Outlook Care - Neave Crescent

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 69 (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.

Systems were in place for learning lessons when things went wrong. For example, we saw accidents and incidents were reviewed to see what could be done to reduce the risk of similar incidents occurring again. Learning was then shared with the staff team through team meetings. Policies were in place covering accidents and incidents, complaints, and safeguarding adults to provide guidance in this area.

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.
Before people moved into the service, a member of the management team carried out an assessment of their needs. This was to determine what the person’s needs were and if the service could meet them. Assessments covered areas including personal care, mobility, health and equalities. People and relatives were involved in the process. A relative told us, “They met with me to do an assessment.” This helped ensure there was a smooth transition for people between services.
 

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.

The provider had a safeguarding adults’ policy. This made clear their responsibility to report allegations of abuse to the local authority and CQC. Where there had been allegations of abuse, these had been dealt with in line with the policy. Staff had undertaken training in safeguarding adults and understood their responsibility to report allegations. A member of staff told us, “I would make sure the person is OK and would report it to my manager.” A relative said, “I haven’t heard of any abuse here.”

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 in place for people. These set out the risks people faced and how to mitigate them. They covered risks including those related to medicines, mobility and skin care. We observed staff understood the risks people faced. For example, we saw the support provided to a person with eating was done in line with guidelines drawn up by the speech and language therapy team.

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

Various checks were carried out on the physical environment to help ensure it was safe. These included tests by qualified person relating to fire, gas, electrics and water. We noted that 2 fire doors did not fully close when the fire alarm was tested during our inspection. Staff reported this to the firm contracted to deal with this. We also found there was a problem with underfloor heating in one bedroom and the sensory room, where the heating could not be turned off. An engineer visited the service during our inspection but did not fix the problem. After our inspection, the registered manager told us a timeframe had been agreed to carry out the necessary work, and that the person had moved into another bedroom which had become available. The heating worked properly in this bedroom. A member of staff said two beds did not fully raise. This meant they had to bend low when providing support with personal care, causing them back pain. We discussed this with the registered manager who said he was seeking to address this issue.

The provider did not always make sure there were enough qualified, skilled and experienced staff.

All the staff we spoke with, including the registered manager and their line manager, told us that staffing levels had been reduced approximately 6 weeks ago. They said there used to be 6 staff on the early shift, but this was now reduced to 4, except on Fridays when there were 5. Staff told us there were still enough staff to keep people safe. However, they had less time to support people to access the community and to spend quality 1 - 1 time with them in the home. The registered manager told us they initially believed the local authority had agreed to fund higher staffing levels than they actually had agreed to. One of the provider’s directors told us they were seeking to arrange individual review meetings for those five people with the local authority to discuss the issue.

Pre-employment checks were carried out on staff to help ensure they were suitable to work in a care setting. These included employment references, proof of identification and criminal records checks.

Staff undertook regular training to help support them in their role. This included training about working with people with a learning disability and autistic people.

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.

Steps were in place to help prevent the spread of infection. Cleaning schedules were in place and the home was visibly clean during our inspection. A relative told us, “[Person’s] room is always clean.” Staff wore personal protective equipment when providing support with personal care and had undertaken training in infection control. The provider had an infection prevention and control policy to help guide practice in this area.

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

Medicines were managed safely. They were stored in designated and locked cabinets inside people’s bedrooms. Staff undertook training before they were able to administer medicines which included an assessment of their competence. Medicine administration records were maintained so there was an audit trail of all medicines given. These were accurate and up to date. Guidelines were in place about when to give medicines that were prescribed on an ‘as required’ basis.