White Gables Residential 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. This included when incidents and accidents had happened. Lessons learned were documented and shared with staff in meetings and handover. Staff confirmed they were updated when changes had been implemented.

There was a duty of candour policy in place, and this was understood and followed where required.

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.

Prior to people moving into the service a needs assessment was undertaken, with the input of the person and their representatives, where appropriate. This was to ensure people’s person-centred needs could be met. These assessments were used to inform care plans and risk assessments.

A summary of people’s care plans could be downloaded from the electronic system to share with other professionals, for example if a person required hospital admission, to ensure continuity of care.

A person’s family member told us how the staff had worked with them to support their family member to move into the service, after they had waited for a room to be available. They told us how the staff had suggested arriving later in the day, which allowed their family member to have lunch and meet other people while the relatives moved their belongings in. The relative said the process was, “Seamless, so [family member] was having a nice lunch while we were dashing about, [family member] was having fun.”

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.

Staff had received training in safeguarding and understood their role and responsibilities in identifying and reporting concerns of abuse. Information was on display in the service relating to the provider’s safeguarding procedures. As well as safeguarding policy and procedure, there was a whistleblowing procedure in place.

Safeguarding concerns were documented, including lessons learned to reduce future risks.

People told us they felt safe in the service, this was confirmed by people’s relatives. We observed people were clearly comfortable in the presence of staff and they confirmed they would speak with staff if they were worried about their safety.

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 were assessed and measures put in place to reduce them. These included risks associated with falls, pressure injury, nutrition and hydration. There were no people in the service with pressure ulcers. Where people were at risk of falls equipment was put in place to help reduce them, this included the use of crash mats at the side of beds and pressure sensor mats which alerted staff if a person was attempting to mobilise independently. There was no one living in the service who had been assessed at risk of choking; however, staff were aware of referring to speech and language therapy team (SALT) should this be required. People’s choices and independence were respected to ensure people could participate in the life they chose to.

Staff received training in moving and handling and we observed staff supporting people to move position safely, including when using equipment.

A person’s relative told us they could go on holiday knowing their family member was cared for, “I know [family member] is safe, I trust them, that is a big thing.”

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.

Checks were undertaken in the environment to reduce risks to people, this included fire safety, electrical, portable electrical appliances, and window restrictors. Fire drills were undertaken to ensure staff understood their responsibilities in case of a fire. Emergency contacts were displayed on the office wall and included details of the on-call duty in case of an emergency, when management were not in the service.

Mobility equipment was checked and items such as hoists and the lift were serviced as required.

Records demonstrated where staff had identified risks and the need for repairs, this was documented, as was the actions taken to address them.

Risks were monitored and addressed by the management team and the maintenance staff. We noted a bathroom was out of order on the first floor, a member of staff told us a new bath was needed, and the door was locked, however, we found it unlocked, this was addressed immediately. There were sufficient bathrooms and shower rooms available whilst the bath was not being used. There was a programme of refurbishment planned, including redecoration and new furniture. Areas for improvement in the environment were being listed and shared with the provider, with new items being purchased.

There was a set of stairs which were steep and curved which held a door at the top and gate at the bottom which were not accessed by people using the service. However, the top door was unsecured and if opened by a person, there was risk of falling down them. This was immediately addressed by adding a keypad on the door, so mitigating the risk. In addition, risk assessments were undertaken to each set of stairs in the service

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 told us they felt there were enough staff who were available when they needed them. This was confirmed by people’s relatives. We saw staff were attentive to people’s needs and responded to requests for assistance promptly. Staff, although busy, had time to spend with people to chat and listen to their views.

Staffing levels were determined by people’s dependency needs, and this was kept under review by the provider and management team. Staff told us there were enough staff to meet people’s needs.

Staff received training relevant to their role. Staff training was kept under review to ensure training was completed as required.

Staff told us they felt supported and worked together well as a team. Without exception staff told us they felt supported in their role. The registered manager was in the process of considering how to improve staff supervision, to keep staff interest and encourage participation, such as smaller group supervision, as well as individual.

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 service was visibly clean. We spent some time with the head housekeeper who explained the infection prevention and control (IPC) processes including cleaning schedules, all of the information verbally shared with us was also provided in records. Cleaning schedules demonstrated the service was routinely cleaned throughout, including deep cleans and touch points. Guidance was in place for staff responsible for cleaning, including colour coded equipment to reduce the risks of cross contamination. Staff had signed records to show when cleaning had taken place. Specific cleaning materials and equipment were in place and available should there be an outbreak of infection.

Mattresses, pillows and bedding was routinely checked and laundered or replaced when needed. Mop heads and toilet brushes were cleaned and replaced regularly. Checks and actions such and descaling and running water from little used outlets, were undertaken by both housekeeping and maintenance staff to reduce the risks of legionella bacteria in the water system.

Personal protective equipment (PPE) was available for staff, and this was used appropriately, including gloves and aprons.

The registered manager told us they were a member of the IPC electronic information sharing group, so up to date information was received and used to drive improvement.

The provider made sure that medicines and treatments were mostly safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. However, we noted on our first visit a pot of medicines in a person’s bedroom which had not been taken. We discussed this with the deputy manager and noted Immediate action was taken. Guidance shared with staff of the importance of ensuring medicines were taken by people and not left. We were assured actions were taken to mitigate risks going forward.

Medicines were securely stored and systems in place for ordering and disposing of medicines safely. Records showed people received their medicines when they needed them. Monitoring systems including audits supported the management team to identify any discrepancies and take action to keep people safe.

Staff responsible for supporting people with their medicines were trained and their competency assessed. Risk assessments relating to people’s medicines were in place and measures to reduce them, this included protocols in place for medicines to be given as required (PRN).

People told us they were satisfied with how they were supported with their medicines.