Whitefield House

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 as good.

This meant people were safe and protected from avoidable harm.

This service scored 66 (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 said they felt confident in raising concerns, as they would be treated with compassion and understanding. People told us appropriate action was taken when concerns arose. One relative said, “There is enough staff and they are very good, take recently the GP altered the medication and they rang and said (they) had started night time pacing again, so they contacted the mental health team and got it thrashed out that the GP wouldn’t alter the medication again without checking, so (they are) back on what (they) should be and is so much better.”

There were systems in place for when accidents or near misses occurred, ensuring these were logged and regularly reviewed.

In addition, Prevention of Future Deaths Reports were obtained from the coroner’s website and utilised in team meetings as a teaching exercise. Managers and staff worked collaboratively to discuss measures they could implement to prevent such concerns arising at Whitefield House.

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.

Initial assessments were completed prior to people moving into the home. The Registered Manager collected information about people’s physical and emotional needs with input from external professionals, such as GPs and social workers. The Registered Manager also took care to gather people’s social history and preferences. This enabled staff to gain knowledge of the person, which helped them to settle into the home. The Registered Manager also explained they considered how a new person’s needs might impact those currently living there.

Upon admission, a detailed care plan was completed in conjunction with people and their families. Staff demonstrated a strong awareness of the risks to people across their care journeys. The approach to identifying and managing these risks was mostly effective. Some families told us about concerns they had during the admission process; however, these were promptly addressed once brought to the attention of management. One family member said, “They have dealt with everything we have raised, and we have no worries at all.”

The provider did not always effectively assess people’s ability to make decision around their care. They did promote people’s right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect.

Some people required Mental Capacity Act assessments; however, these were not consistently completed in full or were not always decision specific. This was raised with the management team whilst we were onsite, and they promptly planned to review all files. A sample of the reviewed and improved documentation has since been shared. These now clearly detail the decision required, the individuals involved, and the support provided to the person. Management reported they now had a greater understanding of what was required when completing capacity assessments and had sought further training.

Staff demonstrated a good awareness of safeguarding and whistleblowing policies. Staff and management felt confident in identifying potential safeguarding concerns, implementing appropriate action, mitigating risk, and keeping people safe. Without exception, staff told us that the management team was supportive and would quickly address any safeguarding concerns.

People who had authorised Deprivation of Liberty Safeguards (DoLS) had been referred to and assessed by the local authority. To prevent any lapses and maintain a clear record of who was subject to a DoLS, there was a robust system in place detailing when the next application for reassessment should be made.

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 had individual care plans and risk assessments in place relating to the care and support they received. People and their families were offered the opportunity to be involved in discussions around risk. One relative said, “I did the care plans and I do the reviews, they let you know about stuff, they are very good with all of that.” Where any risks were identified, plans detailed how these needed to be managed, with input from external professionals where appropriate.

Where people required support with assessments but did not have family available, referrals were made to advocacy services. This ensured their voices were heard by an independent professional.

Personal Emergency Evacuation Plans (PEEPs) were also in place for each person, detailing how they would need to be assisted to leave the building in the event of an emergency.

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 environment was decorated to a good standard and had a warm and inviting feel. However, we found windows were not always suitably restricted in line with guidance and some furnishings were not suitably secured which could pose a risk to people using the service. The registered manager arranged for these to be rectified immediately.

Essential servicing had taken place such as the maintenance of gas, water, and fire extinguishing equipment. Fire risk assessment had also been completed with an action plan that demonstrated required changes had been made.

The provider did not always make sure staff were suitably qualified and skilled. They did not always work together well to provide safe care that met people’s individual needs.

Although there were sufficient staff on duty, staff did not always carry out care in-line with their training. This meant care did not always meet their needs and put them at risk of increased harm.
Staff training in moving and handling was up to date, however, we observed some shortfalls in their practice which presented a risk of harm to people. For example, we observed staff using slings for people which they had not been assessed for.
When using the stand aid, staff were not consistently prompting people to push down through their legs to maintain safe moving and handling practices. This increased the risk of harm through injury and falls. Staff did not use the right equipment when transporting people through the home to maintain their safety. Feedback was provided to leaders during the assessment and plans were put in place to disseminate learning to staff.

There were enough staff on duty. People’s needs were considered via a dependency tool, and this determined staffing levels. Staff said they felt they had adequate numbers to safely deliver the care required in a person-centred way. One staff member reported, “No one is ever rushed; it takes as long as it takes." Relatives reported a staff presence when arriving at the home. One family member stated, “We looked around and chose this home. I see plenty of staff about and I have been in day and night.

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.

There was an effective approach to assessing and managing the risk of infection, which was in line with current relevant national guidance.External Infection Prevention Control (IPC) audits were completed against which the home scored highly. Staff also had annual training in IPC.

Observations that took place demonstrated effective use of Personal Protective Equipment (PPE). During mealtimes staff wore gloves and aprons, changing these as required. Feedback from families also contained comments linked to the consistent use of PPE. On relative reported, “Well it’s very good. I see plenty of staff when I go in, I do see them use their PPE and the place is always clean and tidy. Our observations further support this as it was noted that the home was clean, tidy and free from malodours.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

People did not always receive their medicines in line with manufacture’s guidance. For example, at the time of our visit there was not a robust system to ensure people who required medicines at a specific time, or before or after food, always had these medicines in line with those requirements.

People did not always receive their medicines in line with manufacture’s guidance. For example, at the time of our visit there was not a robust system to ensure people who required medicines at a specific time, or before or after food, always had these medicines in line with those requirements. We found systems for ensuring medicated patches were correctly rotated around the body to protect the skin from becoming irritated were not used effectively. Therefore, we were unable to satisfy ourselves that rotation was taking place. Some people had medicine they only required occasionally, or medicines which was prescribed at a varied dose, or topical creams. There was not always guidance in place to help staff know how to administer these medicines. However, where this guidance was in place the detail was sufficient and many people at the home were able to tell staff themselves. The provider was responsive to concerns we raised and took immediate action.

Medicines were correctly stored and people were receiving their medicines daily. We observed staff support people to take their medicines in a kind and patient way. Staff had suitable training and checks of their competency to administered medicines.