Wolfe House 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.

The service was in breach of legal regulation in relation tosystems in safe infection prevention and control processes and the cleanliness of the home.

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.

Systems were in place to report, review, investigate and respond to accidents and incidents. Actions were taken promptly where risks were identified and monitored for their effectiveness. This included putting additional measures in place to reduce the risk of falls, choking and skin breakdown. The registered manager reviewed data from accidents and incidents to monitor any trends and ensured these were addressed such as ensuring a staff member was in the lounge at all times to support people with their mobility.

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.

Systems had been developed alongside healthcare partners to ensure information was shared when people needed to attend appointments or required admission to hospital. Information such as a copy of the persons basic care plan, medication and a record of their current health monitoring information was made available to hospital staff to help ensure people received a good continuity of care.

When people were discharged from hospital, processes were in place to ensure any changes were shared with the staff team, updates were made to the care plans and that prescribed medicines were available. Where people had experienced significant changes in their needs, the registered manager completed a full assessment to ensure they could continue to support the person safely.

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.

People told us they felt safe living at Wolfe House. One person told us, “I feel safe having people around to call on.” One relative told us, “Yes I think [they are safe]. The staff are really good to [them].”

Staff had received safeguarding training. They were aware of the different types of abuse to be alert to and reporting processes should concerns arise. The registered manager monitored safeguarding concerns closely and ensured the local authority safeguarding team were informed promptly where issues arose. Investigations were completed in detail and action taken to minimise risks where required.

Systems were in place to protect people’s rights under the Deprivation of Liberty Safeguards (DoLS). This ensured that where restrictions to people’s freedoms were in place, DoLS applications were submitted in line with requirements. A register of DoLS authorisations was maintained which enabled the registered manager to monitor any conditions in place and to submit re-applications as required.

The provider worked with people to understand and manage risks relating to people’s direct care needs 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. However, concerns regarding the hygiene of some areas of the service put people at risk of avoidable infections.

Relatives told us they felt risks to people’s safety were managed well. Comments included, “I feel they know the risk and they do things to limit it” and, “I believe they try to manage risks the best they can.”

A range of systems were in place to assess and review risks to people’s safety and well-being. Monitoring systems were in place to identify emerging risks and control measures were implemented to minimise concerns. Information regarding people’s safety was clearly recorded and available to staff. One staff member told us, “It is all on our (electronic devices), so we know what we need to do for them to be safe.” Risk assessments were monitored in areas such choking, mobility, falls and skin integrity. Information was also available to staff in relation to specific health conditions to ensure staff were able to identify and respond to any changes in their well-being.

The registered manager closely monitored people’s risk management plans to check the were being followed. For example, ensuring people received support to reposition at regular intervals where this was required.

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 had received training in the use of equipment within the home. Equipment used to support people with standing and moving between rooms was used safely and staff provided reassurance to people.

Processes were in place to ensure regular checks and servicing of equipment and facilities were completed. This included checks of fire equipment, gas and electrical appliances, lift servicing and water quality testing.

At the time of our assessment, planned building work to extend the communal areas available to people was coming to an end. This work had taken significantly longer than originally planned. Risk assessments were in place to monitor people’s safety during the work.

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.

People and their relatives told us there were sufficient staff available who demonstrated a skilled approach. One relative told us, “I do feel there are enough staff and they are really lovely.” We observed staff responded promptly to people’s requests and people were not found to be waiting for support.

Staff told us they were able to support people’s needs and did not feel the need to rush. One staff member told us, “There are enough staff. We are able to help them with their care and then have time doing other things together.” The registered manager reviewed people’s needs on a regular basis to assess if the staffing ratios were in line with people's needs.

Staff received training in relation to their roles which was regularly updated. The registered manager told us they looked for opportunities for staff to complete additional training to develop their skills. This included working alongside the local authority training partners and a local training provider.

Safe recruitment practices were followed to ensure fit and suitable staff were employed to work at the service. Staff files contained evidence of recruitment checks including application forms where gaps in employment were explored, references from previous employers, right to work and identity checks being completed. In addition, Disclosure and Barring Service (DBS) checks were in place for all staff. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

The provider did not always assess or manage the risk of infection. This placed people at risk of avoidable infections.

Relatives told us they felt the home would benefit from additional cleaning. One relative told us, “It could be improved, there are areas that need attention.” A second relative said, “I think it could be cleaner and they could upgrade some areas.”

We found areas of the home were not cleaned to a hygienic standard. Examples included the seat of the stair lift and some soft furnishings being heavily stained, sticky and dusty skirting boards and radiators, tea stains up walls and a dirty stair carpet. In addition, some areas of the home had a strong malodour and issues such as the waterproof covering on some chairs being cracked had not been identified as a hygiene issue. A room being used temporarily to make drinks was unclean, the sink dirty and rips in flooring being taped together meaning it could not be cleaned effectively. Poor levels of hygiene pose a serious risk to older people and those living with health conditions.

Whilst these concerns had not been identified prior to our assessment, the registered manager responded promptly when these concerns were raised. They assured us a deep clean of the home was being undertaken with specialist cleaning organised as required. An action plan was shared with us which was designed to manage the cleaning process. This included implementing additional cleaning checks going forward.

In other areas we found safe infection prevention and control processes were followed. Staff had access to personal protective equipment as required and hand-washing training and audits were completed.

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 received their medicines in line with their prescriptions. Staff supporting people with medicines completed training and their competency was regularly assessed. Medicines were safely stored and systems were in place to ensure stock was always available.

Medication administration records were completed following each administration and stock counts recorded. Protocols were in place where people were prescribed as and when required medicines (PRN) informing staff of when and how to administer. Where medicines were prescribed for periods of anxiety, protocols gave guidance on what steps may support the person without the need for medicines, such as the use of breathing techniques.

The management team completed regular audits of medicines management processes within the home to ensure any concerns were identified and addressed in a timely way.