Wrawby Hall 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 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 72 (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. The service had a positive learning culture where staff felt able to raise concerns and reflect on incidents. Staff recorded accidents and incidents on the electronic care planning system, and discussed what happened and what needed to change in team meetings and supervision. Lessons from complaints, safeguarding and audits were shared through daily “flash” meetings, staff meetings and area manager compliance audits. A staff member told us, “If I raise a concern, it is acted on and I am told what has happened.”

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 experienced safe and well planned‑ admissions into the home, with pre‑admission assessments, hospital discharge information and family input used to create initial care plans. The service worked with GPs, district nurses, and therapy services to support changes in people’s needs and made prompt referrals when needed.

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 Mental Capacity Act 2005 (MCA) provides a legal framework for making decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take specific decisions, any made on their behalf must be in their best interests and as least restrictive as possible. 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 MCA. In care homes, and some hospitals, this is through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty had the appropriate legal authority and were being met. DoLS applications had been submitted to the local authority for authorisation, in line with legal requirements. The provider shared concerns quickly and appropriately. Staff knew how to recognise and report abuse, and escalated concerns to senior staff or the registered manager. Safeguarding and incident records were up to date. People and their relatives said they felt safe, and people were well cared for.

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. Risk management was proactive, with risksbeing assessed in detail and monitored using falls, choking and mobility assessments. Technology to monitor falls was used to support people to remain independent and reduce restrictions in their environment. Personal emergency evacuation planswere in place to support safe evacuation were this to be required. Staff encouraged people to mobilise to reduce the risk of pressure damage, and they balanced safety with people’s choices, recognising that people could make “unwise” decisions

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The environment was clean and well maintained, with evidence of the completion of required health and safety checks, such as the fire system, gas, legionella, lifts, and window safety. The home was well decorated, free from odours and well-equipped. The service used a falls detection‑ system in some rooms to support people to remain safe while promoting their independence, and monthly room checks further reduced environmental risks.

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,with care plans updated when needed. Recruitment checks were thorough, with enhanced Disclosure and Barring Service checks, references and employment histories recorded. When agency staff were used, appropriate checks were made. Staff followed a structured induction process. Staffing levels met people’s needs and were calculated based on the needs of people using the service.

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 odour free.The registered manager inspected the environment daily and carried out routine audits and checks, including the kitchen.Staff understood when to use personal protective equipment (PPE) and how to dispose of it safely. PPE was readily available in corridors and bathrooms, and domestic routines and records showed ongoing monitoring of cleanliness and hygiene. A healthcare professional told us, “The care here is really good; the rooms are always clean.”

The provider did not always make sure that medicines and treatments were safe or met people’s needs, capacities and preferences. We identified minor shortfalls with medicines recording and oversight. These issues had no impact on people’s safety or wellbeing and were addressed immediately. Medicines were stored securely, including controlled drugs, and staff followed structured medication rounds that helped provide reassurance. District nurses administered insulin safely, and where DoLS authorisations required medicines review, these conditions were being met.