Outlook Care - Veronica Close

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.

There were systems to learn lessons when things went wrong. Accidents and incidents, and safeguarding allegations were reviewed to see what steps could be taken to reduce the risk of similar incidents re-occurring. The registered manager told us that there had not been any complaints over the past 12 months. People we spoke with confirmed this with us.

Learning was shared with staff through team meetings. The registered manager told us there had been only 1 incident in the past year. The provider took relevant steps and informed the relevant authorities about the safeguarding concerns.

The service had a procedure for staff to follow when things went wrong. The staff we spoke with demonstrated a good understanding of how to respond to any such incidents. Relevant policies provided guidance about how to respond if necessary.

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.

People’s needs were assessed before they started using the service to ensure the service was able to meet them. This helped to achieve a smooth transition from 1 setting to another. People and their relatives were involved in the assessment process, so their views and wishes were taken into account. Relatives we spoke with confirmed this with us.

A healthcare professional told us, “The provider seems to be quite proactive and communicative about concerns regarding the people living there which allows us to guide them with strategies or signpost them to professionals and services that could support clients.”

The provider had systems to support safe care and continuity, including personalised risk assessments, personal emergency evacuation plans [PEEPs], and hospital passports. These documents were shared with external professionals to help them understand people’s needs and provide safe care.

The provider did not always work well with people and healthcare partners to understand what being safe meant to them and how to achieve that. They did not always concentrate on improving people’s lives or protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider did not always share concerns quickly and appropriately.

The provider requested legal authorisations where restrictions amounted to a deprivation of liberty for people who did not have the capacity to consent to these. Decisions about people’s care were made in their best interests and for their safety. However, the provider was not meeting the condition which had been agreed as part of 1 person’s authorisation. We discussed this with the registered manager who agreed to make the required improvements.

People, and their relatives, told us they felt safe receiving a service from the provider. People who were able to talk to us said they felt safe with the staff. A person told us, “I feel safe here. No problems here”. A relative said, “My [Relative] is happy and safe. They seem to like staff.”

Appropriate systems were in place to help protect people from abuse and neglect. The provider had relevant policies including safeguarding adults and whistleblowing. The safeguarding policy made clear the providers responsibility for reporting any allegations of abuse to the local authority and Care Quality Commission.

Staff were aware of safeguarding procedures. Staff had received safeguarding training, and they knew and understood how to recognise the signs of abuse and report on any concerns to help keep people safe. A member of staff told us, “Safeguarding means protecting people from harm and abuse. I will raise concerns with my manager and local authority if I see any abuse happening.” Another staff member said, “I will report abuse to my manager. I will record the incident and follow instructions from my manager. If police need to be involved, I will do it.”

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

During the site visit, we found unsecured cleaning products which posed a risk to people’s safety. In addition, we also found a bottle of bleach in the staff toilet which could be accessible to people who use the service. This put people at risk of consuming these chemicals and could be fatal. This was brought to the attention of the person on duty and was addressed promptly.

Care plans provided information about the person’s diagnosis, hobbies, interests, lifestyle, care and support required as well as the potential risks to the people. Appropriate risk assessments were completed to mitigate the risks to people using the service.

People and their relatives told us they were involved in planning and reviewing their care which involved managing any risks to their safety.

A healthcare professional told us, “The provider was clear on the difficulties and detailed steps they had taken to manage issues, which were appropriate. The provider managed some data collection when requested”.

Staff were aware of the risks to people and the steps they would take to keep them safe from harm.

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 provider carried out various checks on the physical environment to help ensure it was safe. These included tests by qualified contractors relating to fire, gas, electricals and water safety. The provider also carried out health and safety assessments annually to ensure premises was safe for people.

People had a personal emergency evacuation plan (PEEP) in place. This is guidance for staff on what to do in the event of an emergency, and how to safely evacuate people.

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.

People’s initial assessments determined the level of support they required. Rotas showed there were sufficient numbers of staff scheduled to work in accordance with people’s needs.

Staff undertook a comprehensive induction programme which included shadowing experienced staff, training, gaining further qualifications and refresher training courses. Staff supervision and appraisal were carried out, and learning objectives were agreed between supervisor and supervisee.

There were robust and safe recruitment practices to make sure that all staff were suitably experienced, competent and able to carry out their role. Disclosure and Barring Service (DBS) checks were carried out. These provide information including details about convictions and cautions held on the police national computer. The information helps employers make safer recruitment decisions.

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.

The provider completed various audits including infection prevention and control. The provider had a policy for infection prevention and control to provide clear guidance to staff in this area. All the staff completed training in infection prevention and control and demonstrated a good understating of the measures to manage and prevent the spread of infection. Staff were provided with personal protective equipment [PPE], and they confirmed they had access to enough PPE.

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.

We reviewed medicine records and no concerns were identified. The medicine records were kept up to date, and they were regularly audited by a senior member of staff. People medicines were reviewed by a healthcare professional. A relative said, “My [relative] is being supported with medicine administration, and staff are managing their medicines very well”.

The provider had effective medicines management systems in place. For example, staff had received training in medicines administration, and medicines competencies assessments were conducted and there were relevant up-to-date policies in place.