Ami Group - The Knoll Unit and Ami Court Unit

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 requires improvement. At this assessment the rating has changed to 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 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 management team had oversight of accidents and incidents which occurred within the service. Effective processes were in place to record, analyse for patterns and trends to learn lessons.

When people had fallen, action had been taken to reduce the risk of people falling again including the introduction of sensor mats to alert staff when people were mobilising. The service was open and transparent about incidents and infections. There was a board in the hallway showing each day for the current and previous month and if there had been a fall or infection identified. People, relatives and staff could see how the service was doing and if there were any patterns.

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 met with members of the management team before they came to live at the service. A complete assessment of their needs was completed to make sure staff could support them safely.

Staff could print out people’s information from the electronic care plan system when people went into hospital. The document contained the information needed to support people safely.

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. The registered manager understood their responsibility to keep people safe. There were effective systems in place to identify potential safeguarding concerns, and these were reported to the local authority safeguarding team to be investigated.

Staff had received appropriate training for their roles; they could describe the signs they would look for to identify if people were at risk of abuse. Staff were confident to raise any concerns they may have and action would be taken.

The service had made Deprivation of Liberty (DoLS) applications to the local authority to deprive some people of their liberty. This is a necessary legal procedure to follow when a person who lacks capacity to consent to their care and treatment requires restrictions in order to keep them safe from harm.

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. Potential risks to people’s health and welfare had been assessed and where possible people had been involved in managing risks. People told us how they worked with staff to reduce the risk of pressure damage. A person told us, “I have a mattress which changes my position regularly. I ring my bell for staff to support me, and they come quickly so I can get into bed when the mattress is in the correct position.”

Staff had identified when people were at risk of weight loss, people were encouraged to eat a fortified diet and have nutritional supplements as prescribed. When people were living with diabetes, there was clear guidance for staff about how to recognise high or low blood sugar and the action they should take.

Some people required support to move around the building including using hoists and wheelchairs. There was detailed guidance for staff about how to move people safely. We observed staff transferring people safely using the hoist.

The provider was fully aware of all potential risks in the care environment and controlled them well. They made sure equipment, facilities and technology supported the delivery of safe care. The provider had taken advantage of technology make the environment as safe as possible. There were systems in place to evacuate people safely. The provider had installed a smoke extraction system in the stairwell; this would be turned on by the fire brigade if there was a fire. The system gave a smoke free evacuation route for people and staff.

People had a detailed personal emergency evacuation plan (PEEP) in place including the support they needed to leave their room. There was an evacuation plan from each room, plan of the building, fire zones and the areas they covered. Staff had clear instructions on how to move people to keep them safe. There were evacuation sheets on all the beds and staff had been assessed as competent to use them.

All staff including the cooks and domestic staff had received training and taken part in evacuation fire drills. Staff feedback had been positive, and staff said their confidence had increased.Staff completed regular checks on all equipment including the fire system. There was a stairlift which was in place to support people who could use it to access their rooms if the lift was not in use.

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. There were enough staff to meet people’s needs. People told us, staff supported them when they needed it and they did not have to wait long when they used the call bell. During our onsite visit, we observed staff being present in the communal lounges and the call bells did not ring for long periods.

Staff had been recruited safely. The required checks had been completed including a full employment history, references and Disclosure and Barring Service (DBS) check to make sure staff were of good character. Some staff were sponsored from overseas; checks had been completed to make sure they had a right to work in the UK. Checks had been completed to make sure nurses were registered with the Nursing and Midwifery Council.

Staff had received appropriate training for their role, including online and face to face. All staff had completed autism and learning disability training. Staff received annual moving and handling training including how to move people safely in an emergency. Trainers monitored and supported staff if people’s needs changed such as a change in behaviour due to infection. Staff competencies had been completed including catheter care, the management team also completed spot checks to make sure staff are providing a good standard of care. Staff received regular supervision and appraisal to identify training and development needs.

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 management team completed spot checks to make sure staff completed handwashing correctly and they were following infection control policy. There was personal protective equipment (PPE) around the service and staff wore these appropriately. When people had an infection a PPE station was in place outside their room and visitors were supported to understand how to use the equipment correctly.

The service was clean and odour free. There were a dedicated team of domestic staff and areas such as the laundry and kitchen were clean and tidy. Members of the management team had completed the local authority infection prevention control (IPC) course so they could train other staff to be IPC champions.

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. There were effective systems in place to order, store, administer and dispose of medicines. Staff had recorded the temperature of the medicines room and fridge to make sure medicines were stored at the correct temperature. All records reviewed were accurate and correct, medicines in stock matched the amount recorded on the electronic system. Some people had been prescribed ‘when required’ medicines including pain relief. Staff had used the Abbey pain scale to assess when to give medicine and had, when required, recorded people’s observations such as blood pressure before giving the medicine.

There were clear systems in place to make sure medicines audits were completed, electronic administration sheets were up to date, and medicines were ordered when required. The GP reviewed people’s medicines when required and recorded any changes on the medicine charts.