Wheldale Heights

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. This is the first assessment for this service. 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. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The registered manager maintained good oversight of accidents, incidents and complaints. Systems in place ensured robust recording and reporting of these. Thorough investigations were conducted when needed, and lessons learnt were consistently shared with staff. This supported continued learning and service improvement.

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.

Systems and processes were in place to work effectively with partners and ensure people were safely admitted to the service. The provider completed detailed pre-admission assessments to ensure people’s needs could be met prior to moving in. This process included meeting the person face to face. A “getting to know me” meeting was held with the staff team prior to a person arriving at the service, where information was shared to support a safe transition. Information was appropriately shared with other health care professionals and services when needed.

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 were safeguarded from the risk of abuse. Staff participated in safeguarding training. Safeguarding incidents were logged and appropriately reported to partner agencies, for example, the Local Authority and CQC. Where a safeguarding incident had occurred, this was included in relevant care plans to guide staff in supporting and protecting people.

Where people were subject to Deprivation of Liberty safeguards (DoLS) the provider had made applications to the local authority and there was clear monitoring in place. DoLS ensure if a person is restricted in a way that deprives them of their liberty in a care home, it is only done when it is in their best interests, is necessary for their safety, and all other options have been considered.

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.

Care records were accurate, up to date and reflective of people’s needs. People and relatives were involved, and there was a multi-disciplinary team approach to care, ensuring people’s complex health conditions were safely supported and monitored. Staff knew people well and were aware of their needs and risks. Risks to people were appropriately managed. For example, risks relating to falls and choking. People and relatives felt risks were managed and the service was safe. Feedback included, “I feel safe because they are all really nice people here” and “[Name] is safe because they are not just staff, they are [Name]’s friends.”

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

Systems and processes were operated effectively to maintain a safe environment for people to live in. The environment was clean, nicely decorated and in a good state of repair. There was a book where staff recorded any maintenance issues requiring attention, and the maintenance staff member did a daily walkaround to ensure any repairs were quickly identified and addressed.

Fire safety checks and drills were in place. Practice evacuation sessions were also facilitated, where staff used a mannequin and evacuation equipment, to simulate what they would do, to support people to leave the building, in the event of a real fire. Personal emergency evacuation plans were accessible and up to date.

Regular audits and equipment checks were in place to support safety.

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.

There were enough staff and they worked effectively together as a team. They were visible throughout the service and efficiently responsive to people’s needs. One relative told us, “[Name] is safe here because there is always somebody around.”

Staff participated in a wide range of training relevant to their role. This included specific training relevant to people they supported, for example, Huntington’s disease and brain injury training. Compliance with training was high and staff demonstrated their skills and knowledge in practice. Staff engaged in regular supervision sessions and an annual appraisal to support their role and development.

Staff were recruited safely and there was a robust induction programme in place to support new staff. One staff member told us, “I received an induction which included face to face sessions and e-learning. I shadowed [other staff] for nearly a week.”

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 service was clean, tidy and odour free throughout. Domestic staff were observed cleaning throughout the day to maintain cleanliness. There was an allocated infection, prevention and control champion, and audits were regularly completed to ensure any concerns were identified and addressed without delay.

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.

Medication administration records (MARs) had daily reviews by the clinical nurse manager to investigate any missed medicines from the previous day. Results were analysed and broken down in reports to show why these had not been given.

Staff had good knowledge of people and knew how they liked to have their medicines given to them. People that were given their medicines covertly (hidden in food or drink), did not always have up to date paperwork easily accessible on the electronic care system. However, when asked, staff showed evidence of getting further information from the relevant healthcare professionals to ensure people’s care plans were up to date.

People that were prescribed as and when required (PRN) medicines had in depth protocols in place that were person-centred and explained to staff how and when to give these medicines appropriately.

Body maps were in place for people that were prescribed creams. These showed where staff had applied creams previously, and the system forced staff to input locations before an application could be completed. Creams were stored in clinic rooms, separated from oral medicines. Fire assessments were in place for people prescribed paraffin-based creams, which also flagged on the MAR chart.

People who were prescribed patches had daily checks in place to ensure these were still intact on the skin. Evidence of patch rotation was also in place on the MAR system, to ensure these were being applied correctly for optimum effect and to minimise skin irritation.

Controlled drugs were stored and managed well, with twice daily checks being carried out by 2 members of staff. All stock levels checked on the day of the assessment were correct and accounted for.