Wellfield Also known as Wellfield Pines and Wellfield Acorn

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

The service had a proactive and positive culture of safety and care was delivered safely and effectively. Staff understood how to recognise, record and escalate incidents, and there was evidence that incidents, risks and near misses were reviewed to promote learning and improve practice. Risks were assessed, monitored and managed appropriately through comprehensive, child-centred risk assessments and clear control measures. Safeguarding arrangements were effective, with staff demonstrating a good understanding of their responsibilities and receiving appropriate training. Care was coordinated with partner agencies to support safe pathways and transitions, and staffing levels and skills were sufficient to meet children’s needs safely. Infection prevention and control arrangements were embedded into practice and medicines were managed safely through appropriate storage, oversight, auditing and administration processes. Communication methods and risk management approaches were adapted to support children’s individual needs and reduce risks to their safety and wellbeing. There were no breaches of regulation identified under this key question.

Find out what we look at when we assess this area in our information about our new Single assessment framework.

The provider had a proactive and positive culture of safety.

Staff described clear processes for recording incidents, escalating concerns to management or the on-call manager, and being open and honest when things went wrong. Staff also told us they felt comfortable raising concerns and that leaders were transparent around candour and learning.

Evidence of learning and review was reflected in the way incidents and risks were analysed and updated. Staff described face-to-face meetings where lessons learned were discussed and service learning being shared following incidents, this was also evident in our review of the incident log. The consolidated risk assessment also directed staff to review controls after incidents, near misses, significant change or professional update.

The provider worked with children and partner agencies to establish and maintain safe systems of care. Records showed detailed care planning, daily logs, clinical forms, body maps, fluid charts, complex feeding observations and regular multidisciplinary meetings to review needs and progress. Staff described consistent recording of interactions, which was clear in daily records.

The service also demonstrated coordinated transition and pathway planning. Meeting minutes recorded ongoing planning around education, future placement needs, family contact and continuing support within the service. Staff also described close communication with school, diabetic services and family to maintain continuity and safe support.

The provider worked closely with children at the service and partner agencies to understand what being safe meant to them and how best to achieve this. Staff showed a clear understanding of safeguarding procedures, including when to escalate concerns, and the safeguarding policy set out clear responsibilities for referral expectations, recording requirements and the need to contact the local area designated officer (LADO) without delay where thresholds are met.

Safeguarding practice was also supported by training and legal awareness. Staff were trained to safeguarding level 3, and the staff could explain awareness of consent, restrictions and best-interests decision-making.

Staff worked with the children to understand and manage risks holistically. The consolidated risk assessment was comprehensive and included aspects such as; communication needs, dysregulation, food-related distress, self-injury risk, risk to others, physical intervention and hospital attendance, with clear controls and review arrangements. The document explicitly stated a least restrictive, child-centred trauma-informed approach.

Children’s preferences and understanding were used to reduce risk. Staff used short language, visual prompts, “this or that” choices, social stories, humour, sensory tools, praise and reward systems to support regulation and safe engagement. Staff described positive behaviour support, reflective debriefs, body maps, communication aids and child-friendly follow-up after incidents.

The judgement for Safe environments is based on the latest evidence we assessed for the Safe key question.

The provider ensured there were enough staff with the right skills to meet the child’s needs. Staff told us there was never a time when they did not have enough staff and we saw that managers reviewed staffing arrangements to ensure aspects of care such as supporting moving and handling procedures and access to the community were undertaken appropriately.

Staff also described good access to training, supervision and leadership support. Supervision records showed regular supervision and competency sign-off, including initial and refresher clinical competencies. Staff interviews described feeling supported by leaders, access to monthly supervision, training in de-escalation and intervention, medicines management and specialist approaches relevant to the child’s needs

The provider assessed and managed the risk of infection. During the visit, the inspection team was required to wash hands and have a temperature check due a child’s vulnerabilities. Records described cleaning schedules, handwashing prompts, safe waste arrangements and the presence of clinical waste processes.

The care records also showed that infection prevention was considered in children’s clinical and personal care needs. Risk assessments included personal care, hygiene and infection control, and staff were expected to use visuals to encourage handwashing, record skin issues and follow the infection control risk assessment.

The provider ensured that medicines and treatments were managed safely and met the children’s needs, capacities and preferences. Medicines were stored appropriately with daily stock checks, secure key arrangements and individual MAR processes for each medicine and route, this included medications needed as and when (PRN). Qualified nurse oversight and regular audits of medicines practice ensured medication management was safe and effective.

Documentation we reviewed showed that children were involved as far as possible in treatment delivery and that staff adapted approaches to minimise distress. Staff described always asking and explaining treatment, even where the children lacked capacity to refuse essential care.