Hunningley Grange Residential 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 inadequate. At this assessment the rating has changed to requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The service was previously in breach of the legal regulations in relation to safe care and treatment and staffing. Improvement was found at this assessment, and the provider was no longer in breach of these regulations.

This service scored 59 (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 not always had a proactive and positive culture of safety based on openness and honesty. The provider had not always listened to concerns about safety and had not always investigated and reported safety events. Lessons had not always been learnt to continually identify and embed good practice. However, revised systems and processes had been put in place since our last visit, and we found noticeable improvements where we had previously had concerns. Some areas were still work in progress and new ways of working needed to be fully integrated and sustained over the longer term. We found the management team were open and transparent and wanted to drive improvement at the service. They were confident the regional team alongside the new manager would now provide greater oversight and monitoring of the service over the longer term.

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. Significant improvements had been made by the service regarding information stored about people. The improvements made to records, ensured more accurate, up to date information was now available to be shared with other professionals. For example, when people required support from external health care services.

The provider had not always worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff had not always concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. Revised systems were now in place to oversee accidents and incidents. However, these systems were still relatively new and needed to be reviewed over the longer term to ensure they were robust and provided clear oversight of all accidents and incidents and to ensure that lessons were always learnt. Records showed incidents were investigated and referred to the local authority safeguarding team and CQC appropriately. Staff were aware of the provider’s safeguarding policy and could identify signs of possible abuse and neglect. They confirmed they had received safeguarding training and knew how to report such concerns. Staff we spoke with did not have any concerns but said if they did, they were confident the management team would act appropriately.One staff member told us, “If I suspect someone is at risk or experiencing harm, abuse or neglect, it would be reported immediately to the most senior person on duty or to the line manager. I would document any concerns and follow our safeguarding policy. If necessary, I would escalate the issue to the local safeguarding authority.”People and their relatives felt the service was now safe. Comments included, “Yes, I am safe, I’m alright here,” and “Yes, I am safe and happy here. The staff are lovely.” We checked whether the service was working within the principles of the Mental capacity Act, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. All legal applications had been made in accordance with Deprivation of Liberty Safeguards (DoLS). This meant people’s rights were fully respected. The manager kept a record of DoLS applications and authorisations, and this was regularly reviewed to make sure authorisations were current.

The provider had not always worked well with people to understand and manage risks. Staff had not always provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Previous areas requiring improvement identified at the last assessment had mainly been actioned. However, some further work was needed to ensure all risks to people were identified and addressed. We noted radiators in one area without covers. We discussed this with the provider and interim measures were put in place to ensure people’s safety whilst more permanent solutions were implemented. Care records and risk assessments were now more detailed and provided a more holistic overview of people’s support needs and information for staff regarding risks to people. Some areas of care plans and care records still needed further work which was in progress. Records of support completed by staff were now more regular and detailed. However, the electronic system in place needed further review to ensure the information provided gave a more accurate report and clearer overview of support provided to ensure themes and trends could be identified easily. Staff we spoke with were familiar with people’s needs, identified risks and understood how to support people safely. People were supported to do the things they wanted to do, and staff helped them to do this safely. We saw staff supporting people safely around the home and when participating in activities. Staff were patient and supported people at their own pace.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.Overall significant improvements had been made since our last visit with only a few areas still requiring attention. A complete refurbishment of the building had taken place. The home now provided a clean, bright and comfortable environment for people living at Hunningley Grange. Newly landscaped garden areas had also been established with raised beds and sensory areas to encourage people to spend more time outdoors and also participate in gardening activities. One relative told us, “[Name of person] was asked, and [person] picked the colour to paint their wall. [Person] has their own bedding and curtains [person] picked and they always have it on. [Person] hasn’t had this before. Its [person’s] home and is so much better now.” The provider had introduced new systems and processes to manage the safety of the service including regular audits of the environment. These needed further embedding into practice to ensure they provided a comprehensive overview of all potential risks within the building. Where health and safety concerns were identified, the provider acted promptly to address these.

The provider had not always made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They had not always worked together well to provide safe care that met people’s individual needs.Recruitment procedures were in place, so people were cared for by suitably qualified staff who had been assessed as safe to work with people. However, it was noted that employment history for some candidates did not always include all information back to leaving school. Where references from most recent employers were not provided, we recommended keeping a record of the trail of requests on individual files for easier reference. We noted no concerns with staffing levels during our visit, but both staff and relatives mentioned that additional staffing at busy times would be beneficial. Staff also mentioned that some shifts could be a challenge when staff were off or on holiday and agency staff were supporting. The provider was in the process of recruiting additional staff and we asked them to continue to review both staffing levels and staff deployment to ensure they continued to meet people’s needs. People were supported by staff who were trained and competent to deliver safe care. Staff working with adults with a learning disability or autistic people had completed training in autism awareness. However, we asked the provider to review the training provided around learning disability and autism to ensure it was in line with the Oliver McGowan Code of Practice. Overall, staff told us they now felt well supported and were receiving regular supervision. Record showed supervision was now being completed with staff and which if continued would meet the required frequency identified by the providers policy by the year end.

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. Significant improvement had been made since our last visit. The building was now clean, recently redecorated and refurbished and no odours were noted throughout our visit. This was also reflected in the feedback we received from people and relatives. Comments included, “It’s nice and clean,” and “I think they do keep it clean.” We observed that people were clean, tidy and suitably dressed. Regular infection control audits were now completed and where concerns were identified, action was taken and updated when work was completed. A recent external IPC audit showed a positive scoring of the service in this area. Staff received infection control training and were seen to use PPE (Personal Protective Equipment) appropriately throughout our visit. PPE was also now more accessible throughout the building.

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. Areas requiring improvement at the last assessment had been addressed. The provider was completing regular audits of medicines, and we observed safe management of medicines at the service. People and their relatives overall were positive with the changes that had taken place in this area. A relative told us, “There used to be problems with [person’s] medication, but not now.” Another relative commented, “Yes, it’s fine, as far as I know.” A person did refer to an incident which had happened shortly before our visit. We discussed this with the provider who actioned it immediately. The provider still needed to take into account the principles of STOMP (stopping over-medication of people with a learning disability, autism or both) and make sure people's medicines were reviewed by prescribers in line with these principles.