Care and Support Service - Monica Wills 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

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 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 promoted a positive safety culture where staff were encouraged to report concerns, reflect on incidents and learn from events to improve outcomes for people. Accidents and incidents were recorded, reviewed and analysed by the management team to identify trends, reduce future risks and strengthen practice. Following significant incidents, the manager completed root cause analyses and shared learning through team meetings, supervision and day-to-day discussions. For example, following falls, staff reviewed risk assessments, updated care plans and adapted support strategies to help prevent recurrence.

Staff felt confident to raise concerns and described leaders as approachable and supportive. One staff member told us, “If something happens, we talk about it as a team, learn from it and look at what we can do better next time.” Healthcare professionals also spoke positively about the service's learning culture, describing managers and staff as receptive to feedback and committed to acting on recommendations. This approach helped drive continuous improvement and supported safer, more effective care for people.

The provider had systems in place to support safe transitions and continuity of care when people moved between services or experienced changes in their needs. Staff worked closely with healthcare professionals, hospitals and community teams to ensure relevant information was shared promptly and people received coordinated support. Hospital passports, transfer information and updated care records helped maintain continuity and reduce risks during transitions.

The manager told us, “We work hard to make sure people experience a seamless journey between services and that no important information is missed.” Staff responded promptly to changes in people's health and worked with professionals to review care arrangements and ensure appropriate support was in place.

Relatives spoke positively about how transitions and changes in care was managed. One relative said, “Communication is very good. When Mum has needed extra support or input from other professionals, everything has been organised quickly, and we have been kept informed throughout.” This collaborative approach helped people receive safe, coordinated care and supported positive outcomes.

The provider worked with people and healthcare professionals to understand and manage risks while promoting independence, wellbeing and safety. Staff understood their safeguarding responsibilities, completed regular safeguarding training and were confident reporting concerns. Safeguarding practice was reinforced through supervision, meetings, competency checks and reviews of incidents.

Records showed safeguarding concerns were appropriately investigated, referred to relevant agencies where required, and used to inform care planning and reduce future risks. The provider worked collaboratively with external professionals to protect people from abuse, neglect, discrimination and avoidable harm, and met its regulatory responsibilities for reporting safeguarding incidents.

People, relatives and staff consistently described the service as safe. One resident told us, “I feel very safe living here and know there is always someone to help if I need it.” A relative said, “The staff are patient, caring and always quick to act if they have any concerns about Mum.” One staff member told us, “If I was worried about anything, I would report it straight away and I know it would be taken seriously.”

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In the community supported living is a social care arrangement where individuals receive care and support in their own homes or shared accommodation, promoting independent living. Community Deprivation of Liberty Safeguards (DoLS) refers to Court of Protection orders required to legally authorize restrictive care for individuals who lack mental capacity and reside outside of hospitals or care homes. At the time of the assessment no one was under (DoLS). The service worked in line with the principles of the Mental Capacity Act 2005. Capacity assessments and best-interest decisions were clearly documented where required, helping to ensure people's rights were respected and protected.

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's safety had been assessed and managed effectively. Most people told us they were involved in reviews, and records showed people and, where appropriate, their relatives were involved in discussions about risks and care. This demonstrated a person-centred approach to risk management.

Care plans and risk assessments reflected people's needs and choices and guided staff to support them safely. One person told us staff "always do things the safe way we have agreed."

Staff supported people to make informed decisions about risk and worked with professionals to reduce harm while promoting independence. Staff understood how to identify and review risks and responded promptly to changes in people's needs. For example, staff used a pictorial activities programme to help 1 person understand and choose which activities they wanted to attend. This enabled the person to express their preferences and make informed decisions about how they spent their time. People could choose when they wanted to wake up, what they wanted to eat, and whether they wished to attend activities. They also had their own keys to access the building as and when they liked, supporting their independence while ensuring appropriate risk management measures were in place

The provider identified, assessed and managed risks within people's living environments to support safe and independent living. Environmental and equipment risk assessments were completed regularly, including checks of mobility equipment and home adaptations, with action taken to reduce identified risks.

People had access to a call bell system to request support in an emergency, and staff completed daily checks to ensure it was working effectively. Staff gave an example of responding to a welfare concern when a person did not answer their call. A check of their apartment found them unwell, and emergency services were contacted promptly, enabling them to receive timely medical attention.

At the time of inspection, one lift was temporarily out of service. An alternative lift was available, and repairs were completed during the inspection, ensuring people could continue to access the building safely and independently.

The provider ensured there were sufficient skilled and experienced staff to meet people's needs safely. Staffing levels were reviewed regularly and adjusted when people's needs changed, ensuring support remained responsive and person-centred.

Safe recruitment processes were followed, including appropriate pre-employment checks, to ensure staff were suitable for their roles. New staff completed an induction programme, including mandatory training, shadowing experienced colleagues and competency assessments before working independently.

Staff had access to a comprehensive training programme, with refresher training and competencies monitored by managers and the compliance team. Training covered areas such as safeguarding, medicines, moving and handling, equality and diversity, mental health, learning disability awareness and the Oliver McGowan Mandatory Training.

This training helped staff deliver personalised care and adapt their approach to meet individual needs. Staff gave examples of how learning disability training had improved outcomes for people by enabling them to communicate more effectively, make choices independently and take a more active role in their daily lives. A relative told us new staff worked alongside experienced staff who knew their loved one well before providing support independently, helping to ensure consistent and effective care.

The provider had effective systems in place to prevent and control infection. Staff received infection prevention and control (IPC) training and demonstrated a good understanding of safe practices, including hand hygiene, the appropriate use of personal protective equipment (PPE) and safe waste disposal. PPE was readily available throughout the service, and staff were observed using it correctly.

Infection risks were assessed and managed as part of people's care planning, with clear policies and procedures in place to guide staff practice. Regular audits, observations and spot checks were undertaken to monitor compliance and identify any areas for improvement. Where issues were identified, managers acted promptly through feedback, supervision and additional training. These measures helped minimise the risk of infection and supported a safe environment for people, visitors and staff.

People received their medicines safely and as prescribed. Medication risk assessments, care plans and MAR charts medication Administration Record chart) contained clear guidance, including application of medication in patch form and 'as required' medicines, helping to ensure safe and consistent administration. One person told us, “I never have to worry about my medication. The staff make sure everything is organised properly and always check that I've taken what I need.”

Staff completed medicines training and understood the importance of accurate recording and reporting of refusals or omissions. The provider had recently introduced an electronic medicines management system to support timely ordering of medicines, monitor stock levels and improve oversight. This helped reduce the risk of medicine shortages, missed doses and recording errors, supporting continuity of care.

Medicines practice was regularly monitored through audits, spot checks and competency assessments, with action taken where improvements were identified. Staff worked closely with GPs, pharmacies and other healthcare professionals to ensure people received their medicines as intended. A relative told us, “They are very organised with Mum's medication and keep us informed of any changes. It gives us real confidence that she is being well looked after.”