Hunsbury 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 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.

The provider had systems and processes in place to ensure any safety events had been recorded, reported and investigated.

The provider had a internal reporting process where every serious safety event was reviewed by senior leaders.

The provider held weekly internal multidisciplinary team (MDT) meetings where safety events were reviewed.

The provider had an electronic reporting system and a dashboard to analyse safety events.

The provider did not always work well with people and healthcare partners to establish and maintain safe systems of care. They did not always make sure there was continuity of care, including when people moved between different services.

The provider had systems and processes in place to enable safe systems, pathways and transitions. For example, the provider completed a pre-admission assessment before people moved into the service, or transferring from another service operated by the provider as part of the provider’s rehabilitation pathway. A relative told us, “The transition went smoothly.”

However, we found the provider’s hospital grab sheets did not provide adequate guidance for professionals to enable a safe transition in an emergency and the grab sheet for one person did not have the correct information. For example, the address of the person was not correct.

Some personal emergency evacuation plans (PEEP) did not consider how to evacuate people in all potential circumstances. For example, a person’s PEEP did not consider the difference between a day and night time evacuation and from different positions in the service.

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 appropriately.

Staff had completed safeguarding training and understood what to do if they had any concerns abuse or neglect was occurring. A staff member told us they would look out for signs of abuse, for example, people becoming withdrawn, change in behaviour, bruising or injuries.

People and relatives told us they felt safe living at the service. A person told us, “Yes – I get all the help I need from them [staff]. A relative told us, “I feel my relative is relatively safe at the home.” Another relative told us, “I have absolutely no concerns what so ever, [relative] is safe and well cared for.”

The management team reported safeguarding concerns to the local authority as required and were able to describe the thresholds of the local authority safeguarding board decision making framework.

Where required, Deprivation of Liberty Safeguards (DoLS) authorisations had been applied for or authorised.

The provider did not always work well with people to understand and manage risks.

The provider used a risk screening tool to identify risks that people required support to understand and manage. However, we found that risk management plans did not mitigate all the risks we identified during our assessment of the service. For example, bowel health was not evident in a person’s risk management plan.

People, relatives and staff told us they had been involved in the development and review of their risk assessments. However, we found more work was required to involve people to manage their risks and record this.

The provider acknowledged the need to improve risk management plans and we returned to the service and was able to confirm these had been updated before the assessment concluded.

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 health and safety policies and all statutory compliance checks had been carried out by the provider or approved contractor.

We found the building had been well maintained, with some shower rooms being upgraded. The provider told us they were not satisfied with the standard of the work and that the contractor was onsite making improvements.

We found not all routine maintenance checks had been completed for one month due to the absence of maintenance staff. However, the maintenance team had carried these out for the current month, and the provider told us they would look at a contingency for the future.

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 were recruited in line with the provider’s safer recruitment practices and in line with best practice. The rota’s demonstrated that staff had been deployed at the service to meet the staffing requirements the provider told us were required to meet people’s needs.

Staff told us there were enough staff to meet people’s needs and the service was, “Safe”.

Staff received a range of mandatory training and service specific training to meet the needs of people, for example, diabetes training. A staff member told us, “You get more than enough training, some face-to-face and e-learning.” This meant staff were receiving appropriate training to meet people’s needs.

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 provider had infection control policies and we found the home was clean and odour free.

The provider had a cleaning schedule in place and we found the standard of cleanliness of the home reflected how often records indicated the service was being cleaned. A relative told us, “The home always looks clean and tidy including the garden.” Another relative told us, “I have no issues with hygiene for [person] or cleanliness within the home and gardens.”

We found that safe food practices were in place, for example, all open food had been labelled with the date the food had been opened.

Staff had received relevant training and had access to an adequate supply of PPE.

The provider did not always make sure that medicines and treatments were safe.

The provider had medicines policies and procedures and there were systems in place to ensure that people received their medicines as prescribed. For example, a regular medicines audit was carried out by a service lead.

However, we found some discrepancies during our assessment. For example, a medicine prescribed ‘as required’ (PRN) for pain relief did not have the required protocol, a prescribed medicated toothpaste was not recorded on a medicines administration record (MAR) and there was no guidance for staff for a variable dose of medicines for constipation. We raised these concerns with the provider and found these had been rectified on our return visit.

Staff received training and competencies to ensure they had the knowledge and skills needed to manage and administer medicines safely.