White Gables 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

This means we looked for evidence that people were protected from abuse and avoidable harm. This is the first assessment for this service under this provider. This key question has been rated Good. This meant people were safe and protected from avoidable harm.

This service scored 75 (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.

There were established processes in place to learn from events at the service. The registered manager and deputy manager regularly reviewed events and used a number of processes to feedback to staff on ways to reduce the risks of future adverse events. They used handovers, supervisions, emails and meetings to ensure learning from events. Staff we spoke with said they received debriefs when there was an adverse event and they felt supported.

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.

The registered manager and staff worked with external healthcare professionals to ensure when people needed support and care from outside agencies the referrals were timely and people received their care in the most appropriate environment. This meant some people were supported to have services come to them when it was difficult for them to attend outside appointments. When people needed support to go to appointments outside the service the registered manager and their team worked with relatives and health professionals to ensure appropriate transport arrangements were in place.

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 felt safe living at the service. Relatives told us they were happy with the way their family members were supported by staff. During our visits we saw people were treated with respect and care by the staff supporting them. The staff we spoke with understood their responsibilities in protecting people from any potential abuse. They felt able to raise any concerns they might have to the registered manager and know they would address them. We saw the registered manager had undertaken thorough investigations when issues were raised with them. They worked in an open way with people, relatives and the local safeguarding teams to address any issues raised to them.

Where people lacked capacity to make their own decisions the provider used the principles of the Mental Capacity Act 2005 to support them. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS).

A number of people were supported under Deprivation of Liberty Safeguards (DoLS), their records detailed information to show best interest meetings had been undertaken to support individual decisions around their care in the least restrictive way. This included when people were receiving covert medicines or if the use of bed rails to keep them safe were needed.

Staff had received up to date safeguarding training to provide them with the information they needed to both recognise and address any safeguarding concerns.

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.

The risks to people’s safety were well managed at the service. The care records we viewed showed people’s individual risks had been assessed and measures were in place to reduce the risks to their safety. Where people were at risk of skin pressure damage they had appropriate pressure relieving aids in place and when needed, people were supported to be repositioned in line with their assessed needs.

People who were at risk of falls or needed support with their mobility had measures in place to support them. These included the use of walking aids, good fitting shoes and management of any trip hazards. Where needed, people had sensor mats and call bells to ensure staff were available to support them with walking and there were enough staff to ensure a continued presence in communal areas to monitor people’s safety. Staff we spoke with showed a good understanding of how to manage the individual risks to people. One staff member said, “Different people need different support. Some people need support when walking or getting in and out of bed. Some people are unsteady but still try to walk and we need to monitor them and support them. We know people well and the information about their care is in the care plan.”

Throughout our visit we saw staff supporting people appropriately with their day to day needs. This included supporting people to eat and drink, or talking calmly with people who appeared confused or anxious.

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

People lived in a safe environment and the provider responded to any concerns raised to them from partner agencies regarding the environment. A recent inspection from the fire and rescue service had highlighted a number of concerns prior to our visit. We saw the provider had responded to the issues and worked to address these concerns. During our visit we saw there had been significant progress in addressing the concerns raised and the registered manager was committed to ensuring all work was completed in time for the follow up visit by the fire and rescue service.

The service was in need of some refurbishment in some areas and we saw there was an ongoing refurbishment plan in place. The plan showed different areas of the service had been prioritised in order of need and a number of areas had been completed.

Staff we spoke with took ownership of the management of equipment. One of the housekeepers we spoke with told us they checked equipment such as sensor mats, mattresses etc as they worked around the service. They told us they worked with the administrator and maintenance team to ensure any faulty equipment was withdrawn and replaced.

The provider used an electronic care recording system and staff were able to access this throughout the building to allow immediate recording of people’s care.

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 relatives told us there was enough staff to meet people’s needs. People were happy with the way the staff team supported them. One relative said, “The staff are always plentiful and they are happy and the residents respond to that.”

Our observations of staff interactions supported the comments we received. Throughout our -visits call bells were answered in a timely way and staff responded to people’s needs showing good knowledge of the care required.

Staff told us they felt there was enough staff to support people. One member of staff said, “One year ago I would answer differently. But now we have a brilliant team. Everyone just knows everything about the residents. Very rarely we have agency working – we are a really good team.”

The registered manager and deputy manager undertook weekend and night shifts to monitor staffing on all shifts. The manager told us this showed the staff they were available for support and helped them to ensure staffing levels were sufficient for people’s needs.

The service undertook safe recruitment practices to ensure people were supported by a safe and proper staff group. They used the disclosure and barring service (DBS) to check if potential staff had a criminal record and obtained references from previous employers.

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.

People were protected from the risks of infection as the provider had processes in place to reduce the risks of the spread of infection. There were up to date policies and protocols in place on the management of infection which were accessible to staff. All the staff we spoke with showed good knowledge of infection prevention practices, including appropriate use of personal protective equipment, hand washing and the safe handling of clinical waste and dirty laundry. Throughout our visit we saw staff following good infection prevention techniques in their everyday practices. Housekeeping staff did not leave cleaning trolleys unattended and when not in use hazardous chemicals were stored securely.

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’s medicines were managed safely by staff who had received appropriate training in the safe handling of medicines. People told us they got their medicines when they needed them. Where people required time specific medicines staff used alarms on their phones to ensure these were administered on time. When people were prescribed as required medicines there were protocols in place to provide guidance for staff to ensure these were administered safely and when people needed them. The registered manager and deputy manager had good oversight of the management of medicines, we saw there were robust auditing processes in place which supported this. The processes ensured if there were any medicines errors these could be highlighted quickly and addressed.