Healey 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 81 (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.

There was a positive approach to learning from safety events. The provider’s lessons learnt policy stated, “From time to time, things can go wrong, accidents happen and we can experience ‘near miss’ incidents. By following a structured lessons learned protocol, [the provider] can foster a culture of continuous reflection and improvement."

Staff could tell us what they would do following an incident or accident and debriefs were held following safety events, to discuss what improvements could be made to help prevent reoccurrence.

Whilst systems were in place to record and review incidents, the registered manager explained how they were reviewing incident recording systems, to ensure information captured was more robust.

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.

The registered manager explained the transition process, which took place over several months. Staff would attend activities or visit people in their family homes, to observe their routines and build familiarity prior to them moving into Healey House. Relatives and staff from previous services or educational provisions were involved and asked to share important information with the team.

Pre-admission assessment templates were detailed and prompted staff to capture the relevant information about people before they moved in.

The provider had worked closely with people and their relatives to find alternative accommodation within the service, when placements had broken down due to compatibility.

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.

Staff received safeguarding training and could confidently tell us the signs of abuse and the actions they would take if they suspected abuse or neglect.

Relatives confirmed people were safe living at the service. One relative told us, “[Person] is absolutely safe here.” Another added, “This place is safe and excellent at looking after [person]. They are happy and settled here.”

The service ensured people were only deprived of their liberty with the correct legal authority to do so. The service worked closely with local authorities to ensure Deprivation of Liberty Safeguards (DoLS) authorisations were in place. Details of people’s DoLS were included in their care plans, with the registered manager using a matrix to track renewal dates.

The provider always worked well with people to fully understand and manage risks by thinking holistically. Staff provided care that fully met people’s needs and was safe, supportive and enabled people to do the things that mattered to them.

Staff had training in several topics to help them understand and respond to risk. For example, first aid, epilepsy, diabetes and slips trips and falls. People’s care plans, risk assessments and associated protocols were detailed and included robust information to help staff prevent, identify and respond to known risks.

Enhanced Positive Behaviour Support (PBS) training was provided and PBS leads within the service provided guidance if people’s behaviours changed or more intensive support was required.

People’s PBS plans were extremely robust and person-centred. Information included the different phases of behaviours that communicated a need, emotion or distress, how staff should respond and what support was needed post incident to help people return to baseline. Details of how people presented on a good day or a bad day, and the reasons they may be displaying certain behaviours were also included. For example, past traumas, unmet needs or sensory input.

Staff were prompted to use holistic techniques to redirect and de-escalate situations, and clear information about restrictions and agreed physical interventions was included in PBS plans for when it was required. References to legislation helped reinforce best practice, with staff being directed to always use the least restrictive approach.

The registered manager complimented staff on how they supported people’s behaviours in an inclusive, supportive and effective way; being responsive to potential triggers or signs of agitation, consistently using people’s PBS plans and reinforcing positive behaviour. As a result, there had been a notable decline in the frequency and severity of behaviour that communicated a need, emotion or distress. For a person living at the home, this consistent and holistic support enabled them to better manage their distress on a day-to-day basis; reducing the need for medication and enabling them to enjoy a more varied and active lifestyle.

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

Staff were trained in fire safety and shown how to use fire evacuation equipment safely. Staff took part in fire drills, and people were often involved to help prepare them for any necessary emergency evacuations. The appropriate fire safety risk assessments and fire safety checks were in place.

There was a good level of health and safety checks at the service and external servicing was organised within the necessary timeframes. Moving and handling equipment was safe and well maintained.

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.

Staff were recruited safely with the necessary pre-employment checks to ensure they were of good character. Staff confirmed they received a thorough induction and ongoing support from managers. A staff member told us, “A good induction with quite a few shadow shifts, for as long as I felt comfortable. There was a big checklist, and I couldn’t support certain people without the proper training.”

Staff new to working in the care sector undertook the ‘Care Certificate’. This helped ensure they had the skills and knowledge to provide safe, good quality, compassionate care.

There was generally a good level of e-learning and in-person training provided. However, due to issues with the training provider, there were several gaps noted on the training matrix and some topics had not been refreshed in line with best practice guidance. Following feedback, the registered manager confirmed further in-house training was planned, and assured us training would be reviewed as a priority.

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 service was clean and tidy. Housekeeping staff were available to support the team with cleaning, and people were encouraged to help around the house where able. Cleaning checklists were in place and included quarterly deep cleans.

The provider had an IPC policy and infection prevention information was displayed on the communal noticeboard. Personal protective equipment (PPE) was available to staff and worn when required.

Several people living at the service had been supported to attend a session about the importance of good infection prevention and control (IPC), run by the local authority. They learnt about hand hygiene, oral health and hydration with notes from the session shared throughout the service.

The provider had an extremely effective understanding of the impact medicines had on people, making sure medicines and treatments were safe and met people’s needs, capacities and preferences. There was a proactive approach to involving people in planning, including when changes happened.

The service had systems to order, store, record and return medicines safely, including controlled drugs, covert medicines and homely remedies. Staff at different levels carried out regular checks and audits to ensure good oversight of medicines.

Staff received training in medication and had their competencies checked annually or following any medication errors.

The registered manager involved people and their relatives in discussions about medication and treatment options. One person was supported by staff during hospital stay to assess a long-term health condition. They were provided with tailored information about their treatment options which helped them understand the benefits and potential risks, and make an informed decision about the less invasive and safer treatment. This had resulted in a positive impact on their quality of life.

Care plans emphasised ‘when required’ medicines were only used as a last resort for behaviour that communicated a need, emotion or distress; in line with ‘stopping over medication of people’ (STOMP) guidance. A staff member said, “Other strategies are tried, different strategies for different people. We don’t really like to give medication unless it’s necessary.” The registered manager shared a case study which showed a noticeable reduction in the need of ‘when required’ medicines, due to managing behaviour positively in line with the person’s positive behavioural support plan.

The service worked closely with healthcare partners to plan for and carry out any changes to medication, ensuring approaches were structured, safe and person-centred and minimised the impact on people’s health and wellbeing.