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• 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.

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 was a positive learning culture, where the provider gave opportunities for staff to discuss lessons learnt in staff meetings, supervisions and daily meetings. Staff told us learning was a positive experience in the service. One staff member told us, “If there are any incidents, we work on it as a team.”

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 safe systems and pathways to support safe transfer of care between services, including thorough pre-admission assessments and close working with the GP surgery.

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.

The service made appropriate safeguarding referrals to keep people safe and implemented appropriate measures to mitigate any further risk of incidents occurring. People and their relatives told us they felt safe.

Where people were subject to Deprivation of Liberty safeguards (DoLS) the service had made applications to the local authority and there was clear monitoring in place. DoLS ensure if a person is restricted in a way that deprives them of their liberty in a care home, it is only done when it is in their best interests, is necessary for their safety, and all other options have been considered. There was a tracker in place which was monitored by the provider.

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.

There were robust processes in place to ensure the appropriate professionals were involved o manage risk. For example, there were risk assessments in place which were robust, accurate and regularly reviewed by leaders, and followed by staff. The service also worked closely with the local GP surgery, where a weekly ward round was completed. Professionals we spoke with told us the service escalates to them appropriately where required. One professional told us, “The home is good at escalating heath concerns.”

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

The provider had robust systems and processes in place to ensure a safe environment. This included thorough maintenance checks of the environment and relevant equipment, and appropriate fire safety measures. The service also implemented a clean air ventilation system. We did observe the kitchen, and other areas needed a deep clean, however, this was immediately rectified by the service. The provider advised us they plan to implement different ways of working to ensure kitchen areas remain clean.

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.

There were robust recruitment processes to ensure safe staffing. Staff had completed relevant training. People we spoke with had confidence in staff. One relative told us, “New staff appear to be shown how to do things by more experienced staff. That’s how I can tell someone is new.”

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.

There were robust measures in place for the safe prevention and management of infection, including ample stocks of personal protective equipment (PPE) and cleaning supplies, stored safely in a Control of Substances Hazardous to Health (COSSH) cupboard. Cleaning schedules were completed consistently.

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.

Medicines were managed safely in the service, with robust processes in place such as safe storage of controlled substances, accurate and complete medication administration records (MARs), and equipment checks. The service also had a defibrillator and anti-choking equipment on site. We observed “as and when required” (PRN) protocols required increased detail to better detail support required to staff. There were occasions of minor documentation errors in relation to medicines, for example, use of a PRN medicine where this had changes to an ongoing daily medication. This was not accurately reflected in the persons care plan. However, leaders rectified this issue immediately. People advised us their medicines were well managed. One person told us, “I always get my tablets around the same time each day.”