Albert House

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. This meant people were safe and protected from avoidable harm.

This service scored 75 (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.

Managers reviewed incidents and identified actions to strengthen practice where needed. Following an unwitnessed injury which staff had recorded but not escalated, managers took action to improve understanding of accident and incident reporting through staff supervision, policy reminders and team learning. Staff described a "non-judgmental environment" where concerns and mistakes could be discussed openly.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed and monitored. They made sure there was continuity of care, including when people moved between different services.

Staff worked with a range of healthcare professionals, including GPs, nurses, NHS 111 and hospital services, to support people when their needs changed. Records showed people were supported to attend healthcare appointments, referrals were made when required and follow up actions from professional advice were acted upon. Staff also maintained links with day services people attended for activities and support during the day to help ensure continuity of care.

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.

Safeguarding concerns were identified, reported and investigated. Staff understood their safeguarding responsibilities and were confident to raise concerns, including escalating concerns outside the service if required. Arrangements were also in place to support people’s safety, dignity and individual preferences, including respecting people's choices about who provided their personal care.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. This is done through the Deprivation of Liberty Safeguards (DoLS), which form part of the Mental Capacity Act 2005 (MCA). We found the provider maintained oversight of DoLS authorisations and associated arrangements. Relevant applications and authorisations were in place where required and the provider monitored conditions attached to authorisations. Staff demonstrated an understanding of how restrictions applied to people living at the service and processes were in place to support lawful decision making.

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 understood people’s individual risks and adapted support to promote safety whilst maintaining comfort and independence. We saw how they responded appropriately when one person repeatedly moved their foot from their wheelchair footplate by adjusting how they supported them to reduce the risk of injury. Risk assessments covered a range of health, environmental and daily living risks, and decisions about restrictive interventions were supported by appropriate assessment and Best Interests processes where required.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Systems were in place to identify, monitor and address environmental risks, including regular servicing, maintenance and safety checks. Records showed environmental and equipment related issues were generally identified and progressed through the provider's maintenance systems. Fire safety arrangements were supported by risk assessments, personalised evacuation plans, fire drills and routine monitoring of safety systems.

People's bedrooms and communal areas were well maintained, personalised and adapted to meet their needs. During the assessment, the provider responded positively to an environmental concern regarding wheelchair access to the garden by raising maintenance actions to improve accessibility and safety.

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.

Staffing levels appeared sufficient to meet people's assessed needs and staff worked well together to provide coordinated care and support. They were visible, responsive and had time to support people without rushing. Staff demonstrated knowledge of people's individual needs and specialist health requirements, including the safe use of specialist equipment and clinical support arrangements.

The provider maintained systems to monitor training and competency in areas including epilepsy management, dysphagia, oral suctioning, percutaneous endoscopic gastrostomy (PEG) care and medicines administration.

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 service was clean, tidy and well maintained. Staff followed infection prevention and control practices, including the appropriate use of personal protective equipment (PPE), safe cleaning procedures and management of laundry. Systems were in place to monitor infection prevention and control through audits, cleaning schedules and routine checks. During the assessment, we identified an area where infection prevention and control guidance was not being fully followed. The provider responded promptly by reinforcing organisational expectations and taking action to improve compliance with infection prevention and control requirements. During a subsequent visit, we found the issue had been addressed.

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.

Medicines were generally stored, administered and managed safely. Staff demonstrated good knowledge of people's individual medicines and associated risks, and systems were in place for medicines audits, stock monitoring and competency assessment. PRN (as required) medicine protocols provided guidance to support consistent decision making and staff worked with healthcare professionals to support people's medicines needs. During the assessment, we identified areas where further assurance would strengthen medicines management, including how medication refusals were monitored and reviewed and how medicines exposed to temperatures above recommended storage limits were assessed. The provider reviewed and responded to concerns raised during the assessment process.