Community Places

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.

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. Accidents and incidents were thoroughly investigated, used to inform any changes to the service, and the provider apologised when things went wrong. The provider captured lessons from incidents, and they encouraged members of staff to use reflective practice to improve delivery of care and support. Lessons were learnt to continually identify and embed good practice.

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.

Relatives told us if people became unwell, staff would act on it and contact health professionals as needed. Comments included, “The staff are well-trained in [persons] health condition, and I really trust them. The staff keep me well informed and ring me even if it is only for a chat.” Another relative said, “[Relatives] health needs are well looked after, and [relative] has 1-1 staff. The home is friendly and it's a jolly place.”

Where healthcare professionals provided advice about people's care, this was incorporated into people's care plans and risk assessments. People’s care records contained documents which they could take with them to hospital or healthcare appointments. These documents contained important information about people’s care and communication needs, including personal details, the type of medication people were taking, and any pre-existing health conditions.

One person accessed the service in an emergency. However, the provider was unable to offer long-term support. The provider collaborated with health and social care professionals to identify a service that could meet the person’s needs and was instrumental in facilitating a smooth transition into the alternative service. They shared essential information and arranged joint working sessions, allowing staff to shadow the team and build rapport with the person. The provider maintained open and honest communication with the new care provider, about the complexity of the person's needs, prioritising their safety and well-being throughout.

Another person experienced multiple hospital admissions. A dedicated team of staff was mobilised to stay with the person during each admission. Staff offered familiarity and consistency and worked alongside hospital staff to ensure the person's needs were understood and met.

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.

Safeguarding systems and processes were in place to identify report and investigate, allegations of abuse.

Relatives told us people were safe. One relative said, "The service is very safe. The safest [person] has ever been.” We observed staff speaking to people in a respectful manner and including them in decisions. We saw staff responded promptly when people were feeling anxious or needed support.

Staff demonstrated they were highly skilled at recognising when people were unsafe and were confident when challenging and reporting unsafe practice. They knew from people's body language and actions if a person felt unsafe or were worried about something. Staff told us they would give people time to talk and recognise if there were any changes in their behaviour they felt might need to be reported due to safeguarding concerns.

Any safeguarding concern was investigated thoroughly and learning shared with staff at meetings or during supervision. The provider had logs and records that showed appropriate action had been taken where necessary. This information was then monitored by senior leaders and the provider to identify any themes or trends.

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.

People were encouraged and supported to take positive risks. This allowed them to live as unrestricted a life as possible. Staff we spoke with were aware of people's individual risks and shared with us how they used techniques to reduce the likelihood of people being harmed. Some people living at the service required support to manage difficult or distressed behaviours and staff received training and clear guidance about how to do this safely. Staff regularly evaluated and reviewed risk assessments to ensure they remained up to date and relevant to each person. The manager reviewed incidents and information about risks regularly. Care plans were updated to ensure staff had information about people’s current needs.

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

Decoration within the home was clean and fresh and the environment was free from obvious hazards. People’s bedrooms were well-decorated and personalised. Photographs and items of importance and interest to people were present and people confirmed they had been involved in choices about the decoration in their rooms. The garden was designed to be accessible and included a range of sensory adaptations. It featured specialist leisure equipment and furniture for people to use.

The provider ensured equipment was serviced and checked by external contractors to help maintain its safety. For example, fire equipment, gas servicing, lifting equipment and electrical safety checks were completed as required by regulation.

Each person at the home had a personal emergency evacuation plan. This is a document that describes the help a person will need to evacuate the service in an emergency. This was available to staff and there was a business continuity plan in place to ensure staff had immediate guidance on how to respond to emergencies.

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.

The provider followed safe recruitment processes and had made the necessary checks before staff worked with vulnerable people.

There were suitable numbers of staff available to meet people's assessed need, including 1:1 support where this had been commissioned.

Training was up to date, and it was clearly recorded when the updates would be due. Staff told us and we saw documentation which showed, staff had effective support and development opportunities. Staff received regular training and updates to ensure their knowledge and skills remained current. Completion of training was monitored by the registered manager who identified any shortfalls and took action to ensure training was completed.

Newly appointed care staff went through a comprehensive induction period. This included training for their role, shadowing an experienced member of staff and having their competencies assessed prior to working independently with people.

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 were supported in an environment that was clean and hygienic. Staff received training in infection prevention and control and had an ample supply of personal protective equipment available to them.The housekeeper completed monthly infection control audits which showed any issues were identified and acted upon. These were then checked by the registered manager and action taken where necessary.

Medicines were mainly managed safely. The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

People had their medicines managed safely by staff who were trained and competent. Regular medicines reviews were completed and staff carried out weekly medicines audits to identify any areas for improvement.

There was an effective system in place for ensuring medicines were accounted for and the records about medicines demonstrated that people were given their medicines and creams as prescribed.

During the inspection we saw that medicines were stored safely but improvements were needed to make sure medicines were safe when staff were administering them. Immediately following the inspection these improvements were made.

Arrangements were in place for people to take their medicines when they were away from the service, for instance when people went to stay with their family overnight. However the medicines were not appropriately labelled which meant that the people caring for them did not have access to the prescriber’s directions. To ensure that this process was more robust the provider took immediate action and reviewed their processes to ensure that leave medicines were appropriately dispensed and labelled with the prescribers’ instructions and that there were robust systems for recording the quantities of medicines taken out and returned to the service.

For most people who were prescribed medicines to be taken ‘when required’ there was clear information for staff to follow to ensure that people were given their medicines when they were needed. However, there were some examples seen where this information was missing and when medicines were prescribed with a choice of dose there was no information recorded to guide staff how to choose the most appropriate dose. This meant that sometimes people were at risk of not being given medicines prescribed in this way safely and consistently. We raised this to the registered to the registered manager who told us they review the systems in place and raise this with the staff team.

The records about the use of prescribed thickeners were not always accurate and we recommended that this needed to improve. Medicines which needed to be administered at specific times were not always administered at the correct times. However, there was no evidence of impact on people.

Relatives spoken with did not share they had any concerns about the way medicines were managed.