Priscilla Wakefield 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

At our last inspection in May 2022 we did not change the rating of good in this area. We found the rating remained good during this assessment. Risks to people's safety and well-being had been evaluated, and comprehensive plans were put in place to mitigate these risks. The environment was safe for people. The service followed thorough systems and processes to respond to accidents, incidents, complaints, and safeguarding issues. Staff collaborated and partnered with other agencies to ensure people's safety. Measures were implemented to prevent and control infections. Medications were managed safely, however we noted some areas that need to improve such as the care planing details, the handling of homely remedies and the auditing system. Effective systems were in place to ensure safe staff recruitment, and there were sufficient, well-trained staff on duty to provide safe care for people who lived in the service.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People who used the service and their relatives confirmed they received information about these procedures especially when they enquired.

We reviewed several records demonstrating examples of a proactive approach to handling incidents. Care plans and risk assessments were updated, staff received additional training and guidance as needed, and external professionals were consulted to ensure best practices were followed.

There were effective systems in place to address and learn from any issues that arose. Staff documented and reported any accidents, incidents, or adverse events, which were then investigated by the management team. The provider ensured that the affected individuals and/or their representatives were informed and involved in the investigation process, offered apologies when necessary, and worked with them to make improvements.

Systems were in place to ensure smooth and safe transitions between services.

We found there was appropriate involvement from other health care professionals including Tissue Viability nursing, physiotherapy, GP, speech and language therapists, dentist, dietitian, and others.

The provider collaborated with external partners to ensure that information about individuals' needs was clearly communicated to all professionals involved.

Staff made timely referrals for additional treatment when necessary. People were kept informed about their situation.

People and their relatives told us they felt safe and knew how to raise concerns about abuse. A relative told us: “I feel my relative is very safe here, he is always happy, and the staff are so friendly and helpful.”

Systems were in place to safeguard people from abuse. Appropriate policies and procedures were established, and staff were familiar with them. Staff could explain how to recognise and report any signs of abuse.

The provider kept clear records of safeguarding concerns and their responses, showing that they had investigated these issues and collaborated with the local safeguarding authority and others to implement protection plans to prevent further harm.

The provider also shared lessons learned from safeguarding concerns with staff. The provider applied for Deprivation of Liberty Safeguards for individuals lacking the mental capacity to consent to their care and treatment. Systems were in place to monitor these safeguards and any conditions to ensure they remained relevant and that individuals' rights were not unfairly restricted.

Risks to individuals' safety and well-being were assessed and planned for. The risk assessments were comprehensive and included guidance for staff on how to monitor and mitigate risks. People were encouraged to consider risks and make informed decisions about them.

Risk assessments were regularly reviewed and updated with input from individuals and their representatives.

People and their relatives reported that risks were managed appropriately.

Responses by people and relatives varied with regards to their level of involvement in the care planning, however we saw evidence of feedback being sought and their views being taken into account in the service delivery.

During our visit, the home presented clean in all areas and there were no obvious hazards.

Communal areas were from hazard-free and pleasant. A comprehensive cleaning plan was in place and staff were familiar with it.

People lived in a secure and well-maintained environment. During our visit, the home was undergoing redecoration works one floor at a time, though these did not cause any noticeable disruption.

The provider had implemented robust systems to monitor the safety of the environment and equipment, including fire and gas safety measures. Regular maintenance checks were conducted, and issues were promptly addressed. Staff were knowledgeable about supporting residents in using the necessary equipment to ensure their safety. This equipment was routinely inspected to ensure it remained in good condition. A replacement system was in place to ensure the delivery of service was not impacted when faults were being detected and then addressed.

During our visit we observed there were sufficient staff members to ensure safety and meet people’s needs. People and relatives told us staff have time to speak to them even though some had to wait to be supported during the weekends. Our observations confirmed that staff were readily available and attentive to people's needs. Effective systems were in place for recruiting and selecting staff. Professional development was encouraged, and staff were encouraged to develop new skills. The service had comprehensive policies and systems in place to ensure staff received clinical supervision and supportive meetings took place for the staff team. We saw evidence individual meetings with staff included records of performance progress.

Staff expressed they felt supported and well-informed.

Comprehensive induction programs and training schedules were provided. This ensured staff had the necessary skills and information to support people safely and understand their needs. The majority of staff were up to date with mandatory training. We also saw evidence of regular learning opportunities for staff through safety champions on key safety areas such as pressure care, hydration and nutrition and falls prevention. However, on examining the providers training records, we saw some staff members had multiple overdue training renewals. Through conversation with staff we observed not all staff members were familiar with the term whistleblowing, even though they knew how to report any concerns. We found this had no impact on the people’s safety.

We brought this to the attention of the provider, and they explained some additional training was taking place for staff for example on cultural intelligence and the Oliver McGowan learning disability training. The provider also showed us evidence of further face to face training opportunities such as discussing a different topic each month including whistleblowing. We recommend the service continues to explore alternative ways to ensure all staff receives additional training in areas specific to the people’s needs and the staff team’s areas of interest.

Appropriate systems were in place for managing infection prevention and control. Policies and procedures were up to date, and staff were trained and understood their role in preventing infections.

The environment and equipment were clean, and people expressed satisfaction with the cleanliness and laundry facilities.

Adequate supply of personal protective equipment (PPE) was available for staff.

Regular audits and checks on cleanliness and infection control were conducted, and staff took appropriate actions to address any issues identified. Visitors were asked to follow infection and prevention control principles.

People were given their medicines by staff as prescribed safely and in a timely manner. This was recorded on their medicines administration record (MAR) by the staff. Some people were given medicines covertly. The staff had followed the required process to administer medicines covertly in a safe way. However, care plans were not always person-centred and did not always have the necessary information to guide staff to support people with their health needs. For example, two people we reviewed were prescribed anticoagulants. However, there was no information in the care plans on how to manage and monitor their side effects. Also, three people we reviewed who experienced seizures there was no care plan in place on how staff would support them if they had a seizure putting them at risk of harm.

Medicines policies were in place. Medicines including controlled drugs were stored securely and at recommended temperatures. However, the staff did not always follow the provider’s policy for annotating the date open for liquid medicines and homely remedies. This meant it was difficult to ascertain the shelf-life of these medicines and they may not be effective. Medication administration records (MARs) were updated accurately and in a timely way when medicines were administrated, started, and changed. People’s allergies were accurately recorded. There was a process in place to report and investigate incidents. Regular medicines audits were carried out to identify gaps and make improvements. However, the audits did not identify the concerns we found during the assessment.

We recommend the provider reviews the medication care-planning to ensure the information is person-centre and detailed including specific guidance to support people with specific health conditions and the management of any side-effects caused by their medicines. We recommend the provider reviews the system of monitoring the shelf-life of medicines to ensure people’s medication is safe and effective to use at all times. We recommend the provider reviews the medication auditing system to ensure any errors are acknowledged and acted on in a timely manner.