VanBeekDodge Complex Care

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.

This is the first assessment for this service. This key question has been rated 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.

Learning was shared with staff through team meetings, supervision, and updates to risk assessments and support plans. Where accidents or incidents occurred, these were recorded and reviewed by the service management team to identify for themes, trends and lessons learnt.Where required, concerns were escalated to external healthcare professionals for assessment.

People and relatives said staff responded quickly to incidents and recognised when people were struggling or needed extra support. Relatives told us they were kept updated by staff when incidents occurred.

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.

The provider had effective systems to manage risks during pre-assessment processes, admissions, and transitions. Risk assessments were completed before people commenced a package of care. Care records showed that changes in health needs or updated clinical guidance were accurately recorded to help promote good outcomes for people.

Support plans included clear protocols for managing risks, such as choking, with relevant information shared with professionals to ensure continuity of care. These processes supported safe transitions and reduced the risk of avoidable harm. There were detailed hospital passports in use to support any planned or unplanned hospital admissions.

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 service had effective safeguarding arrangements to protect people in supported accommodation. Staff were trained in safeguarding and understood how to respond to concerns.Staff understood safeguarding procedures and knew how to raise concerns internally and externally, including out of hours.People and relatives said they felt safe and knew how to raise concerns. There were appropriate safeguarding policies and procedures in place. The provider ensured safeguarding alerts were raised promptly where required, and the provider worked with partners to reduce ongoing risks.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In supported living services, this is normally completed by the local authority through the Court of Protection. We saw evidence that applications for Community Deprivation of Liberty Safeguards (DoLS) authorisations had been escalated to the local authority by the service when required. Staff knew when restrictions were necessary and involved people, relatives and professionals in decisions about care. They also ensured the impact of restrictions on others was minimised.

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.

Relatives said staff competently supported people to manage everyday risks, including those related to health and emotional support needs. For example, there were care plans and risk assessments around the monitoring and management of epilepsy. This helped to reduce risks related to seizures for people and gave clear guidance for staff on how to manage and respond in the event of a seizure happening.

The service worked with people to balance safety with choice. They supported people, relatives and professionals in informed decision making and agreed clear roles within each risk management plan. Care plans set out clear actions of goals and objectives, risk management, and de-escalation strategies in line with positive behaviour support (PBS) and least restrictive practice. Positive behaviour support focuses on understanding the causes of distress, teaching new skills, and creating supportive environments, rather than simply trying to reduce behaviours. This helped keep people safe both in their homes and when they accessed the community.

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

Observations and feedback we received evidenced people were supported in a safe environment. A relative we spoke with said, “It is a gorgeous little bungalow. They have supported him to make his home his own, with pictures, memory boxes, summer house with his toys, trampoline in his garden.”

The provider assessed people’s home environments, including risks related to falls and general home safety. Risk assessment documentation was in place for people when they were being supported by staff in the local community. Staff understood how to respond in the event of a fire, and each person had a personal emergency evacuation plan to support their safe exit if needed.

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.

Staffing levels were designed in line with funding arrangements and based on people’s assessed needs. People benefitted from the consistency of having core staff teams in place. This meant they were able to develop trusting and positive relationships with staff. A relative told us, “I am so confident that they keep him safe. He has 3 to 1 care. Even before this was funded the service put the third carer in place because they knew this was the way to keep him safe.”

Staff received appropriate training, covering topics such as safeguarding, positive behaviour support and mandatory training required on learning disabilities and autism. Staff competency was monitored through supervision, observation, and refresher training. There was an induction in place for new staff and there were further opportunities to obtain nationally recognised qualifications.

The provider followed safe recruitment practices. Appropriate checks were completed before staff began working at the service to ensure they were suitable to support people living there. Within 1 recruitment file we identified the provider had not ensured a full employment history had been obtained as required. This was highlighted to the provider for their action as necessary.

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.

Staff used Personal Protective Equipment (PPE) appropriately. PPE was readily available and staff were trained in its correct use and disposal. The provider maintained a record of PPE stock to ensure availability.

The cleanliness and infection control practice by staff were monitored as part of the providers quality assurance arrangements.

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.

Staff were trained to administer medicines. Staff had to undertake training before they could administer medicines and received competency checks to ensure they administered medicines safely. We saw records that supported this. One staff member told us, “Yes I administer medications. Yes I have had training, as well as refresher training. Competency assessments on the spot are undertaken now and again by managers.”

The provider worked in line with STOMP, which is national best practice guidance on stopping the over-medication of people with a learning disability and or autistic people. There were systems to make sure people’s distressed behaviour was not inappropriately controlled by medicines.The service worked closely with healthcare professionals to ensure medicines were used appropriately and reviewed regularly.

Records showed that people’s medicines were reviewed regularly. Staff practice, record completion and regular medicines audits were undertaken as part of the providers quality assurance and governance systems.