Hamble Heights

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.

This is the first assessment for this newly registered service. This key question has been rated Good.

This meant people were safe and protected from avoidable harm. People said they felt safe with staff and were happy with the support provided by them.

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.

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.

People and relatives were supported to raise concerns and were able to meet with the management team if required.

There was a clear focus on keeping people safe. Health and social care professionals were referred to for advice, as necessary.

Accidents and incidents were monitored for any patterns to aid learning and resulted in changes that improved care for people. For example, involvement of relevant health and social care professionals.

Nurses said they had recently completed training provided by the local care home team on how to use a physical deterioration and escalation tool for when people’s health deteriorated. One nurse said, “The training was really needed because the nurses were not escalating issues and not following things through. Because we had a lot of agency nurses it was unclear what, if any actions, they had taken. It's better now though. I think our nurse team is much more proactive.” One staff member said, “I know what to do if someone becomes unwell. Out of hours I can easily call for support if I need it.”

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.

The service 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.

People confirmed they received safe care and support and when indicated staff liaised with relevant health and social care professionals.

There was clear evidence of appropriate and timely referrals and reviews of people’s care and support. Records showed people had been reviewed by their GP, tissue viability nurse, dentist, speech and language, occupational therapist, and specialist nurses.

When specific recommendations had been made by other health professionals on how to support people, this was included within the care plans. Nurses told us they knew how to refer people for specialist advice when needed.

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 felt safe with the staff that supported them and felt able to raise any concerns.

Staff demonstrated an understanding of what might constitute abuse and knew how to report any concerns they might have. Staff had received safeguarding training, to ensure they had up to date information about the protection of vulnerable people.

The provider demonstrated an understanding of their safeguarding role and responsibilities. They explained the importance of working closely with commissioners, the local authority and relevant health and social care professionals on an on-going basis.

There were clear policies for staff to follow. Staff confirmed they knew about the safeguarding adult’s policy and procedure and where to locate it if needed.

We found the service was working within the principles of the Mental Capacity Act (2005) MCA and if needed, appropriate legal authorisations were requested to deprive a person of their liberty. Any conditions related to Deprivation of Liberty Safeguards (DoLS) authorisations were being met.

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.

People were supported and encouraged to be as independent as possible, with measures in place to minimise known risks. For example, throughout the layout of the premises.

Staff were visible and attentive and knew how people’s risks were managed. The provider ensured there were enough staff to support people, for example in the communal areas.

Staff were aware of how and knew where to find information about people’s risks. Staff told us that changes were communicated to them through several different channels, for example internal messages, handovers, and staff meetings.

People’s individual risks were identified, and the necessary risk assessment reviews were carried out for mobility, falls, choking, skin care, malnutrition, and diabetes. Where indicated, monitoring charts were in place to ensure people received safe care and support. For example, charts were in place to monitor people’s food and fluid intake, repositioning, weight, and mattress settings.

Risk management considered people’s physical and mental health needs and showed that measures to manage risk were as least restrictive as possible. This included ensuring necessary equipment was available to increase a person’s independence and ability to take informed risks.

There was evidence that learning from incidents and investigations took place and appropriate changes were implemented. For example, care plans and risk assessments were updated. Involvement of other health and social care professionals was requested where needed, to review people’s plans of care and treatment.

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

People told us staff helped them feel safe without minimising their independence. They felt able to move freely around the home and spend the day as they wished.

People’s individual needs were met by the adaptation, design, and decoration of the premises. People had a variety of spaces in which they could spend their time, and their bedrooms were personalised. Reasonable adjustments had been made to enable people to move around as independently as possible.

Staff confirmed they had received relevant health and safety training, including fire safety to carry out their roles to ensure the safety of people living in the home.

Risks relating to the physical environment had been identified and the necessary remedial actions were completed to ensure people’s safety. A maintenance record was in place and jobs were completed in a timely manner.

The provider had good oversight of all aspects of the premises. The home manager liaised regularly with the provider to address any arising matters.

Environmental risk assessments considered all aspects of the home, both internally and externally to ensure people lived freely within a safe environment.

The provider undertook regular health and safety checks of the premises. Safety systems and equipment used at the service were maintained and serviced at regular intervals to make sure these remained in good order and safe for use.

People had individual personal evacuation plans in place to guide staff in the event of a fire.

The provider did not always make sure there were enough qualified, skilled and experienced staff. They did not always make sure staff received effective support, supervision and development. They did not always work together well to provide safe care that met people’s individual needs.

We received mixed opinions from staff regards to staffing levels. Some care staff told us they did not always feel there was enough time to chat with people and provide other activities. The home currently had vacancies for activities staff. The home manager told us the service was actively recruiting for more activities staff, to include more one-to-one activities for people who required this.

People said they liked the staff supporting them and support was available in a timely manner.

We were satisfied that the dependency assessment tool used determined staffing levels, and this was regularly reviewed as part of the provider’s system of audits. The electronic dependency tool flags if there is any deficit in staffing, which then needs to be raised with the operations director.

Staff deployment across the home was managed and communicated via a notice board by the office. The allocation list took account of staff skill mix on each floor. The service was using their own bank staff rather than agency whenever possible.

We observed people being supported appropriately by staff in a timely manner throughout our visits.

Staff were well trained and competent in their jobs. Staff received training, which enabled them to feel confident in meeting people’s specific needs and identify changes in people’s health.

There were safe and effective recruitment and selection processes in place.

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.

Effective infection control measures were in place.

People confirmed that the home was clean and tidy with a homely feel.

Staff wore appropriate personal protective equipment appropriately.

Staff were trained in infection control and said there was plenty of equipment to ensure effective infection control.

Hoists and other equipment were monitored and kept clean. Cleaning charts were up to date, which covered all aspects of the home.

Infection control audits were completed on a regular basis to ensure the safety of the layout and hygiene of the premises.

The provider’s infection prevention and control policy was up to date.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

There were some care plans which lacked relevant risk assessments for some medicines e.g. blood thinning medication. However, this had already been identified and work started to make sure these were all completed.

We observed medicines being given safely.

People received their medicines in the way prescribed for them, and at suitable times.

Staff we spoke with said that they felt supported with medicines, and they knew how to report any medicines issues or errors. They were knowledgeable about the residents and their needs regarding medicines, including ‘when required’ medicines and when they might be needed.

When medicines were prescribed to be taken ‘when required’ there was information in place to guide staff when these might need to be given. Work was underway to update these protocols and include more person-centred information.

Medicines were stored safely and there were appropriate arrangements for disposal, and for controlled drugs. There was suitable temperature monitoring being carried out.

Medicines audits were completed, and errors or incidents were reported, investigated and any actions put in place to prevent recurrence.

Staff training and competency checks were in place and documented.