Hazel Bank 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 requires improvement. At this assessment the rating has changed to 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.

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.

Accidents and incidents were reported by staff and action was taken to mitigate the risk of events happening again. The registered manager had good oversight of safety events and analysed themes and trends to learn lessons and make improvements. Complaints and concerns were logged and appropriate action taken. People had access to professionals, family and friends outside of the service who they could raise concerns about safety with.

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.

Continuity of care was maintained by ensuring staff had access to clear records. People’s needs were assessed before they started using the service. We reviewed 1 person’s care records who had recently moved into the service, and care plans were detailed and contained clear information for staff about the person’s support needs and preferences. We observed staff following the person’s care plan. Staff told us health care appointments were well planned to ensure staff were available to provide support, where this was required.

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.

There were processes in place to manage safeguarding events and the registered manager worked collaboratively with the local authority to support people safely. Staff had received safeguarding training and understood how to recognise and report poor care and abuse. Where people were subject to Deprivation of Liberty safeguards (DoLS) the service had made applications to the local authority and there was monitoring in place. DoLS ensure if a person is restricted in a way that deprives them of their liberty in a care home, it is only done when it is in their best interests, is necessary for their safety, and all other options have been considered.Where the managing authority had imposed conditions there was evidence these were being closely monitored by the service. This was also confirmed by a social care professional.

People and relatives told us they felt safe. Comments included, “[Name of person] feels safe. I am at amazed how well [person] has settled. They are now smiling again, and the staff are incredible.”

The provider worked with people to understand and manage most 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.

Risks to people’s health, safety and well-being were assessed and regularly reviewed. Key risks such as fire, falls, skin integrity and nutrition and hydration were assessed and monitored. We observed care being delivered in line with people’s care plans, which promoted their independence and choice. Staff told us risk assessments were clear, and the electronic systems highlighted what care and interventions were required. Where people required repositioning some improvements were required. For example, where people with capacity declined to be repositioned there were sometimes lengthy periods of time before this was offered again. This was because staff worked on a pre-determined schedule. The registered manager told us they would take action to address this. Where people required their hydration and nutrition monitoring there was evidence of good record keeping and follow up action, including seeking professional advice, fortifying meals and offering additional snacks and supplements. Where people presented complex behaviours there was monitoring in place. We highlighted this could be improved to ensure any triggers for behaviours were documented more clearly. The registered manager assured us they would provide further training to support staff in this area.

The provider did not always detect and control potential risks in the care environment. Equipment, facilities and technology supported the delivery of safe care.

The service was tidy and safe and there were systems in place to ensure the required health and safety checks were completed. However, checks on hot water outlets were not robust. Regular checks were made but the temperatures were not recorded. We did not find any impact to people from this. The registered manager acted after the first day of our assessment to rectify this shortfall. There was a dedicated maintenance worker on site, who expressed their pride in recent environmental improvements to communal areas, including a cinema screen and a hairdressing salon. There was an ongoing refurbishment in place. However, some people’s bedrooms lacked personalisation, and the quality of fittings and furniture was poor. The registered manager told us they would raise this with the provider and confirmed 5 bedrooms had been immediately upgraded, with a plan to complete the remainder within 6 months.

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.

Safe staffing levels were in place, and this was confirmed by staff, people and relatives. There was a dependency tool in place to assess how many staff were on duty and this was regularly reviewed. Staff were attentive and responded to people promptly when they needed care and support. Recruitment was managed safely.

Staff had the induction, support and training to be able to carry out their role. However, we found whilst care staff had been trained in supporting people with a learning disability and autism this had not been extended to ancillary staff. This is a mandatory requirement for all groups of staff. We discussed this with the registered manager, and they confirmed they would address this promptly.

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.

Processes were in place to ensure people were protected from the risk of infection. The service was clean and tidy, and staff followed good practices to keep people safe. People and relatives did not raise any concerns about the cleanliness or safety of the service.

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 managed safely, and systems were organised. The service used an electronic system, and detailed checks were in place. Staff received training and had their competency regularly assessed. Where people were prescribed medicines to be taken ‘as and when required’ protocols were in place. These could be improved to provide more person-centred information. Staff supported people with patience and kindness and explained what medication was being offered.