July VII Limited t/a Wykenhurst 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 inspection we rated this key question good, this rating remains unchanged. The provider had processes in place to ensure people were protected from risk of harm and abuse. Staff knew potential risks to people and how to report concerns. The provider had processes to learn from accidents and incidents to ensure learning took place to prevent them from happening again. Recruitment policies and procedures ensured staff were recruited safely. Staffing arrangement met people’s needs. The home was clean. Systems and processes in place ensured medicines were well managed and people received their medicines safely.

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.

People and relatives told us they could raise concerns and would be listened to and supported. One person said, “They (staff) often ask if I am okay or if I have any concerns. I like everything about it here and have no complaints or improvement suggestions.” Relatives told us their loved ones were supported safely. A relative said, “I can talk with the managers freely and they are always around and willing to listen and take action as necessary.”

The provider had processes to learn from accidents and incidents to ensure people’s experiences were improved. Any learning was shared with staff to consider how incidents had happened and what could be done differently to improve practice. Where accidents or incidents had occurred, these had been recorded and analysed to determine the cause, identify any common themes, patterns and lessons learnt. Actions were taken to reduce the likelihood of recurrence. Risk assessments were in place and regularly reviewed and updated to mitigate risks. Systems were in place for relatives, people, and staff to raise concerns or share their views. These included residents’ meetings and people and staff surveys.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

Staff and registered managers understood their roles and responsibilities in relation to safeguarding people. They knew how to raise concerns and who to contact. Staff told us and records confirmed they had received safeguarding training.

There was an up to date safeguarding policy in place. Safeguarding procedures were followed and referrals to the local authority as well as notifying the Care Quality Commission (CQC) were made when required. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty. For example, regarding restrictive practices such as locked doors and bed rails.

People and relatives spoken with felt staff understood people’s needs well and supported them safely. A relative told us, “I have no concerns about [person’s name] safety, there seem to be enough staff and they are fully aware of [person] limitations and keep them safe.” Another relative said, “They (staff) do everything they can to help [person] stay independent and just tend to prompt and support them to do things rather than doing it for them. We have no issues or concerns.”

Staff managed the safety of the living environment and equipment in it through checks and actions to minimise risk. However, we found some windows were not compliant with safety regulations. The provider took immediate action to ensure window restrictors were put in place to help keep people safe. In addition, we identified not all radiators had covers to prevent people from scalding themselves if they came in to contact with them. The provider assured us this would be addressed without delay. The registered manager has kept the inspector updated on progress of this since our onsite assessment. For example, evidence low surface radiators had been installed.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us they were supported by staff who supported them safely. One person said, “There are lots of staff around and I just call if I want something, they are very quick to help me.” Another person told us, "Carers are always checking on people to see if they are okay which is reassuring. I have a buzzer in my room and if I press it, they will come very quickly which makes me feel very confident that help is nearby.” Relatives told us staff knew people well and understood their needs. One relative said, “The staff are extremely good at what they do and are very knowledgeable.” Another relative said, “We are more than satisfied with the care and [person’s] quality of life has improved greatly since they have been there, and this is all down to the fabulous staff.” A further relative told us, “Staff demonstrate a good knowledge of people and their conditions; I think they are very well trained and competent.”

Staffing arrangements met people’s needs. We observed people to be supported in a timely manner without any delay. Staff knew people well and supported them in a kind and caring way.

Staff were recruited safely. Processes ensured necessary checks were completed prior to staff starting employment. This included reference checks, proof of identity as well as Disclosure and Barring Service (DBS) checks. A DBS check is a way for employers to check an employee criminal record, to help decide whether they are suitable person to work for them. This protected people from receiving support from unsuitable staff. We did identify 2 staff files did not contain a person’s full employment history or reasons for any gaps. The nominated individual and registered manager assured us they would address this.

The premises and equipment appeared visually clean. Laundry was managed safely. Staff were observed to be wearing appropriate personal protective equipment (PPE) for the task they were carrying out. We did not identify any concerns in relation to infection control.

People told us they received their medicines safely. One person said, "The staff do give me medicines and check if I have any pain. They are very good.” Another person said, “The staff are very regular with the medication, and I never have any issues. I just ask if I need a pain killer and they will fetch one for me.” A relative told us, “Medication is always available and whilst [person’s name] condition is quite challenging staff are very good at making sure medication is given. They also review their medication regularly monitoring any side effects or improvements and keep us well informed.” Another relative said, "There are no issues with any medication, and they (staff) do check if [person] needs any painkillers.”

Staff spoken with were knowledgeable about people’s needs and had a good understanding of their medicines. Staff were able to describe scenarios where they had identified ‘as and when’ (PRN) medicine was required for people. We observed a staff member have their competency assessed during administration of lunchtime medicines; safe practice was followed.

Processes in place meant people were protected from the risk of receiving their prescribed medicines unsafely. Medicines were stored, administered, and managed safely. Protocols were in place. For example, for when to administer midazolam. Midazolam is an emergency medication for seizures. It works by reducing electrical activity in the brain which can stop the seizure. However, there was no procedure in place for taking the medication out in the community when needed. The registered manager immediately implemented a procedure. We identified specific midazolam training for all staff was required to ensure safe administration. Since our assessment the registered manager had booked all staff on to this training. Staff who supported people to take their medicines had completed relevant training and regularly had their competency assessed. Regular audits on medicines took place to ensure these had been given as prescribed and to identify and address any issues. Following any medicine errors, action was taken by the registered manager to reduce the risk of recurrence. For example, where misunderstanding of directions for controlled medications was found to be a cause of concern, the registered manager implemented a new procedure for administration of controlled medications.