Hayward Care Centre

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 requires improvement. At this assessment the rating has changed to 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.

If incidents or accidents occurred staff recorded events on incident reports. These were reviewed by management at the service who made sure immediate actions were taken in response. The registered manager completed monthly analysis of incidents such as falls to monitor for any patterns or trends. The provider also had processes to produce data for incidents which helped all leaders have oversight of what was happening in services and follow up actions.

Staff confirmed they had information about changes to people’s care as a response to management reviews. Information was shared with staff in a variety of ways, including staff handovers and staff meetings. Comments from staff included, “Systems work well, we discuss as a team and share information about changes and why they need to happen” and “There is good information about learning from incidents, we always get updated.”

The provider shared learning alerts from events and incidents that occurred across all their services nationally and from other organisations. The registered manager said these alerts were emailed to the individual services so they could all learn and implement any changes to safe ways of working. Minutes from all health and safety meetings were also shared to enable different services to learn from events in all the provider’s services.

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 provider had systems to make sure information about people’s needs was shared when moving between services. If people went to hospital, important information was shared with emergency staff. When people were ready to be discharged from hospital, staff re-assessed their needs to identify any changes.

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 and relatives told us people were safe at the service. Comments from people included, “I feel very safe, because I have had no falls since I came here”, “I feel safe because they [staff] make sure I am safe moving about” and “I feel absolutely safe, the whole atmosphere and care is wonderful.”

The registered manager was aware of their responsibility to share safeguarding concerns with the local authority in a timely way. Systems were working well to make sure referrals were made and safeguarding cases monitored until closed. The provider also had access to all safeguarding information to make sure staff were taking appropriate action and CQC notifications were made.

Staff understood their responsibilities to report any safeguarding concerns. They had been provided with training on this subject and regularly had refresher updates. Staff were confident the registered manager would act when informed about any alleged abuse. One member of staff said, “I am confident action would be taken if any concerns were raised. There are no delays on anything with [registered manager], action is taken straight away.”

Where appropriate, leaders had applied to the local authority for Deprivation of Liberty Safeguards (DoLS) authorisations. Where they had been approved any conditions were being met. Leaders kept records of those applications waiting to be authorised and had notified the local authority of any changes to people’s circumstances.

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.

Staff assessed risks to people’s safety and produced guidance for staff to follow when providing care and support. Guidance was personalised and gave good details on what people’s risks were and safe ways to provide support. If equipment was needed this was included in people’s care plans. For example, if people needed moving and handling equipment to mobilise or if people needed pressure relieving equipment such as air mattresses. Guidance was recorded on how this equipment should be used and checked.

People and relatives told us they had any equipment needed to help mitigate risks such as falling. One person said, “I have a walker and a wheelchair and they [staff] always take me to where I want and need to go. They are very careful like that.”

Records demonstrated risk management plans were reviewed monthly or sooner if people’s needs changed.

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 provider had processes to make sure all equipment, and the premises were regularly maintained and checked for safety. This was completed by internal and external maintenance workers. Regular health and safety checks for areas such as fire, emergency lighting, hoists and lifts were completed and recorded. People living at the service had maintenance workers employed by the provider who were available to support them with any minor maintenance requests in their rooms.

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 had been employed safely with all required checks being completed.

We observed there were sufficient numbers of staff to meet people’s needs safely. Staff were available to respond to people in a timely way and had time to support people without rushing. The service used a dependency tool to calculate numbers of staff needed, however, the registered manager said they also calculated numbers based on feedback from people and staff. If needed, additional staff were added to the rota to cover busy periods. Whilst we observed there were enough staff to safely meet people’s needs, for 1 person there were not enough staff to provide them with care and support in line with statutory guidance. For example, the person had not been supported to go out into their local community and use services for activities they enjoyed. We shared this feedback with the provider.

People told us they had enough staff to respond to their calls for assistance when needed. Comments from people included, “Lots of them [staff] about, call them with my bell and they get along quite quickly” and “Never have much of a wait for help. Seem to be enough people [staff] around.”

Staff feedback about staffing numbers was mixed. Some staff said there were enough of them to provide timely support, however, some said there were times during the day when there were not enough staff. However, no staff said they felt the service was unsafely staffed.

People and relatives said the staff were well trained. Comments included, “They [staff] are well trained, and they know how to look after me” and “They [staff] are well trained and do things properly.”

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 and well maintained throughout. People and relatives told us they were very satisfied with the cleanliness of their rooms and communal areas. Comments from people included, “They [staff] clean my room very well. The rest of the building is spotless”, “I like the cleaners, they talk to me, and they keep things spick and span” and “It is exceptionally clean, and the building is well looked after.”

Staff had training on infection prevention and control during their induction and had regular refresher training and checks of competence. For example, staff were checked for competence to wash their hands thoroughly.

Regular infection prevention and control audits took place to monitor for compliance in this area.

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.

Records demonstrated people received their medicines as prescribed. Staff had completed medicines training followed by assessments to check their competency. Medicines-related competencies, audits and incident reviews were available and demonstrated good compliance. Weekly medication meetings supported reflective learning and improvement.There was appropriate monitoring for medicines which required higher scrutiny, and risk assessments were in place where appropriate. Body maps were available and appropriately completed for people using topical applications such as creams.

Medicines were stored safely, fridge temperatures were consistently recorded, and room temperature monitoring was in place where required.

People told us staff gave them the support they wanted to help them with their medicines. Comments from people included, “They [staff] come along and bring my stuff [medication]. They are careful to wait until I’ve taken it” and “They [staff] give me my tablets on time, and I do know what they are for.”