Chiltern Support and Housing

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 inadequate. At this assessment the rating has changed to good.

This meant people were safe and protected from avoidable harm.

This service scored 66 (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 completed incident reports which included details of the investigation and understanding why the incident 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. Care records included information on “strengths and interests” and possible triggers for “difficult situations” with strategies to prevent distress.

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 provider submitted statutory notifications to CQC. The staff and leaders took active steps to resolve concerns. Staff completed safeguarding training.

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. Staff understood there were times when people became distressed. Staff took steps to understand why people became distressed and what support they needed to express their emotions. The provider completed risk assessments.

The provider did not always detect and control potential risks in the care environment.

Care records included guidance for staff to keep the environment safe such as, “to ensure that the living environment is safe and free of hazardous materials or substances.” However, we identified risk assessments were not completed for emollient creams which pose a significant fire risk. This did not support the safe care and treatment of people and placed them at potential risk of harm in the event of a fire.

Staff were not always recruited safely. The provider carried out pre-employment checks including obtaining a Disclosure and Barring Service certificate. Disclosure and Barring Service checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. However, we identified gaps in the recruitment records and interview records, and induction records were not always fully completed.

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. Care records included guidance for staff to keep the environment clean. For example, “Staff are to sweep all floors and disinfect making sure that soon after mopping all floors are dry.” Care notes referred to staff cleaning, for example, “Staff mopped the floor using thick bleach and water,” Staff had completed training in infection control.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning. The provider worked with relatives regarding the administration of medicines. However, care records had conflicting information. For example, 1 positive behaviour plan guided staff to offer “when required” (PRN) medicine, however, there were no records of PRN medicines or protocols within the care records. We identified there was no specific guidance recorded within the care records or medicine administration records (MAR) to support staff in administering medicines safely to people with a learning disability or autistic people.