported by staff who were appropriately deployed to meet their needs safely. Staff demonstrated an understanding of people’s needs and were able to explain how they worked together to provide care safely and respond when additional support was required. Staff described how rotas and daily allocations supported them to understand their responsibilities and ensure people received consistent care. Staff spoke positively about the training they received and how this supported them to carry out their roles safely and confidently. The provider described how additional cover, including agency staff where required, was arranged to ensure people continued to receive safe care. Where agency staff were used, the provider told us they used regular staff from a known agency who were familiar with the home and people living there. Information about people’s needs, routines and preferences was shared through handovers and care records to support continuity of care. These arrangements supported continuity of care.

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. People were supported in an environment where infection risks were managed appropriately. During our assessment the setting was clean, well maintained and free from clutter which reduced the risk of infection. Staff demonstrated an understanding of infection prevention practices and were able to explain how they maintained cleanliness within the setting and used protective measures when required. Staff told us they had access to appropriate personal protective equipment (PPE) and explained how and when it should be used to reduce the risk of infection. Arrangements were in place to monitor infection prevention and control, including checks to support cleanliness within the setting. Staff also described how concerns would be escalated if people showed signs of illness, supporting timely action to reduce the risk of infection spreading.

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. People were supported to receive their medicines safely and in line with their individual needs. During the assessment we observed a medicines administration round, and medicines were administered accurately in a calm and respectful manner. Medicines were stored securely in people’s bedrooms. People were encouraged to self‑administer their medicines where they were able, with appropriate support provided when required. Arrangements were in place to monitor medicines stock levels for people, which helped reduce the risk of missed or delayed doses; this had recently been implemented. A staff member administering medicines described how errors were managed and said, “If an error occurs, we report it and follow our processes to make sure the error does not happen again.” The provider also told us they were in the process of moving medicines administration records to a new electronic system, which was intended to support improved oversight of medicines management.