Walfinch Chiswick, Hammersmith & Kensington

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

A very safe service was provided for people, and there enough appropriately recruited, and well-trained staff employed to meet their needs. This meant people were supported to live very safely. Risks to people were thoroughly assessed, monitored, and recorded, by the registered manager, management team, and staff. Accidents, incidents, and safeguarding concerns were reported, investigated, recorded appropriately, and learnt from. Staff were appropriately trained to administer, prompt and support people to take their medicines, when necessary. Infection control procedures were followed.

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 service had a very initiative-taking culture and approach regarding keeping people safe, and they said they felt safe, and were supported to understand and manage any risks. They were given information, and advice about health, care, support, and how to keep as physically, mentally, and emotionally well as possible. A person told us, “I feel absolutely safe when receiving care from the care workers.” An example of this was the advocacy information, contact details, and support provided that enabled people to contact independent advocates, and set this service up.

The management team explained that people’s safety was an absolute priority, everyone’s responsibility, and maintained by being transparent, open, and learning from experiences where people may previously have been at risk. Staff said they were always supported, and encouraged to raise any concerns so they could be minimised without restricting people’s choices. This was supported by the positive culture towards, and enthusiasm for people receiving a service, demonstrated by staff responses to our questions. The service gave examples of people’s wellbeing, and quality of life being improved by the management, and staff participating in learning in areas such as treatment, and management of depression in adults. They also organised, and were involved in community based local events, utilising resources, and support from the Dementia Action Alliance, and actively encouraging staff to join and participate in these initiatives.

The provider’s processes were up to date, and very thorough. This enabled learning from previous incidents where people may have been at risk, and promoting people’s safety as a priority whilst not limiting their choices and empowering them to take acceptable risks.

This is a relatively small service, and the management team and staff kept people safe by being knowledgeable about the people receiving a service, and the need to work collaboratively, using a joined up approach with people using the service, within their teams, and healthcare professionals in a systematic, planned manner. The service has a Care Worker Team WhatsApp where additional information is shared with all staff, ensuring prompt communication of up to date, real time information. Staff said this was a great asset enabling them to give true person centred care.

Healthcare professionals commented that they were very impressed with the positive, and initiative-taking way the service worked with them, by providing thorough, up to date, and appropriate information to keep people safe with their consent. A healthcare professional commented, “The communication with Walfinch has been excellent. The team at Walfinch ensure that their staff are trained and safe to work with the client.”

The provider had very efficient, thorough, and up to date systems that were followed, enabling continuity of safe care, and joined up working. The solid, positive, relationships with healthcare professionals were established to promote, and maintain people’s safety. The provider's policies, procedures, and processes were in line with current, relevant legislation.

People and their relatives said they felt very safe using the service, and the support they received was exceptional. They told us staff supporting people understood how to keep them safe. A relative said, “Yes, she is cared for very well.” People and their relatives were confident in raising concerns, always received a prompt response, and if they felt there were safety issues, they were fully, and appropriately investigated, and they received an outcome. This meant that people were reassured that they received care that would keep them safe, and any concerns about their safety would be fully investigated, and rectified.

The management team and staff understood abuse, neglect, how to protect people from its different forms and to report any concerns appropriately. The pathway system recording was followed to keep people safe. The management team had a clear understanding of the Deprivation of Liberty Safeguards (DoLS) and that they were only used when it was in the best interest of the person.

The provider's safeguarding policy, procedures, and processes were efficient, and followed current, relevant legislation. The systems demonstrated safety concerns were reported to the registered manager, recorded, frequently monitored, and raised with appropriate bodies in a timely way. Where appropriate, people and those important to them were involved in this process and informed about what action would be taken to keep people safe.

People and their relatives said the standard of care and support people received was excellent. Risks to people’s safety were professionally managed, without unnecessary restrictions in place. People and their relatives told us staff knew how to support people with identified risks, and that they were involved in planning the care they received which gave them the opportunity to decide what risks were acceptable, and they were prepared to take. A catheter bag was incorrectly attached which prevented it working. A relative reported this to the management team. A request was made to update and include pictures in the care plan which was carried out immediately with an apology, and there was no subsequent reoccurrence.

The management team explained and demonstrated how people were enabled to take acceptable risks by staff following their regularly reviewed and updated risk assessments. The risk assessments covered all aspects of people’s health, daily living, and social activities. The provider carried out general risk assessments that were regularly reviewed, updated, and included equipment used to support people and identified risks for staff in people’s homes. The provider gave us further evidence of how people were enabled, and supported to manage risks by identifying risks, at an early stage, developing bespoke action plans with the involvement of people, and their relatives, and communicating any changes to staff so they were clear how to manage identified risks. This helped to improve people’s safety, and quality of life, engagement with people and their relatives, and to minimise the risk of poor care, and incidents.

Risks to people were assessed, and care plans put in place to help staff prevent or minimise the identified risks, when possible. Risks included supporting people with their mobility, and personal care. This meant staff had up to date information about the action they should take to manage these risks and keep people safe. The systems enabled, and supported staff to report concerns, incidents, and accidents in a timely way so that people were kept safe, risks minimised, and incidents, and accidents not repeated. This enabled the provider to have oversight of and be able to manage risks. The management team completed regular audits and care plans updated if new risks were identified. A WhatsApp Client and Care Team Hubs was introduced to serve as a dedicated communication channel where staff, and family members were actively involved. These hubs provided constant updates, seamless information sharing, and open exchanges to ensure everyone was kept informed, and connected regarding people’s care and well-being. This involved people, and reduced risk to them.

People did not directly comment regarding a safe environment, as this was their own home. They did comment that they felt safe.

Environmental risk assessments were carried out prior to a service being provided. This highlighted any issues that were forwarded to appropriate healthcare professionals regarding people’s homes, and to protect staff.

The processes in place were followed, and identified areas of concern regarding risks, and hazards in people’s homes.

People and their relatives told us their care and support needs were very well met. This was because enough skilled, and well trained staff were available to support them, and they received care when they needed it. A person told us, “Staff regularly arrive on time, and if they are running late, they always let us know. They stay for the agreed time, and carry out their tasks to a very high standard in a friendly, thoughtful, and caring way."

The staff fed back that there were enough of them to support people with their care needs, and they were given enough time to do in the correct way. The registered manager regularly reviewed staffing levels to ensure there were enough suitably skilled and experienced staff deployed to meet people’s needs. Staff were given regular, relevant, good quality training to support them in their roles. They told us, they were well supported by the registered manager and team to learn from and continuously improve their working practices. Staff said the training enabled them to deliver high quality support, and they were knowledgeable about the areas they received training in. This meant people received excellent, safe, care, and support.

The provider staff recruitment process was very thorough, and records demonstrated it was followed, and regularly reviewed. Staff received training that was comprehensive and based on the Skills for Care 'Common induction standards. They form part of the Care Certificate which is an agreed set of standards that define the knowledge, skills and behaviours expected of specific job roles in the health and social sectors. Disciplinary and capability processes were fair, and regularly reviewed to ensure there was no disadvantage based on any specific protected equality characteristics. The processes enabled staff to receive appropriate, comprehensive training that was relevant to their role. They were supported to deliver safe care by receiving regular supervision, appraisals, development support, and being encouraged to participate in service improvement.

People told us that staff wore appropriate clothing to prevent, control, and reduce infection. One person said, “They do wash hands they have the latex gloves and that’s all that’s necessary with the care."

The management team and staff were aware of the importance of keeping people’s homes and equipment clean, hygienic, and free of infection. They also confirmed they had received appropriate training that was regularly reviewed.

People told us they received their medicines when they were supposed to, and staff supported them to take them. One relative said, “They [Staff] work alongside me. I mainly do that. They know exactly what to give. I do my own Dossett boxes. They know what she has morning and evening. If I wasn’t there, they would know what to do."

The registered manager and management team said appropriate training was provided, and refreshed. This was confirmed by staff, who told us the training provided was very good, and what they required. They added that all care provided was important, and medicines administration, and support particularly.

There were processes that were followed, recorded, and audited including MAR sheet completion, and field co-ordinator spot checks, phone calls to people using the service, and welfare monitoring visits.