Hawabu 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.

The management team had established systems to ensure learning took place from incident and events. Incidents were reviewed and any learning or actions were clearly recorded and assigned to members of the staff team. Where incidents involving the use of physical intervention by staff had taken place, these were documented by staff and then reviewed by senior members of staff to ensure actions taken were proportionate. The management team then reviewed records and where required, held a debrief with the person involved, and staff to ensure any changes or improvements to care plans or staff practice were considered and actioned.

Staf told us they played an active role in learning from incidents. One staff member said, “For routine incidents, staff will speak with the person to reflect on what happened and explore whether staff could have handled the situation differently.”

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.

A team appointed by the provider managed referrals to the service and shared information about people moving into the service with the management team. This information was then reviewed, and assessments were carried out to consider the suitability of people moving into the home, considering the needs of current residents. These assessments balanced any potential risks or triggers which may mean people were not compatible to live in the same home.

Staff told us there were systems in place to enable people to safely move out of the home. They said when people’s needs reduced and they required a home with less support, they worked with people to prepare them for the transition. This support included identifying suitable places to live, liaising with social workers and other professionals to ensure support was in place during and following the move, and allowing the person to say goodbye to other people living at the home as well as staff. This promoted a positive transition 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.

The person told us they felt safe living at Hawabu House. They said, “Staff are with me day and night. Staff keep me safe.” The person was supported to meet regularly with their keyworker and discuss their experience of living at the home. These meetings also gave and the person the opportunity to share any concerns about safety or the home environment.

Staff had received training in how to protect the person from harm and knew how to identify signs of potential abuse. One staff member told us, “If I had a concern, I would escalate it to the manager first. If the issue was not addressed after escalation, I would then take it to our safeguarding lead. If nothing further was done and the concern remained unresolved, I would whistle blow to the police, the Local Authority, or any other relevant safeguarding authority as required.”

Staff explained that if they noticed a pattern of concerns or observed something they were not comfortable with, they would report it immediately. One example of this was where a person would become visibly distressed after returning from visiting relatives. The staff member had raised concerns, and action was taken to ensure the person’s safety.

The provider had systems in place to record and report any concerns relating to the person’s safety and well-being. Where safeguarding incidents had taken place the management team had taken appropriate action in referring these to the relevant local authority and notifying CQC as required.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We found staff were working within the principles of the MCA and DoLS.

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.

The person was actively involved in discussion and plans around how risks to their health, safety and wellbeing were managed. We observed the person discussing with staff how risks for specific activities or visits could be assessed and planned for. The person felt comfortable to challenge decisions made by the management team about how risks were managed and we observed the registered and deputy manager were active in working with them to enable risks to be proactively managed. The management team had a positive approach to risk taking and aimed to promote the person’s independence while also ensuring they were safely supported.

Staff used detailed guidance in the person’s care plans to provide them with support that enabled independence as well as keeping them safe. Risk assessments were regularly reviewed, and any changes were shared with the staff team. Environmental risks were also frequently assessed to ensure the home environment did not pose a risk to the person, particularly in relation to their mental health.

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

Systems were in place to monitor and review the home environment to ensure it was safe. Staff and the management team carried out regular checks to review fixtures and fittings, as well as furniture and appliances to ensure they did not pose a risk.

In addition to this, the management team completed weekly audits of the environment to ensure any hazards were identified and repairs logged with the provider’s maintenance team. This team then used a priority system to ensure issues were actioned or repaired without delay.

Records showed regular checks were undertaken in relation to fire safety, Legionella and gas and electrical systems.

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.

The person spoke positively about the support they received from staff. They told us, “I get worried, so I like staff coming out with me. I like 1 staff next to me and 1 behind, makes me feel safe. Staff are good with me. Hardly have any issues with staff.”

The person’s needs were assessed prior to admission to ensure the right number of staff were available to support them. The management team were flexible in their approach and where the person’s needs indicated staffing levels could be reduced this was actioned and then reviewed to ensure they were supported safely.

Staffing rotas reflected the person was supported in line with their needs assessment and staff were always available to them. Staff had been safely recruited to ensure they were suitable to work with the person. Staff told us, and records confirmed, they had undertaken training relevant to the person’s needs. Staff training records showed staff had completed training to equip them with knowledge about the person’s individual needs and diagnoses. This included positive behaviour support, and the use of physical intervention techniques if required.

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 person told us the home was kept clean and tidy. We observed this during our visit. Staff had received training in the use of Personal Protective Equipment (PPE) and Infection Prevention and Control (IPC) which helped to reduce the risks of cross infection.

One staff member told us, “We use gloves when administering medication and when preparing food. Gloves are readily available in the medication room, the kitchen, and in the COSHH storage area. There is also a supply kept outside the building, stored securely in a locked unit to ensure safe and controlled access.”

Audits had been carried out to monitor the cleanliness of the home, these reflected that where areas of improvement had been identified, timely action had been taken to address these areas.

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.

The person received their medicines as prescribed. They told us, “Staff give me my medication. I am happy for them to do it, and they keep it locked away.”

Staff shared with us the processes they followed to ensure the person received their medicines safely. This included checking doses and the medication name and ensuring they sought consent from the person. A staff member said, “Medication training and competency assessments are completed annually. A competency booklet is kept in the medication room for staff to work through. Before any staff member is authorised to administer medication, their supervision and sign-off is completed by the manager.”

Systems used to ensure the safe handling, storage and administration of medicines were safe. Safe systems were in place to ensure ‘as required’ medicines (to be taken only when specific symptoms are present) were administered correctly. This included the use of clear protocols about how these should be administered. Incident records showed the person was involved in decisions to use these medicines, and we saw examples of where these had been requested by the person and administered by staff.