The Emmie Dixon Home

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 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 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 provider had a proactive and positive culture of safety, based on openness and honesty. Staff were aware of safety concerns and followed processes to investigate and report incidents.
Lessons were learnt to continually identify and embed good practice.The registered manager responded positively when issues arose and took appropriate action when mistakes were identified.
Medication errors were thoroughly investigated, and changes were made to processes to reduce the risk of recurrence. Where we identified areas for improvement within the home environment, the provider and registered manager were proactive and took prompt action to address them.Relatives reflected this approach, telling us their feedback was regularly sought and any concerns raised were acted upon promptly and effectively.
 

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.Before people moved into the home, a comprehensive pre-admission assessment was completed with input from the person and their relatives. This captured detailed information about their care and support needs. This information was regularly reviewed to ensure the person’s needs were being met and the home was the best place for them. The registered manager worked with people, their relatives and social workers to ensure people were happy and content in their new home. Where people accessed other services for leisure activities, clear communication processes were in place to ensure relevant information about their needs and preferences was shared to support consistent care.
 

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 registered manager monitored all safeguarding concerns and the actions taken. Safeguarding concerns were recorded and dealt with appropriately, with a tracker used to monitor them and record updates. Information about how to raise concerns was readily available to staff. Staff received safeguarding training when they started working at the service and through regular refresher training.
Where necessary, the registered manager submitted Deprivation of Liberty Safeguards (DoLS) applications to help ensure people who lacked the mental capacity to consent to their care were supported in the least restrictive way. Best interests’ decisions were made where appropriate and involved relatives and others who knew the person well.
 

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 supported to take positive risks in a way that reflected their individual needs, preferences and goals. Risk assessments were developed with people and, their views were considered whenever possible when deciding how risks should be managed. People were supported to make choices important to them, and staff helped them understand any associated risks so they could make informed decisions.Staff understood the importance of positive risk-taking and worked with people to identify ways of achieving their goals safely. Staff received training in Positive Behaviour Support (PBS) and learning disability awareness, which helped them understand people's individual needs, promote independence and provide support in ways that reduced distress and enhanced wellbeing.
 

The provider ensured equipment, facilities and technology supported the delivery of safe care; however, risks within the care environment were not always identified appropriately. Environmental oversight was generally effective; however, auditing processes had not consistently identified all maintenance issues. We found a frayed carpet, damage to a wall resulting from a leak, and a damaged radiator cover. When we fed this back, the provider acted promptly to replace the carpet and made repairs to the wall and radiator cover.

There were appropriate systems in place for the maintenance and safety of the premises, including regular checks of equipment, fire safety equipment and electrical systems. External specialists had completed comprehensive audits and risk assessments, providing additional oversight of environmental risks. The equipment people used were regularly checked by staff and external providers completed service visits in line with Lifting Operations and Lifting Equipment Regulations (LOLER). Personal Emergency Evacuation Plans (PEEPs) had been developed for people, providing guidance on the support they would need in the event of an emergency. The provider maintained an emergency grab bag; containing essential information and procedures to support staff in responding effectively in an emergency.
 

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 ensured all required checks were completed before staff began working at the service. Staff had access to a wide variety of training courses tailored to the needs of the people they were supporting. The provider was compliant with the mandatory training requirement on learning disability and autism. Staffing rotas made sure people received the support they needed, including time with staff on a one-to-one basis. Systems were in place to effectively manage staff performance and conduct, supporting the delivery of consistent, high-quality care.
 

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.
The home was generally clean and free from malodour. A clear infection prevention control (IPC) policy was in place, and staff had completed training to ensure they knew their responsibilities around IPC. Personal protective equipment (PPE) was available for staff. IPC risks within the home and kitchen environment were consistently monitored using a safety monitoring audit. There was evidence of an action plan and actions being completed in a timely manner.
 

Medicines and treatments were safe and met people’s needs. Medicines management processes were well embedded within the service. However, staff did not always detect issues. For example, senior staff had failed to identify a medicines error where hospital discharge information on the medication administration record (MAR) did not match the medicines received. When it was identified during the inspection, staff immediately consulted with the person’s GP; fortunately, there was no impact for the person. There were effective systems in place to ensure time-critical medicines were administered as prescribed, and clear processes supported the safe administration of medicines that needed to be taken before or after food. Body maps were used to guide the application of topical creams. Medicines storage arrangements were well managed, with clean and organised storage areas, appropriate fridge management, and daily temperature monitoring records completed. Monthly meetings with the GP to discuss each person provided ongoing clinical oversight and support for medicines optimisation. Staff received appropriate medication training and competency checks were completed annually by the registered manager.