Edgar Street Residential 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 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 as good. This meant people were safe and protected from avoidable harm.
 

This service scored 81 (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.

Staff received training in a range of health and safety related matters, and safety matters were discussed during staff meetings and ‘house’ meetings. The manager and deputy manager investigated safety events such as accidents and incidents, and lessons learnt were shared appropriately. Changes made following safety events were reviewed to assess their ongoing effectiveness.
 

The manager always worked with people and healthcare partners to design, establish and maintain safe systems of care, in which safety was always well managed and monitored. They made sure there was always continuity of care, including when people moved between different services.

People living at the home were supported by an established group of core staff, who provided continuity in care. This meant that staff and people knew each other well. We observed that people felt comfortable, openly speaking in front of staff and often engaging staff in their conversations. People and staff were visibly relaxed when engaging with each other, and genuinely appeared to enjoy being in each other’s company. This resulted in people expressing themselves freely and with confidence, and that staff had in depth knowledge and understanding of people’s needs.

People had health passports in place, and these contained detailed, accurate and current information about people’s communication, mobility, medication, religion, dietary needs, positive behavioural support strategies, and their likes and dislikes.

The manager shared with us excellent bespoke documents that had been compiled specifically to support a person experiencing deterioration in their wellbeing to move between services seamlessly. These enabled the person to understand what to expect when they moved between services, what faces they would see, and the room they would be staying in. This enabled the person to communicate any concerns they had prior to the move, prepare themselves for the move, and minimised the impact the move would have on their emotional wellbeing.

The provider worked well with people and healthcare partners to fully understand what being safe meant to them and the best way to achieve that. Staff had a clear focus 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 always shared concerns quickly and appropriately.

Staff had received training in safeguarding, bullying and harassment and equality and diversity. Staff were able to tell us about the different types of abuse people may experience, how signs of abuse could be identified, and what action they would take if they suspected abuse. Staff communicated with confidence and were able to tell us about whistleblowing and freedom to speak up policies. Staff interacted with people in a kind and respectful manner. People told us staff treated them with kindness, they felt well cared for, and could talk to staff about anything.

In one instance the manager proactively identified subtle indicators of financial abuse. They used their in-depth knowledge and understanding of the person’s finances to demonstrate abuse may have taken place. Concerns were shared appropriately with others, in a timely manner.

The manager held conversations with people to identify what being safe meant to them. As a result of these conversations a ‘Ring’ doorbell had been installed so people could identify who was at the door, and feel safe prior to the door being answered. People’s necessary consent had been gained in relation to this. Where people had lacked the capacity to consent, best interest decisions had been made in line with the principles of The Mental Capacity Act 2005.

People had been educated about abuse, what it may look like, how to protect themselves from it, how to report it, and who they could report it to.

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. We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. One person living at the home was subject to a DoLS, this was current, and staff were aware of it

The provider worked well with people to fully understand and manage risks by thinking holistically. Staff provided care that fully met people’s needs and was safe, supportive and enabled people to do the things that mattered to them.

There was a transparent and open culture at the home, which encouraged creative thinking in relation to the management of people’s safety and risks. Managers and staff talked about empowering people living at the home to have a “can do”’ attitude towards life. Staff were encouraged by managers to “dig deep”, “get creative” and “think outside the box”. Staff were encouraged to engage with people living at the home, see what goals and aspirations they would like to achieve, and come up with ways to achieve these. We saw examples of people engaging in activities previously thought by family members to be “almost impossible” for the person to achieve. Staff thought creatively to overcome any challenges which may otherwise have judged an activity as being simply ‘too dangerous’. This pro-active and dedicated attitude by staff was part of the culture and supported people to live a full and active lives.

People were provided with information about how to keep themselves safe in formats which they understood. People were educated in a way they could understand to keep safe online, how to navigate social media platforms in a positive way, and sexual safety.

One relative told us, “[They] could barely do anything for themselves when they moved into the home, their confidence was destroyed, now they live a pretty much normal life. The work [the home] have done with [person] is just amazing.”

The home did not use restraint, seclusion or segregation to manage risks of any behaviours that challenge. Instead, staff used positive behaviour support planning and adopted proactive approaches such as preventative strategies in response to early signs of distress.
 

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

Safety checks and certification of conformity for fire safety, legionella safety, and electrical safety were all in place and current. Regular fire drills took place and there was a suitable number of Fire Marshalls at the home, and a designated fire safety champion.

The home had a cleaning schedule in place and people living at the home were included in taking care of the home environment. Cleaning checks were in place to monitor the standards of cleanliness.

The provider always made sure there were always enough qualified, skilled and experienced staff, who received thorough support, supervision and strong development opportunities. They worked together well to provide safe care that met people’s individual needs.

People were involved in decisions about staff who provided their care. People participated in interviews to ensure prospective staff aligned with the core values of the home and the people who lived there. People also took part in the induction of new staff. The manager told us that whilst not a barrier to recruitment, they recognised the value of recruiting staff with lived experience of supporting family members living with learning disabilities.

People were supported by a core staff team, and people received good continuity of care from staff who knew them well. New members of staff received a thorough, well documented induction process. Staff had completed sector specific training, which the provider had funded the manager of the home to become a recognised trainer in, which enabled them to deliver this training to staff, developing their learning and strengthening their knowledge. Staffing rotas and shift patterns were assigned 8 weeks in advance, enabling people and staff to work around not only people’s needs, but their activities and interests.

Recruitment systems ensured staff were recruited safely. Staff had the right competencies, knowledge and skills to carry out their roles effectively. Processes such as supervision and appraisals were used to develop and motivate staff and discuss their professional development. Staff told us they found supervisions a positive experience, which allowed them to recognise their strengths and guided them on how to develop.

Training was delivered in a variety of ways to help ensure maximum staff engagement. Recent medication training using a new electronic recording system had included ‘role play’ scenarios to better aid learning, and staff told us how beneficial this had been.

Managers and staff had sector specific qualifications. Staff were supported to gain additional qualifications and develop their careers in 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.

Staff had received training in infection prevention and control (IPC), and there was a designated IPC champion. Staff told us they always had access to personal protective equipment (PPE) and knew when and how to use this appropriately. Policies and procedures were in place that were reflective of best practice and current legislation. The home completed IPC checks and completed regular audits in relation to IPC.

Food safety information was available, food was stored safely, food temperatures were recorded and the home displayed hand hygiene pictures in appropriate places, which guided people and staff to follow effective hand washing procedures, promoting good infection prevention control.

People had their own individual wipeable laundry bins, and their own shower mats to minimise the risk of infection. Where appropriate, people were included and encouraged to complete household tasks, and educated by staff on the importance of maintaining clean living environment.

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.

The provider had effective systems for the storage, administration and oversight of medications. A recent change with the provider’s choice of electronic medication administration system (EMAR), had resulted in the manager of the service engaging with professionals to request improvements to this system, which if made, would enable the recording of medications to be truly person centred.

The manager and staff at the service demonstrated knowledge and understanding of the principles of Stopping over medication of people with a learning disability and autistic people (STOMP). People living at the service received regular medication reviews and the manager advocated for people to support best practice.

Risk assessments were in place for medications, and these were regularly reviewed. Where people wished to manage their own medications, they were empowered to do so safely, this included people choosing to complete their own medication record chart – which they then shared with the provider for oversight.