Hawksbury 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 the last inspection we rated this key question requires improvement. At this inspection the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 78 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a strong learning culture that supported continuous improvement. Lessons were always learnt to continually identify and embed good practice. Staff were encouraged to reflect on their practice and share lessons from incidents and feedback. Staff actively listened to concerns about safety and thoroughly investigated and reported safety events. The management team demonstrated an outstanding culture of learning and continuous improvement. For example, the new registered manager and deputy manager had identified communication between teams would benefit from strengthening and introduced inter-department meetings, improved systems for staff to share information about incidents and put in place a range of champions who oversaw different aspects of people’s care such as oral health. They then shared lessons learnt not just with the team, but the other services the provider ran. Professionals praised the team’s knowledge and responsiveness. Staff described feeling listened to and involved in shaping practice. A staff member said, “I feel able to express myself openly and confident that my input is acknowledged and respected.”

Systems were in place to manage risk and ensure safe care. Risk assessments were completed and reviewed, and staff worked with healthcare professionals to respond promptly to changes. One staff member said, “I feel that risks are managed effectively, and no measures are implemented unless they have been properly risk assessed. We would never place staff or residents at risk of harm, and ensuring safety is always a priority.” People experienced safe and well-managed transitions between services. Staff worked collaboratively with healthcare professionals to ensure changes in people’s conditions were addressed promptly and safely. Care records were person-centred and supported continuity of care. Relatives generally felt informed. One relative told us, “The staff are really good at letting me know about any changes in [person’s] health or care needs.”

Staff worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. People told us they felt safe living at Hawksbury House, and staff understood their safeguarding responsibilities. Staff who raised concerns reported: “Safeguarding matters were taken seriously and dealt with in a timely and appropriate manner”. Relatives confirmed they had no safeguarding concerns, with one saying: “We have never had any safeguarding issues or had any concerns at all.” Records showed deprivation of liberty safeguards (DoLS) applications were made where required and any conditions were followed. The staff had recently refreshed their training on capacity and best-interest decisions.

Staff 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. Risk assessments were in place. Care plans were person-centred and involved people and their families in decision-making. Staff said: “We include them in their care plans and make them as person-centred as possible. We also include the families and other professionals.” Relatives appreciated being consulted, and people confirmed they were asked about their preferences and felt listened to.

The provider detected and controlled potential risks in the care environment. Environmental risks were assessed and addressed. They made sure equipment, facilities and technology supported the delivery of safe care and worked with external professionals to review people’s aids. Since our last inspection the provider had made improvements, including provision of additional lounges, seating areas and a shower, updated fire signage, improved lighting and reorganised storage areas. The provider was refurbishing the laundry to improve infection control. People were supported to be as independent as possible within the environment. The staff team knew who to contact when people might benefit from additional aids or equipment. Staff were trained to use any equipment people needed.

Staff worked together well to provide safe care that met people’s individual needs. The provider ensured enough staff were on duty to meet people’s needs. However, relatives and staff noted occasional pressure points, particularly at mealtimes but we found the management team had recognised this and constantly reviewed staff deployment. One staff member said, “I am able to manage my time effectively to ensure tasks are completed. If I feel unable to complete something, I am comfortable seeking support from both of my managers, who are helpful in addressing this. The administrative team and senior staff are also very supportive, and when assistance is requested, they help as much as possible.” People confirmed there were always enough staff on duty. Recruitment practices were meeting requirements, and the new administrator had reorganised the files to show they clearly met the regulatory requirements. People were actively involved in recruiting staff. The provider promoted a learning culture and ensured staff had access to a wide range of training. Staff had received mandatory and condition specific training. Staff supervision sessions were completed in line with the provider's policy.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Staff followed to infection prevention and control protocols, including appropriate use of personal protective equipment and regular audits. An infection control champion carried out daily checks and liaised with the management. Domestic teams completed frequent touch-point cleaning, and staff received annual IPC training and refreshers. The provider was redesigning laundry facilities to improve separation of clean and dirty areas, supporting better infection control.

Staff made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff who administered medicines had the appropriate training and competency checks. Staff worked closely with the GP and pharmacist to make sure medicines were managed appropriately. The provider had introduced an electronic medicines management system, which was closely monitored and found to enhance safety and efficiency. Staff were knowledgeable about medicines processes, and relatives confirmed they were informed about any changes: “I am informed about any changes in medications or problems and voice any concerns I have.”