Graysford Hall

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 providerhad a proactive and positive culture of safety based on openness and honesty. Managers listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The service had systems in place to ensure lessons were learnt following accidents, incidents, and complaints. The provider ensured staff were told what had gone wrong, and how they could prevent a reoccurrence. A staff member told us, “If something happens, we get a ‘lesson learnt’ note in the handover folder.”

Accidents, incidents, and complaints were dealt with willingly and seen as an opportunity to put things right, learn and improve. Lessons learnt were openly discussed in handovers, flash meetings, supervisions, and staff meetings. People and staff were confident that any concerns they raised with managers would be taken seriously and addressed.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed and monitored. They made sure there was continuity of care, including when people moved between different services.

Prior to admission staff visited people in their homes or in hospital to carry out a ‘pre-move in’ assessment. They encouraged people and their relatives, where applicable, to provide as much information as possible to ensure the service could safely meet each person’s needs. Staff also liaised with health and social care staff to get a full picture of how each person could best be supported.

A relative said that during their family member’s assessment and move into the service ‘communication [from the service] had been great’ which made the move easier. A staff member said managers always alerted them when a new person was admitted and ensured that all the information staff needed to support the person safely was available on a care plan.

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 were effective systems, processes and practices in place to ensure people were protected from abuse and neglect. Staff continually monitored people to ensure they were safe and well. A staff member said, “We are always aware when we’re with residents andobserving the care given. We are always observant.” All staff said they would immediately tell a manager if they thought a person might be at risk of harm.

All staff, including ancillary staff, were trained in safeguarding. A member of the housekeeping team told us, “We get mostly the same induction and training, like safeguarding and health and safety, as the carers, so I know what to look out for.” Staff knew how to escalate safeguarding concerns to the local authority when required. Staff knowledge and training helped to ensure people remained safe at the service.

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.

Managers and staff ensured risks to people’s health and well-being were identified and action taken to minimise them. Risk assessments were person-centred, proportionate, and regularly reviewed. Relatives said staff were proactive about risk and knew how to keep their family members safe.

Records showed how staff had reduced risk to people. For example, people at risk of choking were seen by medical professionals and staff followed their advice when providing food and fluids. People who had fallen, or were at risk of falling, had sensor mats, regular checks, and referral to falls team, as necessary.

People’s individual risk assessments were detailed and included clear instructions to staff on how to safely provide them with care and support. People and relatives were involved in writing and reviewing people’s risk assessments where appropriate.

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

The service’s maintenance manager ensured the premises and equipment were well-maintained and safe for people and staff to use. Records showed the maintenance manager and outside contractors monitored and serviced equipment, for example, beds, wheelchairs, hoists and slings. The service had a rolling programme of refurbishment and decoration.

People and relatives knew the maintenance manager and reported issues to them along with the staff. The maintenance manager told us, “I’m always talking to people, and they come to me about things needed in their rooms.” This meant any concerns about the environment were listened to and acted upon.

People had personal emergency evacuation plans which told staff out how to evacuate them safely in an emergency. These considered people’s protected characteristics and ensured staff made reasonable adjustments, as necessary, when vacating people from the premises.

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.

Most staff and relatives were satisfied with the number of staff on duty at the service. A relative said “There are plenty of staff about and they are regular staff. They know you and you know them, which is good.” Staff told us they usually had enough time to spend with people, support them, and talk with them. We observed staff responding promptly when people needed assistance.

Managers used a dependency tool to calculate the number of staff needed to provide safe care for people at the service. Existing staff, rather than agency staff, were used to cover staff holidays and sickness. This meant people were supported by staff they knew well.

Staff were safely recruited with references and DBS checks carried out before they started work at the service. Staff recruitment files were well-organised. Administrators used checklists to ensure all the required documentation was in place prior to the staff member commencing work.

Staff were well-trained and relatives confirmed this. Staff told us their induction and training was of good quality and included face-to-face and online courses. Staff passed modules and were performance checked during their probationary period before being approved to work at the service. Records showed all staff received ongoing and relevant training.

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.

Relatives told us the premises were always clean, and staff wore personal protective equipment. A member of the housekeeping team said they were proud of how clean the premises were. They said, “We always have the equipment and products to do the job.”

Cleaning schedules were in place for all areas of the premises. Staff were trained in infection prevention and control (IPC) and the service had IPC champions who promoted effective handwashing and completed IPC competencies with staff.

Monthly and annual IPC audits were completed by managers and any actions identified through these audits were added to the service’s improvement plan.
 

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

Medicines were safely managed and stored with accurate records kept. People had personalised medicines plans so staff knew how they wanted their medicines administered.

If people were prescribed medicines on an ‘as and when’ basis, there were protocols to ensure they received these as prescribed. A person who self-administered one of their medicines had a risk assessment to ensure they could do this safely with staff support.

Only trained senior staff gave out medicines. They had regular competency checks and ongoing training to ensure they were safe to do this. Medicines records were audited weekly and any shortfalls addressed.

People’s medicines were regularly reviewed by a GP service which visited the service to carry out weekly ward rounds. This helped to ensure people received the correct medicines to meet their current health needs, and medicines were not over-prescribed.