Crawford Care 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 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. Accidents and incidents were recorded and analysed to see if any learning needed to be put into practice. Team meetings included regular opportunities to reflect on practice and share learning across the team. For example, staff knew people very well and recognised early signs of potential distress and mitigated risks through regular positive intervention. It was evident incidents had been reduced as a result of actions that had been taken. There was a proactive culture of analysis and looking for lessons that could be learned or improvements that could be made.

The provider 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. For example, a health and social care professional told us, “When [person’s name] moved to Crawford, staff ensured timely access to external services and focused on building trust.” It was evident the management and staff focused on maximising people’s quality of life and this included working with people and healthcare partners with a very clear focus on Stopping Over‑Medication of People with a Learning Disability, Autism or Both (STOMP) principles. This is a national NHS England programme designed to reduce the inappropriate use of psychotropic medication and promote safer, person‑centred care. This approach had a profoundly positive impact, as reducing unnecessary psychotropic medication helped people become more alert, engaged, and able to participate more fully in daily life. Families and staff reported clear improvements in mood, communication, independence, and overall quality of life as people experienced greater wellbeing. The registered manager and staff shared examples with us evidencing the work they had completed to reduce the need for people to take anti-psychotic medicines. One staff member told us, “We review medicines, if people don't need it, they don't take it. For example, one person has reduced their need for medicines. We don't like to use anti psychotics. If people are happy and feel safe in their routines and their needs are met, they may not need them.” This approach was confirmed by health partners. One told us, “Each staff member has been knowledgeable and helpful regarding people’s needs and a positive advocate for effective treatment for the person. I have been impressed that they have arranged community pharmacy reviews for people to rationalise medicine prescribing.”

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. Staff had a strong understanding of safeguarding principles and escalation routes which were supported by accessible information for people and staff. Pocket guides and posters reinforced awareness.

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 service. The registered manager and staff understood their role in maximising people opportunities to live free from restrictions and this was evident throughout our assessment. Where people had an authorised DoLS in place, conditions were being met. The manager tracked DoLS authorisations to ensure they were in date and remained relevant.

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. Risk assessments were person-centred and reviewed regularly, supporting positive risk-taking and independence. People who had specific health conditions were supported effectively to protect them from the risk of harm. Best practice guidance was followed, and the risks were identified and mitigated whilst ensuring people were able to maintain their independence and dignity. Staff worked collaboratively with health care partners to ensure people were supported to manage health risks, in a way that promoted their choice and independence. A health professional told us, “The team are prepared to go the extra step to support their residents and manage a high degree of risk and complexity in a people focussed way.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The environment was safe, clean, and homely, with regular checks on fire safety, legionella, and equipment. People lived in a home which was personalised, well maintained and met their needs. Equipment including lifting equipment was regularly serviced and risk assessments were regularly reviewed. This ensured the provider monitored the risks to people, managed and mitigated concerns when peoples needs changed. Personal Emergency Evacuation Plans (PEEPs) were in place and tailored to individuals should they be required in an emergency.

The provider made sure there were always enough qualified, skilled and experienced staff, who received thorough support, supervision and strong development opportunities. The registered manager told us, and we clearly observed, staffing was deployed with exceptional flexibility, shaped entirely around people’s individual needs and preferences. This meant staff were readily available at the times people wanted support, enabling them to choose what they wished to do and when they wished to do it. Whether someone decided spontaneously to go out, take part in an activity, or simply needed support in the moment, staff were organised in a way that made these choices possible without delay. This flexible, person‑led approach significantly enhanced people’s autonomy, independence and daily quality of life. One person said, “They do anything for me, I just have to ask and they sort me out.” Staff spoke of how they worked proactively with people and gave examples of when this had resulted in significant positive outcomes for people. One staff member told us, “[Person’s] behaviour can change. It's just knowing those soft signs. It's just about recognising their body language changes and subtle signs that we pick up on. [Person] loves being outside, we notice when they are not having the best of days and we support them to go for a walk.” Staff had been trained and had an excellent understanding of Positive Behaviour Support (PBS) this ensured they responded effectively in the moment to provide support. The registered manager told us, “Staff provision ensures that people can go out whenever they wish without unnecessary delay.” It was evident the team’s approach had resulted in a substantial reduction in episodes of distress.

There was a strong focus on staff support and development. Staff consistently spoke positively about how they benefitted from opportunities for learning and reflection through staff meetings, supervision and specialist training opportunities to further develop their skills and knowledge. Comments included, “We have regular team meetings to discuss people’s wellbeing or concerns and learn from each other. We do quizzes and refreshers to check our knowledge.” And “We have regular 6 weekly supervision where we set goals and help with progression.” Records confirmed the service’s focus on learning and development. As a result, people were cared for by staff who had received excellent support and training, within a culture that was open and engaged in positive learning and reflection, which meant staff were continuously placing people at the centre of their support exploring opportunities to increase independence.

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. All areas of the home were clean and fresh. Staff demonstrated awareness of infection control responsibilities, and processes were recorded on electronic systems. Staff had received training in infection prevention and control and had access to personal protective equipment to use when needed.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff demonstrated a strong commitment to ensuring people’s medicines were regularly reviewed to ensure they did not take unnecessary medicines. Staff involved people in planning, including when changes happened this included the use of easy read documents to support people to further develop their autonomy and control over medicine choices. The registered manager spoke of their focus on continuous improvement and they were looking at further opportunities to personalise medicines processes. People received their medicines safely from staff who had received specific training to carry out the task. Managers and staff monitored the impact on people from changes in medicines and ensured regular communication with health professionals and relatives which ensured people’s treatment met their needs. Some people were prescribed medicines on an ‘as required’ basis. There were personalised protocols in place which gave staff clear guidance about how each person would express the need for these medicines and included specific strategies staff could deploy to support the person ahead of resorting to administering medicines. Staff were knowledgeable and understood how to recognise communication signals and signs to be aware of which helped to make sure people received these medicines appropriately.