Weald 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

The provider took an innovative approach to minimise risks to people. They had recently installed a new motion sensor system which was individualised to people’s needs. This provided a 3D model of a person’s room and could sense when something changed, for example, if someone got up to mobilise. This alerted staff to those who needed assistance without disturbing call bells ringing. The system had caused a significant reduction in the number of falls at the home. People told us they felt safe living at Weald Heights. Staff knew people well and had a robust knowledge of safeguarding. There was an open and transparent culture at the home, and learning from any accidents and incidents was encouraged. Risks to people were assessed and managed, whilst their independence was promoted. There were sufficient staff levels to meet people’s needs, staff were recruited safely and received training to ensure they could fulfil their role effectively.

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 told us they were happy to live at Weald Heights, they enjoyed the activities and felt well cared for by staff. Relatives spoke positively about the care home and the support their loved ones received, they felt the home was well managed and that staff had been well trained to meet people’s needs. They told us there was an open and transparent culture for learning, communication was good, and they were involved in decisions regarding people’s care.

Staff spoken to advised that they get feedback following any incidents or accidents and can have open and honest discussions in their team meetings. Staff felt that the management team were approachable. Staff were involved in decision making and any learning following incidents was shared to improve practice.

There was a robust and transparent learning culture at Weald Heights. Regular analysis took place of accidents and incidents, including any medicine errors, to establish a root cause and develop any learning which may be needed. All outcomes or learning was shared with staff via bulletins and meetings. Supervision was also considered if this was needed. We reviewed the incident bulletin for a medication error, there was a clear description of how the incident occurred and how this can be prevented moving forward. Staff involved undertook a reflection and it was openly discussed in a staff meeting. Any outcomes or improvements highlighted by internal or head office audits for all aspects of day-to-day care provision were taken forward for future improvements or development of the home.

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.

People told us they felt safe and supported at all times. Comments included, “Very well looked after, I can’t really fault anything, and I feel 100% safe with the staff here”, “I do feel safe here which is down to the staff,” and, “Very well looked after, I have no worries at all, and I feel completely safe”. Relatives spoke positively about the new sensor system in people’s rooms which gave added reassurances, there is more information about this in the ‘involving people to manage risks’ section. Relatives felt that staff understood people’s needs and worked hard to maintain people’s safety.

Staff were confident from their training about safeguarding, they knew the different types of abuse and how to protect people from harm and reduce risks. Staff were confident with how to report any concerns, and that these would be followed up appropriately by the registered manager or deputy manager. We were aware of a recent safeguarding where staff had taken immediate action to report this, and the registered manager engaged openly with the local authority to investigate the matter. Management were clear about what needed to be recorded and had robust follow up processes in place following any incident, accident or safeguarding concern identified and referred.

Staff were always available to support people when needed. We observed staff were quick to attend to rooms if the new sensor system alerted them that someone might be at risk of having a fall or they needed assistance. They also carried out regular visual checks on people in their rooms and communal areas. Staff were knowledgeable about the walking aids and support people required to mobilise safely around the home. We saw people being reminded to use equipment when necessary. Staff assisted people appropriately at mealtimes and were aware of people’s dietary requirements.

There were safe and thorough systems and processes for identifying and reporting safeguarding concerns. Appropriate action had been taken to investigate matters where necessary. Mental capacity assessments, best interest decision making, and Deprivation of Liberty Safeguards (DoLS) were all in place where appropriate. DoLS files contained all required information including the date the referral was due to expire. Information was also recorded in people’s care plans, with clear reasoning for the application. People’s care plans documented consent, and any best interest decisions made. Staff were knowledgeable about consent, the Mental Capacity Act (MCA) and about least restrictive options. Information about the MCA was displayed around the home for the staff to view.

People felt that staff helped to keep them safe and minimise any risks they may face. One person told us, “Staff are always cheerful and helpful. I do feel safe here which is down to the staff.” A relative told us, “Staff know [person] and are amazing.” Another added, “Everyone is always very friendly and welcoming when we visit. Staff seem to genuinely like [person] and have a good laugh with them. They are caring and really do seem to want to make [person’s] life as good and safe as it possibly can be”. People and their relatives were involved in care plan reviews, which included any risk assessments.

Staff knew people well and were able to give examples of how they supported people to manage and reduce risks, whilst supporting them to maintain their independence. Staff were able to identify if people were unwell or if their mobility had deteriorated and what procedures to follow. They knew who was prone to certain ailments, for example urine infections, and would start using a fluid chart if necessary. Staff told us they have time to read risk assessments and that these were updated if there were any changes.

We observed people being assisted with their mobility and hoists being used safely to move people from wheelchair to chair. This was done maintaining the person’s dignity, with staff taking the time to speak to and reassure the person throughout the process, reminding them what was happening, where to put their hands and feet, and generally ensuring they were not anxious or upset during the process. Staff were well trained and confident during all moving and handling we saw. People were supported to have sessions with a physiotherapist to try and maintain and improve their mobility, try new walking aids and reduce the risks of falls. Some people experienced anxiety, they were supported to attend Namaste sessions if they wished. One person was observed to have an anxiety attack, staff knew the best way to support the person. They supported the person to do breathing exercises and sat with the person until they were feeling better.

There were clear and concise processes to monitor and assess risk. The ethos of the home was to manage risk in a holistic way, ensuring people remain safe and supported to live the way they chose, with minimal restrictions in place. The provider had taken an innovative approach to minimising risks to people and had recently introduced a new sensor system, described as a ‘roommate multi system’ which detected people’s movement in their room. People had consented to have this in place. The system established a virtual 3D model of a room, rather than using live feed cameras. This way it was able to pick up whether something in the room changed. Every room had a unique set up which varied in elements such as sensitivity and time of day it was active, dependent on people’s assessed need. Staff would be alerted on a handheld device if there was movement in a room much sooner than other equipment. This also reduced the disruption of call bells ringing. It could also be used at night, to prevent people from being disturbed. The system prevented the use of more restrictive safety measures, such as sensor mats. When staff enter a room, they electronically swipe at the door, this shows and logs who attended and for how long, it gets turned off while care is taking place to maintain people’s dignity. Since the system had been installed, falls had reduced by a third. A clinical risk register was used to identify which people were at highest risk. It considered matters such as skin integrity, catheter care and weight. There were weekly clinical care meetings to review risks and take action, such as following up referrals to tissue viability nurses. When people had skin tears, these were clearly recorded. This included details of any medications people were taking which may impact healing. Wounds were reviewed and assessed regularly. Wound folders were used to document all wounds and treatment or dressing plans. Regular photographs were also taken to record wounds and healing.

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 and relatives spoke positively about staff at the home. People were seen being well supported by staff and they were attentive to people, especially during mealtimes. One relative told us, “We have never been aware of a shortage in staff. The home seems well staffed to cover all areas of care. I can’t comment on training, but everyone seems able to cope within their role.”

The management team advised that recruitment had been a challenge, but they had completed a pay review, and this resulted in more success with recruiting staff and using less agency staff. Staffing levels were sufficient and remained stable. Staff felt the staffing levels had improved lately, that there were less agency staff and more permanent staff now which had improved teamwork and staff morale. Where agency staff were used, they were included in supervisions, learning processes and team meetings, to offer the same development opportunities as permanent staff. Staff spoke highly of the clinical lead, and team leaders, and worked well as a team, supporting each other well.

We carried out observations in communal areas and used our Short Observation Framework for Inspection (SOFI) to support this. We saw warm interactions between staff and people throughout the day. Sufficient staff were visible, and they all had specific roles, for example nurses, housekeepers and some floors had a hostess. We also saw lifestyle staff providing activities and company for people throughout the day. Staff understood their roles and responsibilities and all staff appeared to work well together as a team.

There were detailed and robust recruitment records in place, including all appropriate checks and references completed. Staff had completed the Care Certificate. This is an agreed set of standards that sets out the knowledge, skills and behaviours expected of specific job roles in the health and social care sectors. Information was recorded regarding staff inductions and supervision. An Induction Journey booklet included a clear list of tasks required within a certain time frame. Tasks were dated and signed off once completed. Staff had developed a ‘Welcome to Weald Heights’ document themselves to support new staff members to learn about their role. Staff received regular supervisions which were based around Weald Height’s values. The registered manager kept track of staff training compliance on an electronic system. Staff had access to computers around the home, and quiet areas, to complete their training. Role appropriate training had been completed by staff.

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

People felt supported and received their medicines as prescribed. Comments included, “[Staff] give me my medicines and always check to see that I am not in discomfort,” and “I wouldn’t want the responsibility, and I am offered pain pills and so on, so I get them when I need them”. We carried out observations throughout the inspection and saw examples of good care and nursing staff administering medicines to people in accordance with their prescriptions and preferences.

Staff who were trained to administer medicines told us they received training and competency checks. Staff felt confident to use the electronic medicine administration records (eMAR) system and were able to talk us through the process. Staff felt confident to administer medicines and were supported by the clinical lead, deputy manager and registered manager. We spoke in detail with the registered manager, deputy and staff who were able to explain the process used to ensure people received their medicines correctly. We saw that staff wore a tabard whilst administering medicines and used a locked trolley to store them.

There was a clear process in place regarding medicine management. Policies and procedures were available to staff, and they had good knowledge of these. Safe processes were followed for the ordering and disposal of medicines, and the management team had daily oversight of administration. This involved a dashboard where managers could see if any medicines were overdue or if as and when (PRN) medicine protocols had been followed. Audits of medicines were undertaken monthly and action to address any discrepancies was taken readily. This included specific audits of controlled medicines. Following a recent medication error, clear learning was evident with a medicine incident bulletin completed and cascaded to staff to understand what happened and learn from this. Where people were able to manage their own medicines, this was risk assessed and reviewed regularly to support them to maintain this independence. The home was also supported by an external pharmacist.