Walsingham Support - Langdon Park

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 inadequate. 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.

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.

At the last inspection we found evidence of unsuccessful fire drills and a failure to learn from these events and retraining staff. This was a breach of regulation 12 of the Health and Social Care Act 2028. Safe care and treatment. At this inspection we found improvements had been made and the service was no longer in breach of regulation 12.

At this inspection we found that staff had been trained in fire safety and successful fire drills had taken place. These informed people’s personal emergency evacuation plans (PEEPs) which were regularly reviewed and updated.

The manager reviewed accidents and incidents and promoted a culture of shared learning within the staff team. This meant that knowledge was shared to prevent the reoccurrence of adverse events and to improve the quality of people’s care and support.

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.

People’s needs were assessed before they moved into the service. This was to ensure the service could meet their needs and preferences. Before moving into the service people had the opportunity to visit and to meet people and staff. To support the transition of the most recent people to resettle into the service, their keyworker from their previous care home transferred with them. One relative told us, “I would particularly like to commend [staff member’s name], who transferred. They were instrumental in helping [family member] transition smoothly.”

This meant the provider ensured the continuity of knowledge and skills to safely support people.

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. One person told us, “I like living here. I don’t get bullied.” Another person said, “I’m not worried about nothing.” Staff received safeguarding training. The staff we spoke with understood their role in keeping people safe and their duty to inform the manager if they had any concerns about people’s safety. The provider had an up-to-date safeguarding policy in place which the manager and staff understood. Where concerns were raised the provider cooperated in subsequent investigations and shared the learning within the staff team and the wider organisation.

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 people’s risks and took action to reduce them. Care records contained risk assessments which covered a range of areas including falls and skin integrity. When required staff made referrals to healthcare professionals for specialist assessments and guidance. For example, when staff identified a choking risk, a referral was made to speech and language therapy for a swallow safety assessment. Staff followed their guidance by ensuring meals were prepared to the texture recommended, and people were seated in the correct posture when eating. This meant people’s risk of choking was reduced.

People were involved in their risk assessments and the least restrictive options were used to mitigate risks. For example, rather than use bedrails to prevent one person falling, a new bed which could be lowered, and a safety mat were acquired. This meant the person was protected from harm whilst maintaining their freedom of movement.

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

At the last inspection we found risks to people from an unsafe environment due to cleaning products not being locked away, fire doors being wedged open and loose radiator covers. This was a breach of regulation 12 of the Health and Social Care Act 2028. Safe care and treatment. At this inspection we found improvements had been made and the provider was no longer in breach.

At this inspection we found the environment of the service was safe. One relative told us the service was, “Clean, safe and suitable.” People were protected from the risks associated with accidentally accessing cleaning products. Staff ensured that items containing chemicals potentially hazardous to health were stored in a locked area outside of the main building. Radiator covers were secured in place protecting people from the risk of heat injuries. Magnetised fire doors were kept open to enable people to move freely around the service. These doors closed automatically in the event of fire alarm activation. Fire alarms were tested weekly and specialist contractors undertook specific checks at the service. These included checks of fire, water, gas and electrical safety. The meant the provider ensured people were supported in a safe environment.

At the last inspection we found areas within the service were damaged and in need of repair and redecoration. We found the environment to be unappealing. The failure to maintain a clean environment in a good state of repair was a breach of regulation 15 of the Health and Social Care Act 2028. Premises and equipment. At this inspection we found improvements had been made and the provider was no longer in breach of regulation15.

At this inspection we found the environment was clean and redecoration work had been undertaken. One person told us, “It’s clean.” We observed that two carpeted bedrooms were malodorous. However, the provider had already recognised this problem and a date for their replacement with more suitable flooring had been scheduled.

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 were supported by safe and suitable staff. The provider used robust methods when recruiting staff. These included interviews, taking up references, checks of potential criminal records and the confirmation of identities. New staff received induction and on-going training.

Since our last inspection the number of staff deployed at the service had reduced. One relative told us, “The thing I am concerned about at is the cut back of support staff.” A member of staff told us, “At times we have three staff [on shift] before we had five. This is a squeeze on us. You have to work harder.” The manager informed us that the reduction of staff is the subject of on-going consultation with funding authorities and increased one-to-one staffing had been agreed where it was assessed to be necessary. This meant there were enough staff available to keep people safe.

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.

At the last inspection we found an unclean environment at the service. This included unsafe and unclean food storage and preparation areas. This failure to prevent infection was a breach of regulation 12 of the Health and Social Care Act 2028. Safe care and treatment. At this inspection we found improvements had been made and the provider was no longer in breach of regulation 12.

At this inspection we found people were protected by safe food hygiene practices. Staff received on-going food safety training. Food in the fridge was stored safely and in line with published guidance. This included dating and labelling opened items. Staff followed a kitchen cleaning routine which was audited by the manager. Staff carried out temperature checks of the fridge, freezer and water from taps which were recorded and reviewed to ensure they remained safe. Guidance was in place for the actions staff should take if temperatures were not within safe ranges.

Hand gel was in place at locations around the service for people, staff and visitors to use. Staff received infection prevention and control training and wore personal protective equipment, including single-use gloves when providing personal care. This meant people were protected from the risk and spread of infection.

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.

At the last inspection we found people’s medicines were not administered, stored, secured or recorded appropriately. The failure to manage medicines safely was a breach of regulation 12 of the Health and Social Care Act 2028. Safe care and treatment. At this inspection we found improvements had been made and the provider was no longer in breach of regulation 12.

People received their medicines safely and as prescribed. Staff received medicines training when they began working at the service and on-going refresher training to ensure their skills and knowledge were up to date.

People’s medicines were stored in a locked medicines cabinet, and the keys were stored in a code-locked key safe. This prevented accidental and unauthorised access to medicines. Staff recorded the temperature of the medicines cabinet to ensure medicines were stored safely and in line with the manufacturer’s guidelines.

Staff maintained accurate medicines administration records (MARs). These showed that people received the right medicines at the right time. Individual MARs contained photographs of people to ensure the right people received the right medicine. The manager and deputy manager regularly audited medicines stocks and MAR charts to confirm their accuracy.

Where people received ‘when required’ medicines staff had clear guidance for their administration in care records. This included when to administer ‘when required’ medicine and the number of doses permissible before seeking medical advice. Where people required staff to apply creams, body maps in people’s MARs illustrated precisely where they should be applied.

People gave their consent before medicines were administered, and staff supported people to attend appointments with their GPs and consultants to review their medicines. This meant the medicines people received continued to be necessary and effective.