Davenham Hall Nursing 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 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. If further investigations were required, these was completed and lessons learnt were shared with the staff team. We saw evidence of regular staff supervision to ensure positive feedback was received and any learning needs identified.

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. Pre-assessment processes and documentation enabled a smooth transition into Davenham Hall. We saw evidence of referrals to relevant professionals when required. For example, dietitian and speech and language services. One person’s loved one told us, “They did an assessment, and [name] moved the next day. I stayed at home with my relative because within an hour of arriving home from hospital my relative fell. Now my relative feels safe. The manager is a good manager, professional and attentive.”

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 was a safeguarding policy in place and staff were aware how to report any concerns, they were able to describe situations when referrals would be required and what safeguarding meant. One staff member told us, “I would immediately go to [Name] and the deputy, who is new to role but is very good.” Staff had all received safeguarding training. The provider was reporting incidents to the local authority and CQC as required.

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. Summaries of people’s needs were easily accessible on the electronic system, with an overview of the care and support they required. One relative told us, “My relative is safe and I have no worries, they’re doing their best.”

The provider did not always detect and control potential risks in the care environment. We observed several window restrictors where not the legal recommended standard and could be opened over the 100mm recommended gap and therefore people could be at risk of falling out of these windows. In one of the gardens, which was accessed by people, had a large fence which was unsafe. These concerns were shared with the provider, and they took immediate actions to change all window restrictors and to have the fence repaired.

Areas within the home environment were clean and presentable. We observed the dining room to be beautifully arranged ready for mealtimes. We observed the domestic staff working hard to ensure the environment was clean.

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 recruitment processes were in place with relevant checks of staff’s employment history, character, right to work, and checks with the disclosure and barring service (DBS). Staff we spoke with were very committed and passionate about the work they didat Davenham Hall. Staff had completed their mandatory training and had their competencies assessed when required.

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. We observed the home to be clean and presentable.However, on day one of the site visit we noted one of the communal areas to have a sticky floor. This can be a risk to people who have issues with their mobility. We raised this with the registered manager, and they investigated straight away, concluding the overuse of cleaning products on the floor. Further training and oversight were implemented.

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. We observed staff administrating medicines using the correct methods and following instructions, which were updated for people in their care files. One loved one told us, “I used to manage my relative’s medication, but they do it now and do tell us if there are any changes. The GP goes weekly.”