SENSE - 18 Water Gate

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 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

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.

There were clear safeguarding systems, processes and practices to protect people from abuse, neglect, harassment and breaches of their dignity. Posters and guidance about safeguarding were visible to staff and visitors to the service. We spoke with staff and they understood the principles of safeguarding and if concerns were seen/witnessed, it was their duty to report these.

Relatives and professionals told us they were confident staff were supporting people safely. A relative said, “They [staff] treat [loved one] really well. Staff would never mistreat [loved one]. There have been no concerns, I only see good care.”

We spoke to a visiting social worker who was carrying out the six-monthly care review with a person who lived at the service. They told us, “There have been no safeguarding concerns over the last three years.” This social worker also supported the person’s relative to visit at the same time. The visiting relative told us, “[Loved one] feels safe [at the service], if something was bothering [loved one], I would know.”

Where people’s liberty had been restricted, the provider had ensured this was done lawfully using the Deprivation of Liberty Safeguards (DoLS) process.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, and some hospitals, this is usually through MCA application procedures called the DoLS. The provider was working in line with the MCA.

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.

Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. The service understood what caused people’s distress and this was clearly recorded in people’s care plans which had been regularly reviewed. A relative told us, “My [loved one] does have some behaviours, such as when [loved one] is not well they can become more vocal. I think that’s a good thing, as they know when [loved one] is not well and can give them some medicine for pain relief.” A visiting professional said, “A person they support has high support needs and their communication is limited. The staff know [person] well and can anticipate their needs.”

Staff supported people to manage day to day risks with activities of daily living and when out in the community. Relatives, health and social care professionals were also involved in reviews and updates of risk assessments. A relative told us, “I email them about anything, and I get emails back. A couple of weeks ago there was the belt on the wheelchair which [loved one] was easily taking off, and I raised it, and they got a new belt straight away.” A staff member when asked how they manage escalating behaviours told us, “If an incident occurs between residents, they are separated into different rooms to ensure everyone’s safety.”

One person had received support from a Speech and Language Therapist (SALT) about eating and drinking safely. Guidance had been created and implemented to support this person at mealtimes to avoid the risk of choking. Records showed that the person required no further input from the SALT team.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment and facilities supported the delivery of safe care.

We found concerns when we checked people’s bedrooms and bathrooms. We noted bedroom furniture such as wardrobes, chest of drawers and extension cables not being safely secured. We told the registered manager about these and she gave assurances that this would be actioned immediately. Following our visit evidence was shared by the registered manager that gave assurances the bedroom furniture and cables had now been safely secured. This showed the registered manager took effective action when issues had been raised.

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.

Staff had completed nationally recognised qualifications in health and social care which encouraged them to provide safe and compassionate care. A staff member told us, “The induction process was thorough, with a variety of training sessions provided. Support is available and we can ask for help when needed.”

There were robust and safe recruitment practices. Staff files contained evidence of recruitment checks including application forms, employment references, enhanced Disclosure and Barring Service checks (DBS)/Police checks and identity checks. The information helps employers make safer recruitment decisions.

People experienced a continuity of care, for example being supported by a regular staff team, and care being delivered through a planned and agreed routine. A relative told us, “They’ve changed managers a few times, but the staff were still there so it was still great, still brilliant.”

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.