Weald Hall Residential 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 inspection we rated this key question good. At this inspection the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 63 (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 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. The manager shared learning with staff from incidents, accidents, complaints and safeguarding so that the service could continually improve and develop positive outcomes for people. Information was shared with staff through handovers, memos and staff meetings.
The manager completed daily walkarounds of the service. This enabled them to maintain oversight of the quality and safety of care being provided, identify any issues promptly and engage with people and staff throughout the day. These walkarounds provided additional opportunities to monitor practice, address concerns and ensure any actions required were followed up in a timely manner.
 

The service 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. Before people came to live at the service the manager completed a full assessment of their needs to ensure they could be met by the service. People and their relatives had an opportunity to visit the service before they moved in to see if it was a place they would like to live. The manager liaised with other healthcare professionals to ensure people’s healthcare needs continued to be supported. A relative told us, “We had an assessment completed before [relative] moved into the home. They asked us questions to get to know [relative]. We are fully involved in the care plan and any reviews.”

The service 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. However, the service did not always share concerns quickly and appropriately.
The manager had been raising safeguarding alerts with the local authority however; there had been occasions whereby safeguarding notifications had not been sent to CQC as required. Providers must inform CQC of all incidents that affect the health, safety and welfare of people who use services. Following the inspection, the manager sent the relevant notifications retrospectively to CQC.
Staff had received training in safeguarding and knew how to raise concerns. A member of staff told us, ''I know how to report any form of abuse, and I would take immediate action. I would know who to report to and I would continue to escalate further to the Local Authority if I needed to.'' Staff could recognise signs when people experienced emotional distress and knew how to support them. For example, a member of staff told us they would know what to say and how to support a person's distress when they became anxious.
We received positive feedback from people and relatives. A person told us, “I feel very safe here. Staff are around if I need anything.” A relative told us, “The staff always keep us up to date with any changes and are very responsive.”
 

The service did not always work well with people to understand and manage risks. We found some examples where care plans and risk assessments lacked detail. For example, there was no care plan in place for a person who had epilepsy. This meant staff did not have clear guidance on how to support the person’s specific needs, recognise early warning signs, or how to respond appropriately in the event of a seizure. Following the inspection, the manager ensured all care plans were up to date and contained accurate information.
However, we found staff provided care that met people's needs in a safe and supportive way and enabled them to do the things that mattered to them. Staff identified risks to people and put safeguards in place to mitigate these risks. For example, where people were at risk of falls the manager worked with them to understand the risks and what were the best ways to reduce this risk. Staff were aware of preventative measures they could promote, such as encouraging people to stay hydrated and nourished to minimise the risks of infections or pressure ulcers. People were supported to live full lives and this included going out into the community safely.
 

The service did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.
The environment had been adapted to meet the needs of people living at the service. There were spacious communal areas where people could relax and participate in activities comfortably, and people had access to outdoor spaces and gardens. People had their own bedrooms and specialist equipment was provided where required. Maintenance staff were employed to help ensure the premises were safe and well maintained, and systems were in place to record and respond to maintenance issues promptly.
However, during the inspection we found some wardrobes had not been secured to the wall, which posed a potential risk of injury. We also observed that a number of wardrobes, although secured, had excessive items stored on top, creating a risk of objects falling and causing harm to people. Following the inspection, the manager took prompt action to address these concerns and provided assurance that wardrobes had been secured, and items stored on top had been removed.
 

The service had enough staff with the skills and experience to meet people's needs, and staff told us they received support and opportunities for development. The manager had processes in place to support staff through induction when they commenced employment.
Appropriate recruitment checks were carried out before staff started work, including obtaining references and Disclosure and Barring Service (DBS) checks. However, we identified gaps within some staff records. For example, employment histories were not always recorded accurately or detail to provide a full account of staff's previous employment. References received had been obtained and verified, however, there was no formal audit of staff files in place to identify and address gaps in recruitment documentation.
Supervision arrangements were not always consistent. Not all staff received regular support in the form of a supervision. Where supervision records were available, these were not always meaningful and lacked sufficient detail regarding discussions held, actions agreed, objectives set, or follow-up arrangements. Following the inspection, the manager told us they would introduce a new supervision process to ensure supervisions were meaningful, reflected discussions held with staff, and included clear actions, objectives and follow-up arrangements.
During our inspection we did not identify any concerns regarding staffing levels. People received support in a timely way, call bells were responded to promptly, and staff were available throughout the home to meet people's needs.
 

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Staff had received training in infection and prevention control, and the provider had policies in place for staff to follow, should there be any outbreaks of infectious diseases. The service had regular cleaning schedules in place and staff had personal protection equipment (PPE) available for their use. The manager carried out regular checks and audits to monitor the cleanliness of the service.

The service 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 did not support people with medicines until they had completed the required training, and medicine competency assessments were completed. People had care plans and risk assessments in place which detailed what medicines they were prescribed and how they liked to be supported. Protocols were in place for medicines prescribed on an as required (PRN) basis. Where people received covert medication, clear guidance and appropriate authorisation processes were in place to ensure medicines were administered safely and in line with best practice. The manager and deputy manager carried out regular audits and where discrepancies were noted these were investigated to identify the cause and any actions needed.