Hanwell House

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 69 (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 systems to learn when things went wrong. Staff reported and recorded all accidents, incidents and concerns. The registered manager investigated these and shared learning with staff. They made changes to the service because of these. They discussed what had gone wrong and improvements with relatives to make sure they were involved.

The registered manager explained how they applied learning across the whole service. For example, a person had experienced unexpected seizures, without a previous diagnosis of a condition which would cause these. The doctors explained this was a symptom of their dementia. The provider had implemented risk assessments and ways to manage the risks relating to seizures for all people with dementia and discussed this with their relatives.

Staff told us they had regular meetings to discuss lessons learnt and had undertaken training updates when needed.

The provider supported people to have safe transitions and pathways between different services. They liaised with the person, their representatives and healthcare professionals before people moved to the service. The registered manager told us they completed thorough assessments of people who returned home following a hospital stay. Senior staff created a summary of information about people’s needs which they shared with health and social care professionals when needed. This helped to ensure other professionals supporting people understood how they communicated, what was important to them and any health conditions they were diagnosed with.

Relatives told us they felt the transition to the home and between services was well managed.

There were procedures designed to keep people safe from abuse. Staff completed training about safeguarding. Staff were able to tell us how they would recognise and report abuse. The provider worked with the local safeguarding authority to investigate concerns and protect people from avoidable harm

People using the service and their relatives told us they felt safe. They knew who to speak with if they had concerns about safety or abuse. A relative commented, “[Person] never shows any signs of anxiety living here and I believe [they are] safe.”

The provider requested legal authorisations where restrictions amounted to a deprivation of liberty for people who did not have the capacity to consent to these. Decisions about people’s care were made in their best interests and for their safety.

The provider supported people to stay safe by assessing and managing risks. Senior staff completed assessments of the risks relating to people’s wellbeing. These included risks associated with their health conditions, mental wellbeing and mobility. These assessments included consultation with the person (when appropriate), their relatives and external professionals. Staff developed plans to help people remain independent whilst managing risks. Risk assessments and plans were regularly reviewed.

Staff undertook training to understand how to support people to move and to eat and drink safely. We saw staff supported people in a suitable way.

Relatives told us they thought risks were well managed. People explained they were able to take risks and be independent.

During our visit, we found that staff were using 1 fire escape route to store wheelchairs, hoists and bins. We alerted the registered manager to this. They organised for the fire route to be cleared and reminded staff about the importance of storing these items in a safe way. The registered manager told us there were clear procedures for the storage of equipment.

Other aspects of the environment were safe. Corridors were clear, well-lit and ventilated. There was a range of safety equipment to meet people’s individual needs and support them to move around the home in a safe way. The provider considered best practice for people living with the experience of dementia. They ensured colour schemes and signage were appropriate to help orientation. There were interactive features for people to access.

People had their own bedrooms with ensuite shower rooms. There were a number of lounges and communal areas for people to spend time in.

The provider carried out checks on the safety of equipment and the environment. They took action when they identified concerns.

There were enough staff to keep people safe and meet their needs. The registered manager calculated staffing levels based on people’s needs. People using the service and their relatives told us they did not have to wait for staff when they needed support. Their comments included, “Staff come and sit with us at night if we are in the lounge”, “There is always someone around if I need help” and “There is always staff nearby and they come to check on us.” Staff told us they were not rushed and felt there were enough of them to provide personalised care.

The provider had procedures to ensure staff were suitable during recruitment and their induction. They carried out a number of checks. New staff completed a range of training and managers assessed their knowledge skills and competencies.

Staff completed regular training updates. The registered manager explained they focussed on 2 key areas of learning each month. Staff completed training and then discussed their learning together. Staff told us the training was helpful. They explained they felt supported and had regular opportunities to meet with managers to discuss their work.

The provider had procedures for preventing and controlling infection. Staff completed regular training about these. Senior staff carried out competency assessments to ensure other staff knew how to correctly use personal protective equipment (PPE) and wash their hands. There were supplies of PPE available to staff throughout the home.

The environment was clean. The provider undertook audits of cleanliness and infection control. There were suitable procedures for the management of laundry and disposal of waste.

There were low instances of infection. Any infections were appropriately monitored and responded to.

People using the service and their relatives told us they were happy with the cleanliness of the service. Their comments included, “It is cleaned every day, and my room is taken care of” and “It always looks clean.”

Systems for the safe management of medicines were not always followed.

Some people were administered medicines covertly (without their knowledge). This had been assessed as in their best interests. However, their care plans did not include details to show who had been involved in making these decisions. The provider’s own policy stated this should be done. There were no concerns that people were at risk. The provider explained different professionals had been involved in making decisions. However, the consent of the prescribing doctor and pharmacist had not been appropriately recorded. We discussed this with the registered manager who agreed to make the required improvements.

People received their medicines safely and as prescribed. Medicines were stored safely and securely in line with legal requirements. Controlled Drugs (medicines which require extra security) were managed effectively.

There were clear and detailed care plans and medicines administration records. These provided staff with accurate information about the medicines and how to administer them. Special considerations were also highlighted, such as medicines to be given on an empty stomach or after food. Records demonstrated that all medicines, including time-sensitive medicines, were administered correctly.

There were protocols for ‘when required’ medicines which instructed staff how to safely administer these medicines and monitor for effectiveness and/or adverse effects. There was no evidence that medicines were used to control behaviour. Mood stabilisers prescribed on a ‘when required’ basis were used appropriately and only when in the best interests of the person.

The provider kept a log detailing any actions taken against patient safety alerts, in line with recommendations.

Staff involved in medicines administration and handling had the necessary skills and training. The provider assessed their competencies, knowledge and skills.