Whiston Hall

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

There were sufficient staff at the service to respond to people’s needs in a timely way. However, the provider could not evidence staff had recieved appropriate training. Risks associated with people’s care were identified and managed to keep people safe. People who required hoists to assist them to transfer safely, had details in their care plans regarding how to carry out the task safely. People receive their medicines as prescribed. The home was generally clean and tidy and infection prevention and control was managed to minimise risks. The systems in place to learn from accidents and incidents were effective.

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.

People told us they felt safe living at the home. One person said, “I’ve been here 8 months. Had falls previously, pressure ulcer on hip, improving now. I feel safe, you’re looked after, and they feed you. They are very good to you here."

We spoke with 6 staff including members of the management team, care workers and ancillary staff. Staff told us they worked well together to ensure people’s needs were met in a safe way. One staff member said, “If we need to know any information documents are all kept up to date, ensuring any risks are managed with appropriate risk assessments.” Staff were able to recognise possible signs of abuse and knew how to report such concerns. Staff told us they received training which gave them the skills and knowledge to carry out their role well.

Accidents and incidents were analysed, and trends and patterns identified to ensure lessons were learned to mitigate future risks. The provider had an accident and incident analysis which informed the care plan process. Any actions taken as a result of accidents, were reported within people's individual care planning documentation.

Some people shared details of all the different healthcare professionals involved in their care. People and relatives told us referrals to healthcare professional were made appropriately. One relative said, "There’s a problem at the doctors and prescriptions and not sorted and the people here have to chase."

One staff member said, “If we need to know any information documents are all kept up to date, ensuring any risks are managed with appropriate risk assessments.” Staff were able to recognise possible signs of abuse and knew how to report such concerns. Staff told us they received training which gave them the skills and knowledge to carry out their role well.

The local authority had recently carried out a review of the service with an outcome of good. There are some domains that were rated requires improvement, which included involvement and information, consent, management of medicines and staff support. The local authority also raised concerns with us regarding the lack of evidence to show staff had been trained appropriately.

Processes were in place to enable a smooth transition between services and to reduce the impact on people. The quality of some people's care records and/or medication records had sufficient detail to enable effective information sharing. Care plans for people living with dementia required more detail.

People felt safe living at the home. The relatives spoken with told us their family members were safe. One person said, "Oh yes, I’m safe, I don’t feel frightened.” Another person said, "Oh yes, I feel safe; there’s somebody here all the time. They [staff] come if I press eventually; it seems a long time. You can ask someone to press the buzzer in the lounge if you need to."

Staff and leaders told us they took safeguarding concerns seriously. Staff were able to recognise possible signs of abuse and knew how to report such concerns. Staff told us they received training which gave them the skills and knowledge to carry out their role well. One staff member said, “I would feel comfortable speaking with the deputy and home manager within the home, I feel that any allegation of abuse would be actioned appropriately.”

We observed staff interacting with people and found they carried out support in a safe way. For example, people who required the use of hoists to assist them to transfer, were provided this support safely and in line with their needs.

The management team understood their responsibility to refer any safeguarding matters to the appropriate agencies. The service had policies and procedures in relation to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The service was aware of the need to and had submitted applications for people to assess and authorise that any restrictions in place were in the best interests of the person.

People told us they felt safe living at the home. One person said, “I’ve been here 8 months. Had falls previously, pressure ulcer on hip, improving now. I feel safe, you’re looked after, and they feed you. They are very good to you here." People told us that the home required some investment as the furnishings were old and worn. One relative said, “[Relative] has been here 2 months. Generally, it’s a bit mixed, the building is not conducive to a sense of community with just small rooms, and it needs some investment." A relative said, "The floors are uneven. The dining room is not big enough for everybody."

Staff told us they worked well together to ensure people’s needs were met in a safe way. One staff member said, “If we need to know any information documents are all kept up to date, ensuring any risks are managed with appropriate risk assessments.” Staff were able to recognise possible signs of abuse and knew how to report such concerns. Staff told us they received training which gave them the skills and knowledge to carry out their role well. Staff were aware of people’s moving and handling risks and ensured people had access to their own sling.

We observed staff interacting with people and found they carried out support in a safe way. For example, people who required the use of hoists to assist them to transfer, were provided this support safely and in line with their needs. Specialist diets were provided to people where required.

Risks associated with people’s care were identified and managed safely. For example, one person required a fortified diet due to the risks of weight loss. This person’s care plan was informative and directed staff in the most supportive way. Another person was at risk of falls but had sensor equipment in place to ensure staff would be alerted if the person was walking around. Therefore, the risk of falls was reduced.

People told us that the home required some investment as the furnishings were old and worn. One relative said, “[Relative] has been here 2 months. Generally, it’s a bit mixed, the building is not conducive to a sense of community with just small rooms, and it needs some investment." A relative said, "The floors are uneven. The dining room is not big enough for everybody." People told us the provider responded when they required something. One person said, "I asked for a new bed, and they got one." However, a relative said, “The tired furniture needs replacing. There’s a good outdoor space but the outdoor furniture needs replacing. There’s a lack of investment from [the provider]. The manager and staff are doing well.”

Staff told us they worked well together to ensure people’s needs were met in a safe way. One staff member said, “If we need to know any information documents are all kept up to date, ensuring any risks are managed with appropriate risk assessments.” Staff were able to recognise possible signs of abuse and knew how to report such concerns. Staff told us they received training which gave them the skills and knowledge to carry out their role.

During our assessment we found the environment and furnishings required some investment. People and their relatives also commented the environment needed to improve. We saw evidence that environmental and equipment checks had been completed. Equipment was available in different areas of the service for staff to access easily.

There were arrangements in place to monitor the safety and upkeep of the premises. However, while systems had identified that improvements to the environment were needed, timely action had not always been taken. Environmental safety checks were in place, ensuring the environment and equipment was safe for people to use. This included fire safety, legionnaires and lifting equipment precautions.

We received mixed views regarding staffing. One person said, "I think there’s enough staff and nothing is too much trouble for them [staff]." One relative said, "Staff are very good sometimes there’s not enough. People have to wait; [relative] says she can be waiting ages, so she takes herself to the toilet." Another person said, "Staff numbers go up and down and some days they seem short. They are short of night staff but seem to get the job done."

The management team explained that a new system had been used to record staff training. However, the information from the previous system was not available. The management team told us they had no way of evidencing what training staff had completed. One staff member said, “We have enough staff and would inform the manager if we were struggling to get things done.” Staff felt they worked well as a team to ensure people received good care and support. One staff member said, “There’s a great sense of teamwork, we all work well together.”

During our inspection we observed staff interacting with people and found there were sufficient staff available to meet people’s needs in a timely way. Staff worked well as a team and communicated with each other in order to complete tasks effectively.

Robust recruitment procedures were in place, so people were cared for by staff who had been assessed as safe to work with people. The provider used a dependency tool to assess how many staff were required to support people. This was regularly reviewed to ensure there were enough staff to meet people’s needs. Records did not always evidence staff had received training. The provider explained there had been a change in the way training was recorded and the staff training had not migrated from one system to the other effectively. This meant the provider could not always demonstrate staff received appropriate training to carry out their role. We have reported more about this in the well led section of this report.

People and their relatives told us the service was clean. Nobody raised any concerns regarding the cleanliness of the home, or the infection prevention and control systems carried out by staff. One person said, “They [staff] do keep it clean." Another person said, "Yes, it's clean enough."

Staff told us they Personal Protective Equipment (PPE) when required and that the management team ensure PPE is always available.

We carried out a tour of the home and found the home was predominantly clean. We found some concerns regarding storerooms and cleanliness of cupboards. These were addressed during our site visit. Hand washing facilities were available throughout the home.

Systems in place to monitor infection, prevention and control practices were not always effective and and did not always ensure people were protected from the risk and spread of infections. Audits were carried out frequently but did not always ensure the homes standards were maintained. For example we found storage facilities had not been cleaned effectively.

People told us they received their medicines on time. One person said, "They [staff] never miss my tablets."

Staff told us they received training prior to administering medicines. Staff also confirmed they had their competencies assessed regularly to ensure they understood how to safely administer medicines.

Systems in place ensured people received their medicines as prescribed. An audit to monitor medicines was carried out by the management team on a monthly basis. This ensured any concerns were highlighted and actions taken to address them. People who required medicines on an ‘as and when’ required basis known as PRN, had protocols in place to inform staff when the medicine was required.