White Hart 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. This is the first inspection for this newly registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

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 service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Staff knew what incidents to report and how to report them. The service investigated incidents thoroughly and shared outcomes with relatives and professionals. We did see evidence of change as a result of incidents that had occurred. Serious incidents were shared at shift handover, but records did not show how feedback were routinely shared with all staff to ensure any learning would be understood and implemented by all.

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. One relative told us, “We were fully involved in the transition into the home and the care plan was spot on.” A staff member told us, “The manager introduced the person to the home, and everything was put in place before they arrived. Staff members went out and visited the person in their setting prior to them moving in. It was a very thorough process. I have worked in care for a long time and never seen it done as well.”

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on protecting people’s right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm, and neglect. Staff knew how to protect people from abuse and who they would report any concerns to both internally and externally. The service shared concerns quickly and appropriately. Deprivation of Liberty Safeguards (DoLS) were in place to legally authorise restrictions placed on people to keep them safe. The manager was reviewing people’s DoLS to ensure all restrictions were noted and considered.

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive, and enabled people to do the things that mattered to them. Staff supported people to manage risks whilst maintaining their independence by promoting positive risk taking. For example, people were assessed for risks of falls, risk of choking and risk to their skin. When risk had been identified staff followed actions to keep people safe such as providing specialist equipment to protect people from skin damage. The manager told us about some people’s communication aids and how they used these to communicate and discuss risk with people.

The service did not always detect and control potential risks in the care environment. Concerns with fire doors identified through a fire service audit had not been acted on prior to our site visit. All the fire alarm testing call points were also not tested regularly to ensure they remained effective. The manager took remedial action during our visit. Time was needed for all fire safety systems to be implemented consistently. The service mostly made sure equipment, facilities and technology supported the delivery of safe care. For example, firefighting equipment, gas, and electrical testing had been routinely carried out. We did note not all the fire alarm testing call points were tested regularly. Which meant the provider could not be assured they would all work in the event of a fire. We spoke to the manager about this who told us, they would add a call point schedule for staff to follow when undertaking fire alarm testing.

The service made sure there were enough qualified, skilled, and experienced staff, who received effective support, supervision, and development. They worked together well to provide safe care that met people’s individual needs. A relative told us, “The team has been consistent for the last eight months plus which has been good. And I feel that they are adequately trained.” Staff told us, there was enough staff to allow them to provide consistent care and they described a comprehensive induction process. Managers followed safe recruitment practices.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. The provider had an up to date Infection Prevention and Control (IPC) policy. Staff attended IPC training. We reviewed cleaning schedules which were consistently completed. Most relatives told us they felt the home was clean.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened. Staff supported and involved people to manage their medicines and mostly followed best practice for administering medicines. There had been some medicines errors, however, the manager had taken appropriate actions following these, including a debrief for staff discussing lessons learned and additional training.