Homewood 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.

This service scored 78 (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.

Staff had a clear understanding of the action to take in the event of an accident or incident. Records showed that events were reported and the leadership team reviewed these and where lessons had been identified, these were shared with the team.

The provider always worked with people and healthcare partners to design, establish and maintain safe systems of care, in which safety was always well managed and monitored. They made sure there was always continuity of care, including when people moved between different services.

A person was transitioning into the service and had stayed overnight for the first time. We saw staff were assessing the person’s needs and getting to know how they liked to be supported. Documentation showed this information was shared amongst the team. The senior leadership team had completed a robust assessment, and this information was used by the team. Staff established the person’s compatibility with others, for example, their daily notes detailed interaction with others and choices they made. Information for the assessment was gathered from a variety of sources and included the person’s skills. The registered manager described how these skills could be developed if the person moved to the service, planning a month’s stay to fully establish their strengths. Daily records seen during the site visit demonstrated staff were involving the person and monitoring their presentation to establish if they appeared happy in the home. Staff communicated with the person using closed questions to establish their mood, for example staff asked, ‘did you enjoy your breakfast’ and the person responded, “Very nice.”

The thorough and thoughtful approach to supporting people during transition between services was confirmed by another person’s relative. They told us, “It was a very good transition…a long transition, so information could be passed on a gradual basis.” This approach helped to reduce the risk of placement breakdown.

Health and social care professionals confirmed there were good systems of communication in place between the home and external partners.

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 policies in place to protect people from abuse and staff received training in safeguarding. Staff had a thorough understanding of safeguarding, including the types of abuse, signs abuse may be occurring and the action they would take if they suspected abuse may be happening. Records showed where suspected abuse had been reported, the service took steps to protect the person, by increasing the amount of support they received. The use of physical interventions had stopped since the previous inspection; the staff team had proactive strategies in place that were effective when people become distressed. The service investigated and reported any safeguarding incidents to the local authority and to the Care Quality Commission and implemented strategies to mitigate the risk of similar incidents.

Where people were subject to Deprivation of Liberty Safeguards (DoLS), staff knew how tosupport them as people’s care plans contained information and guidance.

The provider worked with people to understand and manage 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.

People’s care plans contained risk assessments and guidance for staff on how to manage risks associated with people’s care and support. These included, for example, personal care, accessing the community and taking part in activities, money management, and responding to the fire alarm. Staff demonstrated their knowledge and understanding of people’s abilities and support requirements.

We saw staff explained to people using their preferred ways of communication, which enabled people to better understand risks and increased their involvement in how to mitigate them. For example, records showed and staff told us people were involved in preparing meals. We observed staff explained the risk when using the kettle. Risk assessments were in place, and these considered the actions to be taken to manage risk and were proportionate.

A relative told us, “They would know if he was upset…Some things he can't communicate. He takes them to show them, so they get what he's on about.”

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

The provider undertook regular audits to monitor the safety of the home environment and equipment. Safety equipment was tested regularly to ensure it was in good working order, for example, fire equipment and emergency lighting. There were also water temperature checks, legionella testing, gas safety certificates, electrical hard wiring and portable electrical appliance tests.

People had individual Personal Emergency Evacuation Plans (PEEPs) and fire drills were completed regularly. There were clear fire evacuation plans and staff demonstrated understanding of the action they would take in the event of a fire. The service had a business continuity plan which included risk assessments for a wide range of events with clear action plans.

The layout of the home environment met people’s individual needs. Staff told us people had chosen the colour of the walls in communal areas of the home and helped to design the cinema room.

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 had the knowledge and skills to meet people’s needs. Staff had received training in supporting people with learning disabilities and autism, and other specific training to enable them to meet people’s individual needs and ensure people received safe care. Staff competency checks took place and were recorded. New staff had an induction that included shadowing experienced staff, followed by further ongoing training, which they said was all useful in supporting them to carry out their roles. Staff received regular supervision and yearly appraisals.

We received feedback from the provider’s learning and development officer who told us the management team were very proactive in asking for support, and “Have always been responsive to any advice and suggestions I have made and are very creative in coming up with their own ideas to improve.” Positive Behaviour Support refresher training included a bespoke module that enabled the registered manager and staff team to have input in how the training was tailored to meet the specific needs of individuals living at Homewood.

Relatives told us they felt there were always enough staff around to support their family member when they needed it. Comments included, “There’s plenty of staff. Every time we've been going there's always enough staff.” Staff told us they thought there were enough staff most of the time. When short of staff, this was due to staff sickness, and the leadership team would support the team by completing hands on tasks. Observations assured us there were enough staff to meet people’s needs.

Systems and procedures for recruiting new staff were robust. Records showed thorough recruitment checks were completed including full Disclosure and Barring Service (DBS) checks , references and employment histories.

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 home was clean and there were no malodours. Staff had been trained in infection prevention and control and demonstrated a robust understanding of how to minimise the risk of infections and prevent infections from spreading. Staff told us there were enough cleaning products and personal protective equipment (PPE) available, such as gloves and aprons.

Clinical waste was stored securely. The kitchen was clean, and food was labelled when opened and stored appropriately. Different coloured chopping boards were in use. Clear and appropriate laundry procedures were being followed.

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.

Staff were responsible for the ordering, storage, administration, disposal and record keeping. Staff demonstrated they had a thorough understanding of the safe use of medicines. Medicines were stored appropriately. Temperatures of storage areas were monitored and recorded.

Stock levels were counted when new stock arrived and prior to medicines being administered. We observed medication being administered in accordance with people's preferences, needs and wishes. People's medicines were stored in a place of their preference; some people chose to store their medicines in their bedrooms. People had regular medicines reviews with their GP and staff demonstrated they worked in accordance with national guidance. (Stopping over medication of people with a learning disability and autistic people(STOMP) is a national NHS England work programme to stop the inappropriate prescribing of psychotropic medications).

Protocols for medicines taken on an “as required basis” (PRN) were in place and applied for those people requiring them, including clear instruction as to what, when and why the medicines could be given.