Archived: Alderwood L.L.A. Limited - Rushden

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

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.

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.

During our assessment, we saw evidence of continuous learning throughout the service. Leaders had identified additional concerns to that raised within recent whistleblowing disclosures, and been proactive to address, rectify and prevent recurrence. This was then shared with staff during team meetings to ensure learning was filtered to people directly caring for people using the service.

During our assessment, we were able to see systems and processes in relation to learning in action. We found a discrepancy when looking into medicines. Although current process had been followed, and the over-the-counter medication had been discussed, reviewed and signed off with the person’s GP, a discrepancy in the administration instructions was identified.

The manager took immediate and prompt action to consult with relevant professionals, staff and relatives to rectify this concern and their process around over-the-counter medicines was altered to prevent recurrence.

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.

The provider had tools and processes in place to aid a smooth transition in an emergency situation, including an emergency bag equipped with items to help in an emergency. We found that the provider had developed Personal Emergency Evacuation Plans (PEEPs), with key information on how to support people during an evacuation. These initially weren’t kept in a location people could access promptly; however, this was rectified immediately during our assessment.

When people’s needs were changing, the manager referred people to internal and external professionals, to ensure people got the right support. This included Speech and Language Therapists, and internal teams who specialise with positive behaviour support. The manager embedded the information provided into people’s care plans, and staff communications to ensure staff were consistent with their approach.

As an additional measure to ensure continuity, the provider operates a paid handover time between staff at shift change over times. This ensures ample time to share relevant information between staff.

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.

We observed examples during our assessment of the provider upholding Duty of Candour, ensuring they were open and transparent about mistakes, and involving people, relatives and professionals in solutions, to ensure a holistic approach.

Staff were knowledgeable about the signs of abuse, and what constituted abuse. Staff were familiar with the reporting process, including to external organisations.

Leaders and managers were prompt to share concerns with external organisations, such as local authority safeguarding teams, and worked with these organisations to ensure people were safeguarded.

The provider understood the Deprivation of Liberty Safeguards (DoLS) process and applied for these were necessary. Staff were knowledgeable about restrictive practice. Previously, there had been inappropriate restrictions in place for the people using the service, the new management team had done extensive work to change this practice. This included removing unnecessary restrictions, developing staff’s knowledge which in turn augmented people’s liberty and freedom within their home.

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.

Managers had taken steps to embed the involvement of people and encourage positive risk taking since being in post. For example, previously, two people using the service had been unable to be in the same room with each other at the same time. Managers had worked with people and the staff to change this, and just before our assessment, these people had begun going to activities together in their community, such as attending a circus show together.

People had risk management plans in place, which detailed known risks for them, and informed staff and other professionals how they should support people with these risks. There was room for improvement to ensure information was person centred for everyone in relation to all risks, but largely, this was the case.

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 were systems and processes in place, to monitor the environment which included auditing systems. This enabled staff to identify concerns promptly. Staff were knowledgeable on how to escalate concerns to the providers internal maintenance team. The maintenance team were prompt to rectify concerns with the environment, on a priority basis.

We found some concerns during our assessment, for example, scuffed flooring around dining tables and chairs, however these had already been identified and escalated to the maintenance team who were taking steps to rectify this.

Staff had good knowledge of emergency evacuation processes, including in circumstances of fire. The provider conducted regular checks on fire systems and worked with external organisations to maintain these. People and staff also participated in regular practice evacuations. Since the arrival of the new managers, there had not been a practice evacuation during the night, however, we were assured this would be completed promptly.

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 had systems in place to ensure staff were recruited safely. The utilised systems to monitor training compliance. There were times that staff’s training expired before a refresher could be completed. The provider had a risk management plan in place for this, to ensure there were some staff present with the correct, up to date training, during each shift.

We found during our assessment, that where people’s training had lapsed, they were already booked onto refresher courses in the near future, so we were assured this was actioned quickly when it did occur.

Staff told us that they found the training good, and that it helped them to do their job effectively. Some staff particularly favoured face to face courses. A lot of their training was completed online, which is standard now within the sector.

Staff told us that they felt supported by their managers, supervisions were productive and that managers follow things up when staff raise them. Some staff felt that the heavy promotion of communicating via the provider’s app, meant they weren’t welcome to pick up the phone and call someone directly.

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 there were systems in place to maintain good hygiene within the home. There were auditing systems in place which enabled staff and leaders to identify concerns promptly. Staff were aware of their roles and responsibilities to prevent infection, including proper processes for donning and doffing Personal Protective Equipment (PPE) such as gloves and aprons.

We observed good practice whilst at the service, in relation to PPE. We also observed people being supported to prepare and cook food, with the support of staff, for their peers. We saw food safety, and good hygiene was promoted and upheld.

The provider did not always make sure that medicines and treatments were safe.

During our assessment, we found some concerns around the management of medication. This related to storage, and incorrect administration of a homely remedy.

The provider operated regular auditing processes, and daily checks on medication storage temperatures to ensure medicines wouldn’t spoil. One person had some of their topical medication stored in a separate area where the temperature was not being monitored. This was rectified during our assessment.

Another person’s medication cabinet had been fixed to the wall above a radiator. When the inspector completed a medication audit of this person’s medication, the cabinet temperature had almost reached the maximum temperature for medicines storage. This was shared with managers, who took steps to rectify this immediately and the cabinet was moved.

Additionally, there were concerns with the homely remedies processes, previously mentioned in Learning Culture. We identified that one person had been receiving 3 times the recommended dose of a vitamin supplement for an undetermined period of time. Immediate action was taken to rectify the administration instructions, and health professionals were involved to ensure there had been no impact on the person.