50 Vassall Road

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 good. At this assessment, the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 78 (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.

The service had effective systems in place to record and monitor incidents, accidents, and complaints. Records clearly detailed the nature of concerns, actions taken to reduce ongoing risks, and any learning identified as a result. The staff recorded this electronically so this could be monitored promptly and remotely by the provider and the senior management team. This ensured they had both oversight and appropriate actions had been completed swiftly. This also enabled them to share learning across the organisation where relevant.

Learning from incidents was used to promote and embed good practice. The service coordinator held regular staff meetings, providing opportunities for staff to discuss safety concerns, share learning and promote continuous improvement. Daily shift planning meetings ensured staff remained informed of any changes, risks or concerns affecting people using the service.

There was a culture of openness and transparency, consistent with Duty of Candour requirements. The registered manager and the service coordinator demonstrated a clear understanding of their responsibilities in relation to regulatory reporting and notifications to the Care Quality Commission (CQC). A relative confirmed they were kept informed of incidents, accidents, and safeguarding concerns, where appropriate.

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.

People regularly accessed community-based opportunities, including day centres and work placements at a local farm. There was evidence of effective partnership working and positive communication between the service and external organisations involved in people’s care and support.

Feedback from an external provider was highly positive. They told us, “Communication from Vassell Road has always been excellent. We hold reviews which are well attended, and we also contribute and attend meetings and host health professionals when assessments have been needed. For example, occupational therapy and speech and language therapy for eating and drinking assessments.” They confirmed that any changes to people’s needs, health or support requirements were communicated promptly. This collaborative approach helped to ensure people received consistent, coordinated care and support across services, promoting continuity and positive outcomes.

People had healthcare passports in place to support effective communication and continuity of care when admitted to hospital or transitioning between services. These documents contained important information about the person, such as how people communicated, the support they required to make decisions, and any reasonable adjustments needed to ensure their care remained person-centred. This helped professionals to deliver consistent support and respond appropriately to individual needs during periods of transition or hospital admission.

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 had appropriately raised safeguarding concerns. This included sharing information with the local authority and the Care Quality Commission (CQC). The level of information shared with other agencies had been appropriate and sufficient to keep people safe. As a result of the safeguarding concerns and subsequent investigations, changes were made to people's care arrangements when required to keep them safe and help prevent recurrence.

Staff confirmed they knew what to do in the event of an allegation of abuse being made. A member of staff told us, “If I have any concern at all, I'm able to report this to the manager but no concern at the moment.” All staff completed safeguarding training. Staff were aware of the reporting process for allegations of abuse. There were policies and procedures to guide the staff on what to do if an allegation of abuse were made and how staff could raise concerns using the whistle blowing policy.

Staff told us people living at the home had established positive relationships and had lived together for many years. A member of staff told us, “It is like a family home and whilst there are minor altercations, everyone gets along really well.” Staff knew people well and understood the factors that could affect their emotional wellbeing. They were able to recognise early signs of anxiety and identify individual triggers, such as when the home became particularly busy or noisy. Care plans included guidance on how best to support people during these times and reflected their personal preferences. For example, some people chose to spend time in quieter areas of the home or in their bedrooms when they needed space away from others. Staff respected these choices and provided reassurance and support as required.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the home. We found appropriate assessments and applications had been made.

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 manage risks in ways that promoted choice, independence and fulfilling lives. Staff adopted a positive risk-taking approach, working in partnership with people, their families, and advocates to enable people to participate in activities safely rather than imposing unnecessary restrictions. For example, rather than restricting a person’s freedom by keeping the front door locked, the service had installed a door alarm to alert staff when the person left the home.

This approach enabled the person to continue an activity that was important to them, as they enjoyed helping with the recycling, while ensuring staff could monitor their safety and provide support if required. The least restrictive option had been considered, balancing the person’s right to independence with the need to manage any associated risks. This demonstrated a person-centred approach to risk management that focused on enabling people to live meaningful and fulfilling lives.

Individualised risk assessments were in place to support people to pursue activities that were important to them, including going on holidays, accessing the local community, and maintaining relationships with family and friends. These assessments considered any risks associated with a person’s needs or behaviours and identified measures to reduce those risks while preserving their rights, independence, and quality of life.

Each person had a personal emergency evacuation plan (PEEP) which contained information on how to support them to remain safe in the event of an emergency. Staff knew what to do in the event of an emergency, and the provider had a business contingency plan in place.

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

There was a planned programme of ongoing maintenance, refurbishment, and decoration to ensure the environment remained safe, comfortable, and homely for people. During the assessment, we noted that the kitchen flooring was stained, and the bathroom would benefit from redecoration. The service coordinator confirmed that these areas had already been identified and were included within the planned maintenance schedule for the forthcoming year.

We observed that a fridge freezer showed signs of exterior rusting. This was promptly addressed, and the appliance was replaced during the assessment process. This demonstrated the provider’s commitment to maintaining the environment and responding quickly to issues identified, helping to ensure people lived in a safe, well-maintained, and suitable home.

Systems were in place to help ensure the home environment remained safe, - and responsive to people’s changing needs. Regular safety checks and servicing were completed on equipment, including fire safety systems, gas appliances, and legionella management. These arrangements helped identify and address potential risks promptly.

Environmental adaptations had been made to promote people’s safety and wellbeing, including the installation of window restrictors and radiator covers. Staff had also been proactive in ensuring the environment continued to meet people’s needs as they aged. For example, a stairlift had recently been installed, and specialist bathing equipment had been sourced to support individuals to get in and out of the bath safely and maintain their independence. These measures reduced risks while enabling people to move around their home safely and comfortably and promoted people’s independence.

Staff received training to use equipment safely and competently. This included moving and handling training, which helped ensure people were supported safely while reducing the risk of injury to both people and staff.

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.

People were protected by safe recruitment checks of new staff. These checks included obtaining a full work history, references and a Disclosure and Barring Service (DBS) check. DBS provide information about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

Staffing arrangements were planned and structured to ensure there were sufficient staff available to support people to participate in activities and pursue their individual interests. Some people received 1 to1 support to help them achieve the outcomes they wanted, while also ensuring their safety and wellbeing.

The service coordinator told us they did not use agency staff and instead utilised internal bank staff when additional cover was needed. This ensured people were supported by staff who were familiar with their needs and preferences. Managers were also flexible in providing additional support when necessary to ensure people's needs were met.

The team was well established, and some staff had worked in the home and for the provider for many years. New staff completed a comprehensive induction, and all staff completed regular refresher training.

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.

We found the home to be clean and free from odours. Cleaning schedules were in place, and the care staff had delegated areas of cleaning to complete to ensure the home was clean and free from odour.

Staff had completed infection prevention and control (IPC) training and were knowledgeable about their responsibilities in maintaining a safe and hygienic environment. The service had comprehensive infection prevention and control policies in place, supported by regular audits to monitor compliance and identify areas for improvement. The service coordinator explained that additional monitoring of cleaning practices had been introduced following a recent audit. This enhanced oversight had resulted in improvements being made, and there was evidence that these changes had been effectively embedded into everyday practice.

Staff had completed food hygiene training to ensure that they understood how to handle, prepare, and store food properly to protect people from illness. Records were maintained demonstrating food preparation was completed satisfactory with regular food probing and cleaning records maintained. All food items were dated once opened.

The provider always made sure that medicines and treatments were safe and met people’s needs, capacities, and preferences. Staff always involved people in planning, including when changes happened.

People's individual medicines were stored in a secure cabinet in their bedroom. This helped staff to provide a more person-centred approach to the administration of people’s medicines. Each person had a medicine profile describing how they wanted to be supported and information about their medicines and any side effects.

Electronic medicine records were maintained of all medicines administered. This enabled the registered manager and the provider to monitor medicines remotely. Alerts were sent if medicines were missed meaning staff could rectify this promptly. Daily stock checks were completed to ensure all medicines were administered.

Staff received training in medicines management, and their competency was checked before they were authorised to administer medicines. The service had a medicines policy which clearly described the process in place to report and investigate medicine errors and incidents. The management team carried out regular audits of medication practices to ensure they remained safe and effective. The service ensured people’s behaviour was not controlled by excessive and inappropriate use of medicines. Staff understood and implemented the principles of STOMP (stopping over-medication of people with a learning disability, autism, or both) and ensured that people’s medicines were reviewed by prescribers in line with these principles. Annual health reviews were completed to ensure people were receiving medicines appropriately.