Webb 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 75 (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.

Staff felt comfortable to report any accident, incident or concern. The managers encouraged an open and honest approach to reporting which supported staff. There was a simple process to follow to record accidents and incidents. This included a review by the managers and the senior managers to ensure appropriate actions were taken to reduce any immediate risk along with steps taken to prevent a reoccurrence. Lessons learned were discussed and put into practices to keep people safe in the future.

For example, when it was noted that 2 people were clashing with each other it was agreed with both that a change in accommodation would provide more space for each other. This action has improved the dynamic and interaction between them and reduced incidents that were occurring.

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.

Any new admission to the service was considered on an individual basis and took account of the person’s needs and those of people already living at the service. People’s move into the service was fully planned and included a transition plan that was agreed with them, their families and professionals involved. This planning fully considered how best to facilitate a safe and considerate move that supported welfare of people and their families. This included emotional support and transitions that included short stays to allow time for people and families to adapt. All appropriate equipment was also sourced before admission. A relative who was planning a person’s admission to the service praised the managers on how they were handling the process. “They are so sensitive to our feelings, recognising how difficult it is for us all. We have a 6-week plan for admission that is very personalised.”

Hospital passports were used to share information should people be admitted to hospital. This set out important information for hospital staff to understand people’s individual needs including their daily routines. Staff accompanied people on appointments and hospital stays to promote safety and comfort for people.

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 were confident that people were protected and safe. We saw people were comfortable with staff and sought them out to spend time with them. A relative told us, “I don’t worry about them now, their gran does not worry now either. We trust the staff completely. We feel so lucky that they live here.”

Staff told us they had received training on safeguarding. They were aware of the need to report any concern quickly and to be aware of different types of abuse. They had access to the service’s whistleblowing process if needed, which had been placed in an area that facilitated private access. This process allows employees to report serious wrongdoing, within their organisation without fear of reprisal.

The managers understood their role in raising and managing safeguarding concerns and making referrals to the local authority for investigation and resolution.

Staff had received training on The Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS).

Staff ensured they were working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty. The documentation supported that each DoLS application was decision specific for that person. The registered manager was currently reviewing all DoLS and their associated records. A systematic recording system was now in place to allow a robust oversight.

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 had individual risk assessments and care plans that provided information on strategies for staff to follow to keep people safe and reduce the risk of possible harm or distress. These considered the person's environment, care, support, medicines and activities. Staff were knowledgeable about the people they supported, and the risks associated with their care.

For example, some people were at risk of choking. Staff had worked with a Speech and Language Therapist (SALT) to ensure any risk was fully assessed and responded to. Clear guidelines confirming the texture of food and support people needed were recorded within the care records and we saw these were followed by staff.

Risk assessments supported staff to manage identified risks whilst ensuring people's rights and independence was promoted and respected. Positive risk taking was supported and encouraged in line with the principles of right support, right care, right culture to help people complete tasks they wanted to do, including cooking. When one person was unable to use their push call bell an alternative air pressure bell was sourced enabling the person to call staff when needed.

People had individual emergency evacuation plans in place which highlighted the level of support they required to evacuate the building safely in the event of an emergency. As the occupancy of the service changed the managers agreed to ensure a suitable system to alert emergency services of the accurate occupancy when required.

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

Webb House was purpose built and provided disabled access throughout and adapted facilities for bathing. Corridors were wide and fitted with handrails to support people’s independent mobility. Equipment that was used to support individuals to maintain their posture and mobility was maintained and all required checks were undertaken to ensure continued safe use.

This included wheelchairs, overhead hoists, bath and bath aids. Any lifting equipment was checked on a regular basis by an external company.All certificates relating to gas, electricity and legionella were in place and in date.

Safety checks had been carried out on fire safety equipment, and a fire risk assessment had been completed. Routine environmental safety checks were completed although records did not support all checks completed. This was taken up by the managers to improve record keeping.

One person’s bedroom was not supporting their safety due to the positioning of items and layout of room impacting on the use of hoist. This person asked for a room change, and the opportunity was taken to re-organise items and layout of facilities to reduce risks and provide a safer environment.

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.

Feedback from people and their relatives confirmed there was enough staff to respond to all their needs. People told us, “Staff are always around, staff look after you so well, they do a good job.” They told us they enjoyed the 1-1 staffing that was provided. A relative reflected on how the staff met people’s needs. “This is the first time I can take a step back and know that everything is being done for them.”

Staff were also positive about the staffing numbers, the quality of the training and support provided. Staff said, “There are always enough staff, I feel very well supported by the managers and the organization, it’s a good company. I feel part of a good team. The training has been informative and well organized” and “Staffing is good, and lots of training.” One staff member told us about the recruitment and induction process reflecting on how it involved people and was thorough.

Safe recruitment procedures were followed and included people in the interview process, this ensured people were supported by staff who were suitable and fit to support them. Recruitment records included satisfactory references, employment history, and criminal records checks. An induction programme was completed and included a probationary period with regular staff reviews to monitor progress.

A staff training programme reflected the specific skills required and was adapted and changed to ensure people’s individual needs were added as needed. For example, the manager discussed the need for updated staff training on the safe management of a PEG, (Percutaneous Endoscopic Gastrostomy) system that provided food to people having difficulty eating. As staff supported people with a learning disability or autistic people, they completed a nationally recognised training programme.

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 clean throughout with a high standard of cleanliness maintained by the domestic staff who worked in the service Monday to Friday. Staff had all received training in infection prevention and control (IPC) and there was a good supply of personal protective equipment (PPE) which was used appropriately by staff. Appropriate hand-washing facilities were available throughout the service. Staff had completed food hygiene training to ensure that they understood how to handle, prepare, and store food correctly.

The laundry room was clean and well managed with the use of red bags for contaminated linen when necessary to reduce the risk of cross infection.

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.

Systems followed ensured medicines were handled safely. Only staff who had received medicine training and been assessed as competent gave people their medicines. We observed some staff administering medicines. Electronic Medicine administration records (eMAR) were used to support staff to give medicines when prescribed and needed. Staff were seen to be diligent and worked in pairs to complete checks and audits that supported safe practice and good stock control.

Staff were knowledgeable about the medicines people had been prescribed and how people liked to take their medicines. For example, one person preferred some liquid medicine to be given in a syringe. Some people had been prescribed ‘as required’ (PRN) medicines. The individual guidelines to support staff to give these when required needed updating and review. Staff were very mindful to ensure people were not over medicated. Staff followed the protocols about Stopping Over Medication of People with a learning disability, autism or both (STOMP). The deputy manager ensured PRN guidelines were immediately updated and reviewed.

Storage arrangements for medicines were well managed this included individual cupboards for each person in their own private accommodation to promote an individual approach.