SEL Mind – Bromley MindCare

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.

We did not assess all the quality statements within this key question. We did not identify concerns relating to these areas which we judged as being met at our last inspection.

This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 78 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There was a proactive and positive culture of safety, openness and honesty within the service. Managers and staff investigated and discussed concerns, and any improvements required were made to the service because of this. Staff listened and responded appropriately to concerns about safety and events. Lessons were learnt to continually identify and embed good practice.

There were clear procedures in place for responding to incidents, accidents and complaints. Staff we spoke with were very knowledgeable about these and the actions they needed to take. The registered manager held regular staff meetings and provided information to staff regarding any lessons learnt. Leaders proactively shared learning with the providers other services to help drive practice and service improvements.

The registered manager told us, “We have regular meetings with staff including supervision and appraisals. We hold staff group supervision and invite other health and social care professionals to join to enhance learning and to share good practice. We recently connected with a local hospice to discuss good end of life care and practice as staff often support people at the end of their lives. We also enable and support staff to attend relevant external conferences.”

The registered manager also told us they were working to produce leaflets to be shared within GP practices to help inform people about dementia from people living with dementia perspective.

Staff were exceptional at working effectively with colleagues and health and social care professionals to establish and maintain safe systems of care. This helped to ensure there was continuity of care when people moved between different services.

Care records showed effective communication and good working partnerships were in place with colleagues, local authority commissioners and health and social care professionals when required. The registered manager told us they regularly attended local authority domiciliary care forms and learning forums where they could learn and share good practice. They also attended ‘Skills for Care’ forums and ‘young onset dementia’ forums to help further enhance their knowledge, skills and service development.

People and their relatives told us staff were very supportive when accessing and transitioning between services. Comments included, “[Staff] is very well trained and immediately got onto the district nurse when there was an issue with [loved ones] catheter”, and “We do a handover when [staff] arrives and when she leaves. Recently, she felt [loved ones] mood was very low and she appeared to have hurt her arm and [loved one] was complaining. [Staff] made sure I was aware of it when I returned, and we discussed calling the GP before she left. It makes me feel supported and not so alone with all this.”

The registered manager told us, “Our GDPR (General Data Protection Regulation) document helps us to support people moving between services if people agree for their information to be shared with other services. For example, other domiciliary care services we may work jointly with, community nursing teams and residential care homes. We often link in with residential care homes especially if there are good activities to share for people living with dementia. We also frequently support people to transfer between services offered within Mind.”

The registered manager told us how they supported one person to seek further services and support. They told us, “I was able to support one person who used our ‘Hub’ service to access our respite service. The transition for the person was very smooth as I was aware of the person’s needs and wishes and their situation. I try to help and create good processes between internal services to make better transitions to other services for people. We also hold support groups for carers and for clients where people are provided with information about services that may be of help and support to them.”

The registered manager and staff worked with people and health and social care partners to understand what being safe meant to them and the best way to ensure that. The provider shared concerns quickly and appropriately when required.

People and their relatives told us they felt safe, and staff were very skilled and experienced. Comments included, “I am 100% confident in [staffs’] ability to keep [loved one] safe when we are not there”, “The service really does enable me to stay living safely alone at home”, and “It keeps me on an even keel and I know [staff] is very experienced and [loved one] is safe with them.”

The registered manager was aware of their responsibilities for reporting safeguarding concerns to the local authority safeguarding team and the CQC. Safeguarding records were well maintained to ensure information and actions were taken and addressed when concerns were raised. Staff undertook training to understand how to recognise and report abuse and staff were able to explain the procedures. The registered manager told us that safeguarding was discussed in staff supervisions and staff meetings to embed good practice.

A staff member told us, “I have raised a safeguarding concern recently after a family member disclosed a concern to me. I raised it with the registered manager, and they raised it with the local authority and the community mental health team. I am fully confident of the process and raising concerns to ensure people are kept safe.”

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.

Risks to people were managed and monitored safely. A person told us, “The service really does enable me to stay living safely alone at home. [Staff] will carry things upstairs for me if it’s hard for me to do so on the stairlift. [Staff] know I am a fall risk, but they let me do as much as I can for myself as they know I am still fiercely independent.” A relative told us, “[Staff] identified swallowing issues [loved one] had developed over time and spoke to me about the use of thickeners to prevent choking.” A second relative commented, “[Staff] is very aware of [loved ones] soft diet and has experience with swallowing issues so takes great care.”

Staff we spoke with understood people’s needs and risks and how best to support them safely. Risks to people were identified, assessed, planned for and reviewed to ensure their safety and well-being. Care records included risk assessments for areas such as, mobility, communication and nutrition and hydration as well as specific areas of risk such as detailed guidance for staff on the management of seizures. Risk assessments included information and guidance for staff on actions to take to minimise the risk of accidents occurring. Risk assessments were also carried out on individuals home environments to ensure trip and fire risk hazards were minimised.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. Staff worked well together to provide safe care that met people’s individual needs.

People told us there were enough staff to meet their needs. A person told us, “We have never struggled with staffing issues with Mind as we have the same carer. She has been with us since 2018. In fact, she has become more like a family friend.” Other comments from relatives included, “There have actually been very few times when we have needed another sitter if [staff] has been on holiday or off sick. The office has organised someone if we can’t do without”, and “The office does call me if there is a reason why [staff] can’t come and then we discuss what to do. They are flexible, but it seems [loved one] would rather wait until [staff] can come again.”

Processes were in place to ensure staff were safely recruited. Necessary pre-employment checks were completed before staff commenced employment. These include DBS checks, employment history and references from previous employers. DBS checks provide information including details about convictions and cautions held on the Police National Computer. This information helps employers make safer recruitment decisions.

Staff received up to date training and regular refresher training to ensure safe practice and people’s needs were safely met. Training provided included areas such as disability awareness, mental health awareness, GDPR, equality and diversity, safeguarding adults and children, health and safety, understanding dementia, Mental Capacity Act and Autism and learning disability.

New staff completed a structured induction and shadowed experienced members of staff. A member of staff commented, “I had a very good induction. I had new starter meetings where we went through all the policies and procedures and were given mentors shadowing experienced staff. I really learnt a lot from this.” Records showed that staff received supervision, attended team meetings and had annual appraisals.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

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.

At the time of our assessment there was no one using the service who required support with their medicine. However, we saw there were safe systems in place to support, manage and administer medicines when required.

Staff received training on managing and administering medicines. Their competency to administer medicines was assessed by the registered manager to ensure safe practice. Medicines Administration Records [MAR] and medicines audits were in place and completed when required by the registered manager to ensure safe practice.