Wyndham Hall Care 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 assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 69 (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.

Systems were in place to ensure staff were aware of their roles and responsibilities to report incidents and accidents. Staff told us they knew how to report concerns about people’s safety. They felt able to raise concerns with the registered manager and felt they would be listened to, and action taken. Daily meetings were held with the registered manager or person in charge, these were used as opportunities to share any learning points to prevent harm to people. In addition, occasional, group supervision meetings were held with staff where accidents and incidents were discussed to share learning. The provider also had systems in place to share learning across their locations. The regional manager also cascaded learning with the manager’s they supervised.

Senior managers told us, incidents, accidents, complaints, compliments and audit findings were reviewed through governance systems, trend analysis and lessons learned discussions. Learning was shared with staff, families and external professionals to improve safety, quality and outcomes for people using the service.

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.

Feedback from people and relatives confirmed when people’s needs changed action was taken to get the right help and support. People who required hospital admission were supported by staff to ensure the transfer happened smoothly. Relatives confirmed when people had been discharged from hospital staff were aware of any new equipment needed to ensure people were safe. One relative told us “[person] is quite weak… they[staff] reviewed this and now they have a lower bed and a sensor mat in the room. The staff wheel [person] to the lounge so they can see they are safe.”

External healthcare professionals told us how the service worked well with them to support their visits to Wyndham Hall Care Home. They said communication was good and it was clear what they were required to do each visit. One healthcare professional told us, “Staff go above and beyond what I would expect”.

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 their relatives told us they were safe living at Wyndham Hall Care Home, comments included, “[person] is in very good care here and we can sleep easy”, “[person] is very safe here and they feel safe and comfortable” and I think it is a safe place to live. It is much better than the last home [person] was in.”

Staff told us they had received training on how to recognise abuse and had confidence to report any safeguarding concerns to the registered manager. We noted where safeguarding concerns had been reported to the local authority, the service worked in collaboration with them to ensure risk of harm was minimised.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act 2005 (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). The provider was aware of their responsibilities to apply to the supervisory body (local authority) when a person was not able to consent to live at Wyndham Hall Care Home and were not safe and free to leave. There were systems in place to monitor applications 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 were kept safe and the likelihood of injury or harm was reduced. We found written risk assessments were in place to assess likely hazards and how these could be reduced. For example, where people were helped to reposition, appropriate measures were put in place to minimise the risk of skin pressure damage. When required, two staff assisted people who required lifting equipment to help them move.

Where the service had recorded a person was diabetic, we found information was recorded about additional checks carried out to maintain their health. For instance, eye screening and foot care.

Risk assessments were reviewed regularly or when changes in people’s needs occurred, for instance following a fall. In addition, we noted clinical observations were made after a person had fallen. This process ensured their health did not deteriorate further and any concerns observed were escalated.

People who communicated with expressions of distress or signs of anxiety had care plans in place to support staff on what strategies to use to support them to feel safe and secure. Staff showed professionalism and patience when supporting people who showed signs of distress or discomfort. Feedback from relatives about family members who displayed distress was positive.

Relatives told us they had been reassured risks were identified, reviewed, and responded to, rather than ignored. One relative told us their family member liked to sleep on the floor, which initially caused concern and panic from the staff. However, the relative told us staff, “had to work out safe options…. [person] would lie down on the lounge floor or even in the dining room. They [staff] monitor [person] closely now and try to predict when they are sleepy… Everything is individually tailored to their needs.”

The provider 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.

We observed clinical waste items were not always disposed of appropriately. We discussed this with the registered manager who took immediate action to prevent a reoccurrence.

We found remedial action for hazards or faults in the environment were not always rectified in a timely manner. We discussed this with the registered manager and regional director who provided assurances to us and confirmed work had been booked to make the required repairs.

Maintenance staff undertook regular health and safety checks. We saw evidence all necessary routine maintenance and safety checks had been completed. The provider held up to date certificates for key safety systems, including gas safety, fixed electrical wiring, fire safety systems such as emergency lighting, alarms and extinguisher servicing, portable appliance testing (PAT), Legionella testing and lifting operations and lifting equipment regulations (LOLER) inspections for hoists and beds.

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 staff who had been recruited with robust recruitment processes. Staff recruitment files contained full and robust checks as required, including a Disclosure and Barring Service check (DBS). A DBS checks for criminal convictions and inclusion on lists of people who would be unsuitable to work with people at risk. A review of nursing staff records confirmed each qualified nurse was currently registered with the Nursing and Midwifery Council (NMC). Registration numbers and renewal dates were verified using the NMC online register and checked monthly. All staff held appropriate and up to date registration with no lapses identified.

There was a comprehensive training programme to develop and update skills, to meet people’s needs. Systems were in place to monitor staff compliance with training. The regional manager told us, “We are strict with our training.” Staff told us, “The training I receive is very helpful and gives me the knowledge and confidence to carry out my role safely and effectively. It helps me stay up to date with best practice.” Another member of staff told us they were “encouraged to be kept up to date” with training.

Feedback from people, relatives and staff , together with our observations, confirmed there were enough staff to support people. Comments included… “I think there’s enough staff. I’ve not noticed a lack of them, and we go in three times a week”, “There always seem to be staff around; we don’t have an issue with staffing”, We see the same faces mostly; the nurses are a stable band of staff” and “The same staff have been there for most of the time [person] has been there.”

We observed call bells were answered and when we observed an emergency bell was activated this was responded to very swiftly by staff.

The provider did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading. We found staff had access to personal protective equipment (PPE), such as gloves and aprons, however staff told us and we observed the stock PPE was located a distance away from many rooms. We discussed this with the registered manager and regional manager and have asked them to fully discuss this with the staff.

At the time of the assessment the service did not have a dedicated infection, prevention and control lead. This is a recommended best practice. The registered manager agreed a member of staff needed to be identified to lead on this and they would appoint a person.

However, we found the home was clean and laundry facilities were well organised. Comments from people and their relatives included, “I see the staff wear aprons and gloves when serving food and the home looks clean”, “Yes, it’s clean. There are always cleaners around with their trolleys” and “It is clean and hygienic and there is a nice feel there.”

Staff had access to policies and procedures to ensure they kept up to date with any changes in guidance. Routine audits were carried out to assess the effectiveness of infection control and prevention systems.

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.

People who required support with the administration of their prescribed medicines had support from staff who had been deemed competent by the provider. People’s medicines were recorded on an electronic system.

We received feedback from one relative about how medicines prescribed for pain and anxiety were effective, and their family member appeared settled and comfortable. Another relative explained staff reviewed and adjusted their family member’s medicines following previous difficulties related to distress and agitation, which resulted in a noticeable improvement. Relatives reported confidence medicines were reviewed in response to changes in need and resulted in positive outcomes for people

Comments about medicine included, “They let me know what [person] is on and on anti biotics etc”, “We know what [person] takes and what they are for and some creams”, “On time, they are very hot on that” , “They are really good at giving [person] the meds when they are supposed to have them” and “They give [person] meds and look after them.”

We observed medicine administration. We found people were supported by staff who demonstrated professionalism, patience and knowledge. People were given time to take their medicines. Where people demonstrated reluctance to take their tablets, staff ensured they returned to them at a later time to offer the medicine again.

People told us they received their medicines when they needed them. Some people were prescribed ‘as required medicines’, additional guidance was available for staff on when and how it should be administered.

Senior staff carried out regular checks on medication records, stock and procedures. We looked at stock records for medicines, including those which required additional storage requirements due to the risk of abuse. We found records were accurate and up to date. The areas where medicines were stored were clean and tidy.

We provided feedback to the provider about improvements which could be made to ensure people who required insulin were supported safely. On the second day at the home the clinical lead provided evidence this had been actioned.