Potensial Limited - 1 Newlands Drive

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 encouraged a positive learning culture where staff reflected on incidents, concerns and near misses to improve people's safety and wellbeing. When things went wrong, these were reviewed to understand what had happened and to identify any changes needed to reduce the risk of the same thing happening again.

Learning was used to improve the support people received and was tailored to their individual needs and preferences. This included reviewing care plans, adapting support strategies and providing staff with additional guidance or training where required. Staff told us they were encouraged to share their ideas and experiences and felt involved in finding person-centred solutions that helped people stay safe while maintaining their independence and choice.

Learning and improvements were discussed during team meetings, supervision and competency checks to ensure staff understood their responsibilities and were equipped to provide safe, effective and personalised care.

The provider worked with people and health and social care 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 systems in place to support safe admissions, transfers and transitions between services. Before people moved into the service, comprehensive assessments were completed to ensure their individual needs, preferences and risks could be safely met. These assessments involved the person, those important to them and relevant professionals, helping to ensure decisions were based on a full understanding of their needs and wishes.

Information was shared effectively when people accessed other services, including hospitals and healthcare providers. People had personalised communication plans in place and hospital passports that provided important information about how they communicated, what was important to them and how they preferred to be supported. This helped ensure care remained consistent and centred around the person's individual needs.

People were involved in planning changes to their care and support wherever possible. Staff worked alongside people, relatives and professionals to make sure transitions were well coordinated and tailored to the person. This helped reduce uncertainty and anxiety and supported people to experience safe and positive outcomes when moving between services or accessing healthcare support.

The provider considered both people's needs and compatibility with other people supported when planning admissions, helping to ensure people could live safely together and enjoy positive relationships within the service. This supported people's wellbeing and contributed to a safe and supportive living environment.

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 had systems in place to help protect people from abuse and avoidable harm. Staff received safeguarding training and understood how to recognise concerns, respond appropriately and report issues to the relevant agencies when needed.

The registered manager-maintained oversight of people's safety through regular monitoring and review of incidents, including accidents, falls and medicines errors. This helped to identify any trends, reduce risks and improve outcomes for people.

The provider worked in line with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). People's capacity to make specific decisions was assessed where required, and best interest decisions were made when people were unable to make certain decisions for themselves. The provider sought the least restrictive options to support people's safety, rights and independence, ensuring care and support reflected their individual needs, wishes and preferences.

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 what mattered to them.

Risks to people’s health, safety and wellbeing were assessed and reviewed to reflect their individual needs and circumstances. Assessments covered areas such as moving and handling, skin integrity, nutrition and hydration. Where risks were identified, clear guidance was in place to help staff provide safe and consistent support.

Staff knew people well and understood how to support them in ways that reflected their needs, preferences and routines. Care plans included personalised guidance to help reduce risks while ensuring people received support that was right for them.

People were supported to make choices about their lives and take part in activities that were important to them. Staff worked with people to manage risks in a way that promoted their independence, dignity and wellbeing, while helping to keep them safe. This approach ensured people were not unnecessarily restricted and could continue to live their lives in the way they chose.

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. The provider had invested in refurbishing parts of the service to create a more supportive environment for people developing life skills and preparing for greater independence. Some areas had been redecorated and adapted to support people to progress towards more independent living. However, this approach was not consistent across all parts of the service.

Within the 'home for life' area, the environment was not consistently maintained to a standard that fully supported safe care. We observed areas requiring refurbishment, including worn flooring, damaged décor and ageing fixtures and fittings. While the provider had identified some of these issues through environmental audits and monitoring processes, sufficient progress had not been made to address them in a timely manner. Oversight arrangements had not always been effective in ensuring identified repairs and improvements were completed.

One relative told us, “’Names’ bedroom needs redecorating and their window blinds are broken”. One person said, “I like my room, it is just how I like it” and another said, “I don’t really care what my room looks like”.

As a result, the premises did not consistently demonstrate good standards of maintenance and refurbishment. People were not always supported in an environment that was well maintained and fully reflective of their needs. Improvements were required.

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.

Safe recruitment procedures were followed to help ensure staff were suitable for their roles. Appropriate pre-employment checks had been completed before staff commenced work. The registered manager had maintained a stable staff team and did not use agency staff, helping to provide continuity of care and ensuring people were supported by staff who knew them well. They had a team of regular bank staff who knew people well. This contributed to positive relationships, consistency of support and improved outcomes for people using the service.

The provider ensured there were enough suitably skilled and experienced staff to meet people's needs safely and consistently. Staffing levels were planned around the needs of people using the service, helping to ensure support was available when needed and delivered in a timely way. One relative told us that staffing numbers were variable. During our assessment we found there were enough staff to meet people’s needs.

Staff received regular supervision, competency checks and opportunities to discuss their performance and development. New staff completed a structured induction and worked alongside experienced colleagues to develop the skills, knowledge and confidence required for their role. Staff also completed mandatory and role-specific training to help them provide safe, effective and person-centred support.

Staff told us they felt valued and supported by the management team and had access to the training and guidance needed to carry out their roles effectively. This helped ensure people were supported by staff who understood their individual needs, preferences and goals.

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 provider had effective arrangements in place to reduce the risk of infection and maintain a clean environment for people, staff and visitors. Staff received infection prevention and control training and understood their responsibilities for maintaining hygiene standards throughout the service.

Cleaning tasks were completed regularly and monitored through routine checks to ensure standards were maintained. Systems were in place for the safe handling of laundry, helping to minimise the risk of cross-contamination.

There were ample supplies of PPE including gloves and aprons. Staff were observed wearing these while undertaking personal care tasks and also when working in the kitchen.

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.

The provider had effective systems in place to ensure medicines were managed safely and in a way that reflected people's individual needs and preferences. People received their medicines as prescribed, and staff followed clear guidance to support safe administration, recording and monitoring.

People had personalised medicines information which described the support they needed and how they preferred to take their medicines. This helped staff provide consistent support and ensured people's choices and routines were respected.

Staff received medicines training and had their competency assessed regularly to ensure they could support people safely. Medicines records were accurate, and regular audits were completed to identify any concerns and support continuous improvement.

These arrangements helped to ensure people received their medicines safely, achieved the best possible outcomes from their treatment, and were supported in a way that was tailored to their individual needs.