Helen Ley 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 72 (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. Staff understood the process for reporting and recording any accidents or adverse incidents. Accidents and incidents were reviewed by the deputy nurse clinical lead to ensure referrals to other healthcare professionals had been made and action taken to mitigate future risks. The provider and registered manager had regular oversight of accidents and incidents to identify any trends and areas for learning and development. Staff described a culture of shared learning to mitigate risk and improve staff practice. One senior staff member told us, “It is about being able to talk it through with staff to get their views and opinions." Managers understood their responsibilities under duty of candour. One manager told us, “You have to be open and honest because we all make mistakes. If we have made a mistake, we have to inform the resident and we have to inform the next of kin as well."

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed. They made sure there was continuity of care when people moved between different services. Pre-admission assessments ensured Helen Ley House could provide the care people needed and ensure positive outcomes. When people were admitted to hospital, information was shared so other healthcare professionals understood people’s risks, support needs and preferences for future care. When people transitioned home or to other services, therapy staff compiled discharge reports about the therapy the person was currently receiving and their long-term goals. This included detail about the number of care staff needed to meet the person's needs and any specialist equipment they required. A member of staff gave us the following example, “We take the person into the therapy kitchen to see what support they need to use the kitchen. We consider the number of staff, and the type of equipment required for them to make drinks and meals and tidy things away. We then visit the person's home/placement to identify if there are any bespoke changes that need to be met.” Discharge reports were supported by face-to-face meetings where staff shared details of people’s functional competencies and therapeutic requirements. This ensured people continued to receive their ongoing care and rehabilitation as they transitioned home or to a new care provider. Care plans detailed people’s health conditions so staff understood when support was needed from specialist healthcare partners. The provider’s processes ensured people did not miss medical appointments and other healthcare professionals had the information they needed to provide safe, effective care. One healthcare professional told us, “As far as I know the team at Helen Ley has a very sufficient way to keep track of oncoming follow up appointments or investigations booked and none of them was ever missed.”

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. People told us they felt safe living at Helen Ley House and were confident staff provided them with safe care. Comments included: “I’m very safe, the people who work here look after me” and “I feel very safe, they are excellent at looking after me. There’s always a carer present when needed.” Staff had received training in safeguarding people from harm, discrimination and abuse. Staff told us they would not hesitate to report any poor practice or suspected abuse to senior staff and managers. One staff member told us, “When I feel something is wrong, I can speak up if I need to. At the end of the day, I am here for the residents, and they are my responsibility." The provider’s safeguarding processes ensured concerns were investigated and referred to the local authority safeguarding team. When someone was identified as potentially being deprived of their liberty, applications were made to the authorising body as required. Nobody had a condition on their DOLs at the time of our assessment.

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. Risks to people's health and safety had been identified and assessed. Clear guidance was in place to direct staff on how to support people in a safe way. Risk management was based on people's individual abilities and reviewed regularly or in response to incidents or changes in people's health. Staff supported people and their relatives to develop insight into their conditions and associated risks. They worked collaboratively with people, their relatives and as part of a multidisciplinary team to look at how risk could be reduced with minimum limitations on people's freedoms. A healthcare professional told us, “A lot of the clinics are dedicated in making risk assessments for specific clinical decisions and then discussed with the patient and the family.” We saw one person who was learning to walk with a walking frame. A staff member walked beside the person, and another staff member followed them with a wheelchair to support the person when they needed it. A relative told us, “[Name] is absolutely safe here and has never had any falls. When she walks, either the staff or I am there.” During our assessment we saw examples of positive risk taking which respected people’s right to make their own decisions and supported their emotional wellbeing. One person told us, "I know what risks I am taking, and I know what the risks are.” Staff were confident and knowledgeable about people's assessed risks and felt communication and how they worked as a team, minimised risks to people.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The home was purpose built; rooms were spacious, and doorways and passages were wide enough for people using wheelchairs. All bedrooms had an en suite bathroom and most had outdoor access. If people required specialist equipment to promote their independence, this was procured and installed as necessary. The servicing of specialist equipment was managed by the estates manager, but staff regularly checked equipment was clean and fit for use. We identified one area where storage of items had potential to compromise a fire exit. This was addressed immediately. Staff had received fire safety training and information was centrally maintained of the support people needed to evacuate the building in an emergency. The provider had processes to ensure the premises and equipment were regularly checked and maintained in good order.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked well together to provide safe care that met people’s individual needs. We received mixed feedback from people and relatives about the availability of staff when they needed them. Some people shared no concerns, but other people told us there were occasions when they had to wait for staff to respond to their requests for support. Comments included: “I use my bell at night, they always come quickly”, “I have a call bell, sometimes I can wait 5 minutes for them to come” and “Usually they answer her call bell quickly, very occasionally it can take longer.” Nursing and therapy staff shared no concerns about staffing levels in the home. Care staff described safe staffing levels but told us they would like more time to spend with people before moving to the next care task. The registered manager acknowledged time pressures on care staff and how the complexities of people’s conditions meant personal care could take an extended period to complete. They told us they regularly reviewed people’s dependency needs to ensure they received the level of support they required, and workloads were evenly distributed through each unit in the home. New staff received an induction into the service which included training appropriate to their role. The provider required staff to regularly refresh their training and records demonstrated a high level of compliance in line with the provider’s expectations. Failure to complete required training was managed on an individual basis. The provider’s recruitment processes ensured checks were carried out to ensure the suitability of staff before they started working in the home.

The provider assessed and managed the risk of infection. However, some practices needed to be improved to reduce the risks of any infection spreading. We found some staff were not sealing the bags used to manage soiled laundry which presented a risk of infections spreading. The registered manager assured us this would immediately be addressed with staff. Staff had received training in food hygiene and good infection control practices and there were clear roles and responsibilities around infection prevention and control. We saw staff followed good hand hygiene practices and wore personal protective equipment (PPE) appropriate to the tasks they carried out. Staff followed a process to ensure other staff and visitors were aware if a person developed an infectious illness, so extra precautions could be taken to avoid cross contamination. All areas of the home were visibly clean and had suitable furnishings which were cleaned and well maintained. Clinical waste was disposed of in line with good practice guidelines.

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. People raised no concerns about the management of their medicines or the availability of pain relief when they needed it. One person commented, “I take my pills 4 times a day and they wait for me to take them. If I am in pain, they quickly look after me.” One relative told us, “Medication is top quality here, it is a big thing for me. They messed it up in hospital, but not here.” Staff followed best practice guidance in their management of people’s medicines. Where people were prescribed medicines to be given as and when required, there was guidance in place to ensure they were given when needed. Storage arrangements for medicines were well managed. This included stock control and ensuring medicines were stored in accordance with manufacturer’s guidance.