Avenues South East - 87 Westbrook Avenue

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 72 (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 was a positive culture in place where any incidents or accidents were treated as an opportunity for learning. There was a system in place to analysis themes and trends from incidents, and to determine if further action was needed to ensure people experienced the best outcomes from their care. All incidents were analysed for any contributory factors, and how they might reflect an unmet support need. One person had recently experienced greater instances of distress and anxiety, with a Positive Behaviour Support Plan (PBS) put in place following a review of these incidents. A PBS plan is designed to understand the causes of such incidents and put in place personalised strategies to help reduce them and ensure people have the best possible quality of life.

Team meetings were used to focus on and discuss lessons learned from incidents both within the service and other services operated by the same provider. For example there had been a recent focus on supporting safe eating and drinking following a choking incident at another service. Focused workbooks and supervision had been put in place as a result. One staff member told us “If something goes wrong we have reflective practice sessions at team meetings where we all get a change to give our opinion. We talk about what we could do differently next time. This is a positive and not accusatory process”
 

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 were regularly supported to access appointments with support from staff to manage their health. There were clear pathways and guidance in place for people’s health and care needs, setting out when staff might become concerned about a person’s wellbeing and need to make a referral to a partner agency. For example, one person had a feeding tube in place and staff could confidently explain how they would monitor this, and signs such as redness or difficulty in moving the tube which would require specialist advice. If people needed to be taken to hospital there were detailed health passports setting out each person’s physical and social needs, including how staff should communicate with them in person centred way so they understood what was happening.

Stakeholders who worked with the home spoke of positive and proactive relationships based on open communication and information sharing. One professional who worked with the home told us “All my visits to the service were scheduled with the client and a staff member that knew them well”.

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.

All staff had completed appropriate training and were knowledgeable about their responsibilities to safeguarding people from abuse or neglect. One staff member explained “I might suspect somebody was being abused if there were changes in body language, or they appeared withdrawn around certain people. I would report this to my manager, or raise a safeguarding referral if needed”.

There had been no recent safeguarding incidents at the service, and there were robust plans of how to protect people who might be at risk of neglecting their own health and wellbeing. For example, there was clear guidance on how staff would respond if people declined personal care or medications. This included strategies to encourage people to do so whilst respecting their rights to make their own decisions.

Where the risks to people were deemed sufficient that restrictions such as living in locked accommodation were needed, to ensure their safety, appropriate authorisation for this under the Deprivation of Liberty Safeguards (DoLS) were sought and recorded.
 

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.

There were clear and detailed assessments and plans setting out how the service would work together with people to manage risks to their health and wellbeing safely. These were based on up to date guidance from relevant professionals and regularly reviewed alongside people and their families. One person found fire alarms distressing, so work had been undertaken to try and manage fire drills in the most sensitive way to promote this person’s emotional wellbeing and understanding around this. There was clear guidance on techniques staff could use to communicate with them in case of a fire to evacuate safely. Another person had reduced mobility and was at risk of falls, so staff had risk assessed the needs for bed rails and lap belts as well as adapted equipment to ensure their safety. They had worked with professionals to ensure this equipment remained appropriate and had clear guidance on how safely help this person to transfer both within the service and in the community. For example, there was guidance on how they would use hoists at a local swimming pool to allow them to take part in this activity safely.

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.

There were some inconsistencies in recording of fire safety checks. Whilst regular fire drills were taking place, for the previous 3 weeks recording of checks of fire call points, extinguishers and fire doors had not been documented. There were some minor areas requiring improvement identified including replacing a degraded and unsecure shed, and ensuring radiators which posed a risk of burns were appropriately guarded. The provider told prompt and immediate action once these matters were raised.

The premises was a bright and vibrant space, which included a large garden area where people were able to spend time with peers, family and staff during warmer months. The building was largely well maintained and there were regular checks to ensure the safety of utilities such as gas, electricity and water. Where people had specialist equipment in place such as hoists or adapted bathrooms these were also regularly checked to ensure they remained safe.

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.

We identified there were sufficient staff employed who had received the training they needed to support people’s needs. Although agency staff were used on occasion, the manager explained they would use the same agency staff members to ensure people received consistent care. People, relatives and staff all told us they felt the numbers of staff at Westbrook Avenue were enough to safely support people. A relative told us “I have no concerns about the numbers of staff”.

Staff received ongoing supervision and appraisals to ensure they retained up to date knowledge, and were working well to provide the support people needed. We observed that staff were extremley knowledgeable about the people they supported, and knew how to work in partnership with them to empower them to enjoy positive lives. There were robust recruitment processes in place including use of Disclosure and Barring Service (DBS) Checks. A DBS check is used by employers to make safer employment 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.

There was a high level of cleanliness at the service which was monitored through a regular system of checks. One relative told us “It’s always clean and pleasant when I visit”. All staff had received training around infection prevention, and described how they would support people to be in control of the keeping their personal space and belongings clean. Staff told us how even where people could not physically support with such tasks due to their health and care needs, they would keep them involved for example by letting them handle items of clothing during the laundry process and by explaining what they were doing.

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 stored and administered safely by staff who had been assessed as competent to do so, meaning people received the medicines they need when they needed them. There were clear checks on medicine management, for example monitoring of stocks to ensure people would always have a supply of the medicines they needed to support their health needs. There had been instances where the wrong medication had been delivered and staff had taken prompt action to escalate this with the pharmacy to ensure people had continuity of the medicines they needed. One person required medication to be administered through a feeding tube, and there was clear guidance on how to do this as well as specific training for staff to ensure they were doing so safely. People were supported to access regular medication reviews with their GP practice to review if they continued to meet their needs.