The Hamiltons 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 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.

Where people had an accident or incident, a log was maintained about what happened and any actions taken. The management team regularly analysed accidents and incidents to identify any emerging themes or patterns in order to improve the care provided. These findings were then shared with the staff team.

Staff confirmed they were informed of any actions following an accident or incident through daily meetings that took place. Any concerns about a person’s safety could be discussed during staff handovers.

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.

The service worked in partnership with other professionals such as GP's, dietitians and speech and language therapy (SaLT) to support people to access healthcare when they needed it. One person said, “If I need any appointments the staff deal with that. I have seen the doctor and also had my eyes tested.”

The management team and staff demonstrated how when a person's needs had changed, they had promptly engaged with several services to ensure the person's needs were fully met and understood. For example, where 1 person had suffered a fall, changes had been made to the environment near their bedroom as a result.

People who used the service and their relatives said the service was safe. One person said, “The staff ask me if I am ok all the time. Continually checking on me. I think this is why I am safe.” Another person said, ‘I do feel secure here. I can just live as I want to. I smoke and have access to outside for a cigarette. A relative also said, “(Person) is safer here than at home. We did have some falls but none since being at the home. It's all down to the attentiveness of the staff.”

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.

There was a safeguarding policy and procedure in place which was in date and provided an overview about what people could do if they experienced any abuse. A safeguarding log was maintained, with details about any incidents reported to the local authority for further review, or other actions taken.

Staff had completed safeguarding training, which was documented on the training matrix and understood how to report concerns. A member of staff said, “Examples of safeguarding concerns could be physical abuse, or problems with a person’s finances.”

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Medicines were appropriately stored safely with a locked trolley in a locked office. Medication administration records (MAR) were completed accurately, with no missing signatures noted. Some people required topical creams to be administered by staff, however we found these charts were not always completed consistently.

There were clear protocols for staff to understand when they needed to administer ‘as required’ PRN medicines. Staff undertook training about the safe handling of medicines and competency assessments were completed by management.

The feedback we received was that medicines were managed safely. One person said, “I would definitely forget to take my tablets but the girls remind me. I have never been without my medication because the staff order them for me.” Another person said, “All my medication is given to me and sometimes there are changes which I’m told about.”

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

We assessed this service due to concerns we received regarding fire safety. Overall, we found the living environment to be safe for people living at the home. We found regular checks were carried out of fire extinguishers, alarms and emergency lighting. A fire risk assessment had been completed and recently updated due to concerns raised by the fire service who had served an enforcement notice due to compartmentation in the loft area not being fit for purpose. At the time of the assessment we saw the provider had begun to rectify these concerns.

We found that in some people’s bedrooms, windows did not contain appropriate restrictors to prevent people from falling or potentially leaving the home in an unsafe way. Health and Safety Executive (HSE) guidance states window restrictors in care settings should not be able to be tampered with, or removed without using a special tool. The provider gave us assurances that these would be replaced immediately.

We found other maintenance checks of the building had been completed including gas safety, electrical installation and legionella. Faults had been identified with the passenger lift, and although still safe to use, work was in progress to rectify these faults.

The provider made sure there were enough qualified, skilled and experienced staff, whoreceived effective support, supervision and development. They worked together well to providesafe care that met people’s individual needs.

Staffing rotas were in place and this demonstrated how many staff were available to care for people. A dependency tool was used to determine how many staff were required. The feedback we received from people who used the service and relatives was that staffing levels were sufficient. A relative said, “I have never had a time when I questioned the number of staff available here.”

Staff told us they felt numbers were sufficient to care for people safely. One member of staff said, “At the moment we have enough staff and we are able to meet people’s care needs.”

Staff were recruited safely with the necessary pre-employment checks carried out. This included carrying out interviews, undertaken DBS (Disclosure Barring Service) checks and obtaining references. Checks were also carried out to ensure staff were eligible to work in the UK if they worked at the home as part of a sponsorship visa.

Staff told us they received enough training to support them in their role, with a training matrix in place showing which courses had been completed. Staff supervisions and appraisals had not always been carried out consistently, however, the registered manager confirmed a new schedule had been put in place for these to commence more regularly.

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.

We found the home to be clean, tidy and observed domestic staff carrying out their work during the assessment. Toilets and bathrooms were equipped with appropriate hand hygiene facilities such as paper towels, liquid soap and foot operated pedal bins. Hand sanitizer was available in the home and posters were displayed about the environment to encourage compliance.

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Medicines were appropriately stored safely with a locked trolley in a locked office. Medication administration records (MAR) were completed accurately, with no missing signatures noted. Some people required topical creams to be administered by staff, however we found these charts were not always completed consistently.

There were clear protocols for staff to understand when they needed to administer ‘as required’ PRN medicines. Staff undertook training about the safe handling of medicines and competency assessments were completed by management.

The feedback we received was that medicines were managed safely. One person said, “I would definitely forget to take my tablets but the girls remind me. I have never been without my medication because the staff order them for me.” Another person said, “All my medication is given to me and sometimes there are changes which I’m told about.”