Deben Willow Care

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 72 (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 learn lessons from incidents, complaints and safeguarding concerns so they could be analysed for patterns and trends. The leadership team were open and transparent about incidents and accidents that occurred, they were recorded and reported appropriately. Learning from when things went wrong was shared by the registered manager with the wider staff team to prevent reoccurrence.

Staff were confident in the leadership team and felt confident that concerns raised by them would be listened to. Staff told us their learning was continuously updated and best shared to ensure people’s changing needs were met.

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.

There were effective systems in place to ensure people’s needs were assessed before they started using the service. Where possible the registered manager worked with partner agencies to facilitate a planned transition. People had care plans and risk assessments which were based on the assessments completed and these were reviewed and updated when needed.

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 comfortable in the company of the staff. One person told us, “I feel very safe with them. They’re such nice people” Another person said about their experience, “Its fine, very good. They [staff] know what they’re doing

Staff had completed safeguarding training and were able to give examples of a safeguarding situation. Staff were able to tell us how they would report any concerns within the organisation. However, some were less confident as to how they could report concerns to external organisations. We discussed this with the registered manager who advised us of actions they would implement to address this. Staff were confident the management and office staff would take appropriate action if concerns were raised.

Records showed that the provider has reported safeguarding concerns to the relevant authorities and where applicable had cooperated with investigations and conducted lessons learnt to prevent reoccurrence.

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 told us they had been involved with their care planning and they were supported by staff who understood any risks associated with their care. One person commented, “I can’t walk as well as I used to, and my balance is very bad. They’re [staff] that bit more careful now; let me do what I can but are nearby in case I look as if I might fall.” A relative shared, “Most of them [staff] know a bit about Parkinson’s and a few seem to have been reading up and are now quite knowledgeable and so are better at recognising risks.”

Staff understood people’s individual risks. Risk assessments and care plans were in place to guide staff on how to support people safely. People told us staff followed these to ensure they were supported in a safe way. Risk assessments were reviewed on a regular basis to ensure the information was accurate.

Staff shared instances where they were alert to changes in people’s needs and had acted to keep people safe. This included contacting the office to arrange a care review of the person’s needs, from a healthcare professional such as district nurse, GP or occupational therapist for specialist advice.
People’s care records provided the information to ensure people’s needs were met safely and reflected their involvement. Where we found some inconsistencies, such as duplication, details missing, we shared this with the registered manager who took action to address this.

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

Risk assessments were undertaken of a person’s home environment before the care package commenced. This ensured both the person being supported and the staff team were safe from any potential hazards or risks.

Improvements were needed to ensure consistently safe staffing arrangements were in place. The registered manager was taking steps to address the inconsistencies found but these need to be fully embedded into the service and at the time of this assessment it was too early to determine their effectiveness.

There was mixed feedback from people and relatives about visit times. Some shared positive experiences where they had a regular care team who knew them well and provided care and support in line with their individual needs. One person said, “It’s been 2 weeks and so far its fine, very good. They [staff] know what they are doing. Same team, they’re kind, happy. We have a little chat.” Whilst others shared that they had to wait a long time or the staff arrived too early. Several people said they received a reliable service in the week but weekends could be disruptive with different staff coming. Comments included, “Time keeping is generally poor,” “Its fine in the week, but weekends they’re [staff] always changing and they never seem to know what to do.”

Nearly all the relatives and people that we spoke with said they did not know who to routinely expect and were not informed of changes to their planned visits in a timely manner. The registered manager had identified this as an issue and recently implemented a two week rolling rota that was shared with people and relatives reflecting visit times and who to expect and when. The registered manager sought feedback from a number of people about this and shared that it had been well received. This was not yet fully embedded into the service at the time of our assessment.

We found gaps in the recruitment records for some overseas workers. Some documentation was not in English and was unclear if it related to evidence of a worker’s references or their training certificates. The registered manager took action to address this by ensuring an overseas police check was implemented with immediate effect and where required additional monitoring/supervision for staff if needed.

The provider’s systems to track missed visits and late visits did not always fully reflect where issues had occurred and the actions taken to prevent reoccurrence. The registered manager had made recent changes to strengthen the processes. This included daily checks by office staff to identity and respond to any issues quickly and weekly reports to monitor themes and trends.

There were enough staff employed, who had received relevant training and ongoing support in their role through supervisions, appraisals, competency checks and team meetings. Staff told us they felt supported and there was opportunities for professional development and they would recommend working for the service. One member of staff shared, “I am still new to the company, training was good, relevant to the role, but it’s a lot to take in. We covered a lot in the induction and I am still learning about the people and the company before I take on any more.” Another staff member said, “I would recommend working for this service. It can be challenging work, but it's incredibly rewarding. The team is supportive, and there's a strong emphasis on compassion, professionalism, and making a real difference in people’s lives. There’s also a good structure in place for training and development, which helps you feel confident in your role.”

People told us that overall staff interactions were positive and meaningful and not just task orientated, with the majority of staff engaging with them. However, some people told us that there was a language barrier with some staff and this impacted on the level of conversation they could have. One person shared,” I sometimes struggle to understand what they are saying to me and have to ask them to repeat things over. I know my hearing isn’t as good as it used to be, the accents are hard to understand and sometimes they don’t know the names of things.” The registered manager had identified this as a priority when they first started and explained they had made changes to strengthen the induction process for staff on an overseas visa to support their cultural integration. This included practical workshops on making toast, preparing snacks and using the microwave to heat up meals, as well as understanding local dialect and expressions to aid understanding.

The provider assessed and managed the risk of infection. People told us that care staff wore Personal Protective Equipment (PPE) when providing personal care. One person said the staff wore, “Gloves and aprons all the time, masks only if either me or them has a cold.”

Where it was agreed in people’s care arrangements the staff supported people to keep their homes clean. Staff confirmed they had received appropriate training and there was enough PPE available for them to use. This was monitored by the management team who completed spot checks.

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 told us they received their medicines when needed and staff recorded electronically what had been administered onto their handheld devices. One person commented the staff, “Get my tablets ready for me in the morning.” Another person said the staff, “Check carefully and record it on their machine.” A third person described how the staff administer their medicines and, “Always make sure that I take them all.”

Staff told us they had received appropriate training and had their competency to administer medication regularly checked by the management team. A member of staff said, “The medicines training was really good. I think the system we use is safe; provides a safety net in that it alerts [office] staff if there are any issues straight away, no delays. If a carer has not done the meds the office staff will be alerted and can follow up. The training was relevant, it helped me with my confidence, explained how to give people their medication safely, how to record what you have given and also to record if a person has declined.”

Care plans and risk assessments were in place to guide staff. This included information for care staff on when they can give ‘as required’ medicines such as when people expressed pain.

The provider had systems and processes for the safe management of medicines. Regular medicines audits were undertaken by the registered manager and actions taken in the event of any errors or discrepancies being identified.