Anro 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 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. The provider had robust systems in place to monitor and review incidents and accidents. Detailed information was recorded and analysed to identify patterns and trends. When incidents occurred, they were reviewed and discussed with staff to determine what changes could be made to improve safety and reduce risk. Where appropriate, the provider positive behaviour support (PBS) to review and provide advice where people became anxious or distressed, develop bespoke support plans and work alongside health and social care professionals to meet people’s needs.
We saw an example where a person had created a potential risk to other people in the kitchen. In response, the service introduced a proportionate, non-restrictive measure that enabled the person to continue accessing kitchen items in a safer way.
The provider worked with people, carers, and healthcare partners to ensure safe, well-planned and continuous care through smooth transitions, personalised support, and regular health monitoring
 

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. The service ensured there was continuity of care for all people supported, including when people moved between different services.
Where possible, people experienced planned transitions both when moving into the service and when moving elsewhere. This included initial assessments and visits to ensure the service met their needs. One person had recently moved into the service, and their care plan clearly documented the steps taken to reduce stress and support a smooth transition.
We also saw an example of a person receiving regular weekend respite care. The service worked closely with their carer to minimise disruption and create a homely environment during their stay, including decorating their room with personal items. One person’s relative told us “I took them for visits, and I left them there for an hour and they were fine, staff seemed lovely and they seemed happy. They did one overnight stay and it was fine.” Another person told us “Their physical health means they need regular check-ups. They are no longer on anti-depressants or anti-psychotics, their weight, cholesterol and dental health are checked.”
 

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. There were effective systems, processes and practices that made sure people were protected from abuse and neglect. Incidents and accidents were reported and analysed and where appropriate, were reported to CQC and the local authority. We saw evidence of the service working to understand why incidents happened and how they could learn from them.
There was a clear understanding of the Deprivation of Liberty Safeguards (DoLS), which were only used in a person’s best interests. People were only deprived of their liberty to receive care and treatment when this was necessary, in their best interests and legally authorised under the Mental Capacity Act 2005 (MCA). We checked whether the service worked within the principles of the MCA, whether appropriate legal authorisations were in place and whether any related conditions were being met. Where risks required restrictions, such as living in locked accommodation to maintain safety, appropriate authorisations were sought and recorded.
During the inspection, people were observed to be supported safely. A review of incidents and safeguarding records showed that concerns were appropriately escalated, with clear documentation of outcomes and actions taken.

The provider supported people to understand and manage risks in a holistic way.
Staff provided safe and supportive care, helping people do what mattered to them. Care plans clearly outlined individual risks and how to reduce them, and a general risk assessment for the service was available to staff. Support was tailored to each person’s needs, with different levels of assistance provided to enable people to do what they wanted to do. For instance, one person at risk of choking had been referred for a specialist assessment. Care plans documented specific clear guidance and staff were able to explain how to prepare meals and support them eating it. People were encouraged to develop independence by learning daily living skills, including using the kitchen where appropriate and in line with assessed risks. For example, people were supported to use kitchen utensils, such as knives, safely, with staff using hand-over-hand techniques where needed.
 

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

We found that facilities and equipment was regularly checked by qualified people to ensure they were compliant with safety standards. Leaders ensured that health and safety requirements were regularly maintained and checked by professionals. The service received regular maintenance, helping to ensure people were kept safe. However, we found that most beds did not have headboards, with no clear explanation at the time. This had already been identified by the service and replacements were on order. We also saw that some furniture was reaching the end of its life; staff confirmed that new items had already been ordered.
Although regular fire drills were conducted, two people had chosen not to evacuate during drills, highlighting the need for the service to ensure this risk was fully addressed in the event of a fire. We also found that the emergency grab bag did not contain personal emergency evacuation plans (PEEPs) due to a provider policy as this detail was contained on mobile electronic devices. However, the service has since taken action to address both issues and improve emergency preparedness.
 

The provider ensured there were enough qualified, skilled and experienced people, who receive effective support, supervision and development.

We saw regular staff spot checks, holistic supervision and appraisals were carried out. These were detailed and covered key areas of practice, supporting staff development and helped to maintain standards of care. Staff were trained and competency assessed to ensure they had the skills to meet people’s needs. All staff had completed the Care Certificate and essential training, including Oliver McGowan training, which supports staff to provide safe, respectful, and effective care for people with learning disabilities and autism.

Staff worked well together to deliver safe care that met people’s individual needs. There were sufficient trained staff on duty and when required the service was able to source bank staff .
Recruitment practices were robust. Staff files showed appropriate pre-employment checks had been completed, including references from previous employers and Disclosure and Barring Service (DBS) checks, which provide information about any relevant cautions or convictions.
 

The provider did not always assess or manage the risk of infection.

The premises appeared clean and well maintained. Staff had received training in infection prevention and control and were able to explain the importance of reducing infection risks, including practical measures used within the service. However, we identified some expired personal protective equipment (PPE) available and in use at the service specifically gloves, which could place people at risk due to possible deterioration of the material making them ineffective. We found some chair seat surfaces were worn, exposing the fabric underneath, which could harbour bacteria and increase the risk of infection. Leaders told us replacement furniture had already been ordered. Although guidance was displayed on the fridge, staff did not consistently label or record food opening and use-by dates. This increased the risk of food being used beyond safe limits and potentially causing illness. Following the inspection, the provider introduced a new system to manage PPE and provided additional guidance to staff on the importance of accurate food labelling and stock control.
 

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

Staff involved people in planning their care, including during periods of change. Medication was stored securely in the registered manager’s office in a locked cupboard and administered in line with prescription guidance. Some medicines were time-critical and we found these were given as required. For example, one person received medication for epileptic seizures, which was administered consistently and on time. As required (PRN) medication guidance was detailed for each person and person centred.
Stock was appropriately labelled and dated on opening and medication was provided in a person-centred way, reflecting how individuals preferred to take it. The manager had introduced a “medication of the month” initiative to improve staff knowledge of specific medicines used within the service. At the time of inspection, the focus was on Risperidone, which is used to support certain mental health conditions by helping to balance brain chemistry.
Where medication errors had occurred, appropriate action had been taken and investigated. We saw staff reported errors and the provider documented learning outcomes as a result.