Wilkinson 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 requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

People were involved in care decisions and managing risk. There were sufficient trained and supported staff to provide people with care. The provider understood the importance of safeguarding people from abuse. Medicines were managed safely. Some aspects of the environment needed improving and cleanliness and infection control required further review.

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 registered manager had a good understanding of safety issues within the service and systems were in place to monitor any ongoing concerns. Where the service felt unable to contain issues, additional professional advice had been sought. People’s care plans contained good information for staff to follow to ensure care was safely delivered.

Staff told us they received a range of training to help them carry out their roles. They received regular supervision sessions and could raise any concerns freely. Records showed a good uptake of courses and that staff were up to date with most of the training required. Temporary and agency staff were given inductions to ensure they could carry out their role safely.

People told us they could raise concerns with the registered manager, and they would be looked into, and action taken, where possible.

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.

Staff understood their role in supporting people to access appointments. Records showed people had access to a range of health and social care professionals, when needed, although transport could be an issue at times. People were assessed before they moved into the service, and this information was used to develop care plans.

Professionals told us the service was responsive in supporting people as their care needs changed. Comments from professionals included, “I’ve been impressed that they review progress, and I have one resident who has moved up and down greater levels of independence and they have been given a chance to test their ability to identify where they want to get to in the future.”

Policies and procedures ensured a consistent approach to recording, understanding and acting on risks. People’s safety was a priority, and the systems in place supported this. Care plans contained detailed information on how to monitor behaviour and support people during acute events. They were detailed and reflected the physical and mental health needs of people. Staff had a good understanding of people’s health care needs, and were responsive to concerning situations, or when dealing with behavioural issues.

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 were safe from abuse. There was no evidence of bullying or harassment within the service. Safeguarding concerns were raised and dealt with accordingly. Safeguarding was taken seriously by the management and others. Safeguarding formed part of the induction and ongoing supervision with staff, who were confident how to report concerns, and who to.

The service had a safeguarding policy in place that was in date. Safeguarding records had been completed and demonstrated how incidents had been addressed. A professional told us, “The number of safeguarding issues and concerns have reduced significantly in the last few years, since the service was last in organisational safeguarding. We have been impressed by [registered manager], who is very responsive and communicates really well with our staff.”

People told us they felt safe living at the home, although there were some day-to-day tensions. Relatives felt their relations were cared for safely. One relative commented, “He seems okay. He’s safe there.”

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.

Risks to people’s health, safety and welfare had been assessed. This covered all key areas, including falls, nutrition, and skin integrity, along with individual identified risks. Risk assessments were sufficiently detailed, person-centred and effective at reducing risk. Safeguards were not unnecessarily restrictive, and people’s rights and freedoms were respected. Professionals felt staff supported people to manage risks. A professional told us, “I’ve been impressed by the willingness of the staff to work through problems with individuals.”

Records showed staff followed assessments to keep people safe. Staff knew people well and understood the risks people were exposed to. They told us they were kept up to date with changes in people’s needs. There was evidence in care plans people had been asked if they wanted to be involved in care reviews. Relatives told us they were involved in care decisions, as appropriate. One relative told us, “We are involved in decisions about care. But because of their age they are not in contact as much. They are able to make some of their decisions.”

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.

Whilst processes to manage the safety of the home were in place, there remained actions that needed to be followed up. Some items previously identified as requiring action remained in progress. This included the development of a gym and the provision of an allotment in the grounds. Upgrading the overall environment was ongoing. A professional spoke about the environment and told us, “I have seen a general improvement in the service overall. There is less odour now when visiting, the physical environment is better with garden areas, leisure areas and a gradual improvement in the furnishings.”

Environmental risk assessments were in place to protect staff and people. Risk assessments were thorough and well documented. Personal emergency evacuation plans were in place and staff knew what to do in an emergency to safely support people.

People were supported to be safe within the environment of the home. Appropriate restrictions were in place, such as keypad locks and window safety catches. However, the wider environment, including the grounds and perimeters, were not as well managed and presented some potential hazards. Where people’s freedom was restricted, applications had been made under the Deprivation of Liberty Safeguards (DoLS) or other legal frameworks.

The provider did not always make sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development, although they worked together well to provide safe care that met people’s individual needs.

Day to day staffing levels were safe and well-managed. Staff recruitment was undertaken safely. The provider carried out pre-employment checks centrally and new staff went through a comprehensive induction. This included face to face training, shadowing and competency checks. Staff files evidenced employment interviews and references being sought.

Staffing levels were safe, and there was a good skill mix of staff members allocated to shifts. It was not always clear from rotas that people’s 1:1 hours were effectively covered, although people told us they had access to staff support. There was an ongoing issue with having sufficient drivers on duty, to allow people to access the community and attend appointments. Staff confirmed there were sufficient staff on each shift to manage the home safely, although extraordinary events could stretch this and take staff away from everyday activities.

The service made use of agency staff and staff from other services run by the provider. The service received information about agency staff prior to them working at the home, to ensure they had the right skills to support people. Agency staff, and staff from other units, were provided with a detailed induction process, prior to starting work.

Most staff were transported from outside the immediate area, as recruitment within the local community was difficult. Staff told us this system worked well, although this added considerable time to their working day, and they told us they were not paid for this travel time.

The provider did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading or share concerns with appropriate agencies promptly.

Since the last inspection the provider had engaged a cleaning company to provide a service to the home. Cleaning staff attended the home for 4 hours per weekday. We saw 2 contract cleaners working around the building during the inspection. However, there remained areas of the home that looked dirty, and bathroom and toilet facilities upstairs needed improving and updating. The registered manager was aware of this and spoke about planned upgrades of some areas.

There was an infection prevention and control (IPC) policy in place to reduce the risks of people and staff catching and spreading infections. Staff had access to Personal Protective Equipment (PPE) when needed. Staff received IPC training as part of the required development programme.

The kitchen area was generally clean and tidy with food stored appropriately. On the first day on site, we noted one of the freezers required defrosting and cleaning. This had been completed by the second day we inspected.

Relatives told us they felt the home needed to further improve on its cleanliness. A relative told us, “They are all right. It’s not the best place in the world, not exactly. It never looks clean, although he seems quite happy.” Professionals also raised some concerns about the cleanliness and upkeep of the service. A professional stated, “They could do more with the cleanliness. It always looks a little unkempt.” However, another professional stated, “Previous concerns about the number of agency staff, infection control / cleanliness of home…. appear to have been addressed.”

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’s medicines were managed safely. The service had an effective electronic medicines administration system in place which highlighted any anomalies. The electronic system made closer scrutiny of medicines administration simpler and meant fewer errors. 

People told us they received their medicines on time. Care plans were in place. There were appropriate instructions for staff to follow when giving medicines. We observed staff carrying this out appropriately.

Staff received initial training, and regular competency checks of their practice, to ensure they were safe and confident. The provider’s policies regarding medicines were up to date and in line with good practice.

The clinical room was clean and tidy, and temperatures monitored. Controlled medicines were managed effectively.