Cleveland 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. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

People were supported to take positive risks and be as independent as possible. There were processes in place to protect people from abuse. The service learned lessons from accidents and incidents to reduce the risk of them happening again. There were enough staff to support people, who had received appropriate training and supervision. Medicines were managed 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.

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. There were effective systems in place to monitor accidents and incidents, analyse and identify patterns or trends. The service had an incident review process and held a ‘nibble and natter’ session weekly, to discuss with staff any concerns they may have. The provider monitored incidents over all their services to look to see if there were any emerging risks and what actions could be taken to reduce risks.

When incidents had happened in the service, action had been taken to reduce the risk of them happening again. The actions taken had been effective and incidents had not reoccurred. For example, people had been referred to health professionals such as occupational therapists or speech and language therapists. Staff told us they felt engaged and were kept up to date with any changes to people’s support. There were daily handover periods and weekly team leader meetings to keep staff up to date and discuss any lessons learnt when incidents had happened.

People told us they felt safe living at the service and could talk to staff about any concerns they may have.

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. There were systems in place to make sure people were supported when moving into the service. The registered manager and another member of staff completed a comprehensive assessment of people’s needs. They made sure people were supported during this process. For example, one person had been supported by staff from the day centre they attended as they trusted them. The staff also knew them very well and could give person centred details about how to support the person.

Staff made sure there was up to date information available when people attended healthcare appointments or when they went into hospital.

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. There were effective processes in place to identify, report and act upon safeguarding concerns. The registered manager understood their responsibility to report concerns and work with other professionals to keep people safe.

Staff received training, they could describe how to recognise signs of abuse and what action they would take. Staff told us they were confident to raise concerns, and the registered manager would take action to keep people safe.

Relatives told us they thought people were safe at the service. A relative told us, “We are kept informed by the staff and are confident to raise any concerns we have. If we have any little worries, we speak to staff, and they always get straight back to us.” People had access to an easy read document explaining safeguarding and how to raise concerns.

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. Staff were proactive in supporting people to take positive risks. People showed us around the kitchen, explaining to us about where food was kept and how they made their breakfast and packed lunch with support of staff. People made themselves hot and cold drinks whenever they wanted. People were supported to manage their budgets to make sure they could buy items they wanted including electronic devices. They showed us how they used these devices independently. People were supported to maintain relationships with family and friends, including going to stay with relatives. People were supported to have romantic relationships. Staff worked with people to identify how they wanted the relationship to develop, supported them to make decisions and keep people safe and healthy.

People’s support plans contained detailed guidance for staff to support people to be as safe as possible. Some people were being supported to eat a healthy diet, exercise to lose weight and make healthy choices. Potential risks to people’s health had been assessed. Some people were living with diabetes or epilepsy, there was clear guidance for staff to recognise when people were unwell and what action to take.

Other professionals had commented about how people’s independence had improved including mobility and hygiene. Relatives told us, “(Person) gets involved in day to day activities such as meal preparation and cleaning, they have a purpose.”

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 enjoyed living at the service and the building was safe for people to access all areas. People showed us their rooms which were personalised and decorated as they wanted.

The management team ensured the service was safe for people to live as independently as possible. People safely accessed the kitchen and used equipment to clean and do their washing. Adaptions had been made to bathrooms to make sure people could complete their personal hygiene as independently as possible.

The provider 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. Staffing levels were based on what support people needed. There was a core element of staff, but this changed according to people’s activities. At this assessment, building work was being completed, which some people found difficult. Staff had adjusted their hours so they could accompany people to go out when they wanted or stay out later. There was always more staff on a Tuesday evening as people liked to go to a disco.

Staff had been recruited safely and had received training appropriate for their role. Staff had completed all their basic training and were supported to complete additional training. Staff told us they received regular supervision and discussed their training needs.

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. People and staff worked together to keep the service clean. People were supported to clean their room and assist with the laundry. One person told us this was their favourite task and showed us how they supported staff by placing laundry in the machine, folding and putting it away.

There were handwashing facilities in the communal bathrooms and staff toilets. Staff were up to date with current guidance, including the management of visiting during an infectious outbreak.

People were supported to have vaccinations when offered including flu and Covid-19. Staff arranged for the vaccinations to be given at the service, so people were more relaxed.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. There were effective processes in place to order, store, administer and dispose of medicines. Staff made sure people took their medicines when they were away from the service. When people visited family, their medicines were sent with them. Medicines were placed in separate sachets for each time of the day, to make it easier when people were away from the service. There was an electronic medicine management system in place. The system identified when medicine administration had not been recorded, and this was flagged up on the system. This was used to monitor staff performance and part of their supervision.

People were supported to live a healthy lifestyle. One person had been supported to lose weight, and the result was a reduction in some of their medicines.