Southwold 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. Safety incidents had been investigated and reported by the provider. When an incident occurred the provider and manager used this as an opportunity to learn and improve. The provider had systems in place to share learning throughout their organisation to lower risks to people and staff. Lessons were learnt to continually identify and embed good practice. We saw staff discussed risk and learning events in staff meetings to improve practice. The manager was able to share examples of how they had identified some areas for improvements and changes to practice following learning from safety incidents. Where needed, the manager and provider had arranged additional training and support for staff.

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 and manager worked with other professionals, relatives and people to ensure there was a safe transition between services when people were joining or leaving the service. This meant there was minimal disruption to people’s care and their needs were supported 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. Staff had received training in safeguarding people; this had recently been updated and included training on reducing restrictive practices and closed cultures. Staff told us they felt confident to raise any concerns they may have directly with senior staff or during staff supervision and meetings. One member of staff said, “I would report any poor practice or abuse to the manager. If this was not taken seriously, I would raise with the hierarchy.” Staff we spoke with were aware of how to raise ‘whistle blowing’ concerns both internally and externally.

A relative told us, “All the staff are caring, there was a couple of incidents a few years ago but this was dealt with, and those staff members no longer work there. The current staff are caring and friendly.” Another relative said, “They (loved one) always seems happy when we collect them or when we are dropping them back. They want to go back, they would let us know if they didn’t, so they must be meeting their needs.”

The provider had systems in place to raise and investigate safeguarding concerns and shared these appropriately with relevant professionals. The manager understood their responsibility under duty of candour and worked with the local authority to investigate safeguarding concerns when raised to keep people safe.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that the manager understood their responsibility to make DoLS application when required and did this in conjunction with people’s relatives and advocates. Staff had received training in the Mental Capacity Act and supported people in making informed decisions.

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. The provider recognised that people needed to live full lives with the least restrictions in place possible to maintain their safety. For example, 1 person was working towards reducing the staff support they needed to help them move to more independent living. Staff encouraged people to enjoy activities they chose to do in the community whilst mitigating the risks. We saw people had individual activities planned in the community such as swimming, bike riding and attending local clubs supported by staff. Where a person wanted to go away on holiday, staff had helped them facilitate this safely.

Where people’s needs had changed the manager had consulted with other health professionals such as occupational therapists and physiotherapist to establish what adjustments were needed to planned care. The manager worked collaboratively with people, relatives, advocates and health professionals when people’s support needs changed to review all options and identified the best outcomes for people.

There was documentation in place in the form of care plans and risk assessments for staff to follow. We identified some areas where these needed more detail, however the provider had already identified this and had put resources in place to address this.

The provider detected and controlled potential risks in the care environment. Health and safety audits were in place on the general management and running of the environment. For example, checks were in place for gas, electric, water temperature testing and legionella testing. Aspects of the environment needed updating, this included redecoration, changes to some room layouts and generally making the environment more conducive for supporting people with a learning disability. We saw some work had already been undertaken and completed and some work was scheduled in the service improvement plan. A person had been supported to redecorate their room in colours of their choice. The manager had consulted with other people and their relatives on ways of making rooms more personalised. Externally space had been landscaped and was accessible for people to use.

Staff had training in fire safety and fire drills were undertaken at the service. Fire safety was also discussed with staff during staff meetings. Each person had a personal evacuation plan in place. Where people’s needs changed referrals were made appropriately to occupational therapists to have their needs reassessed and additional equipment sourced.

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. A relative told us, “The staff and manager are caring.”

The provider recruited staff safely, applicants provided a full working history, provided references and undertook a disclosure and disbarring check (DBS), to ensure they were suitable to work with vulnerable people. New staff completed training including the care certificate and worked shadowing more experienced staff whilst they developed their skills. The manager told us they had gone through a process of recruiting new staff and did not use any agency staff. This meant people were supported by a consistent team of staff.

One member of staff told us, “My induction was good, I did on-line training before I came into the service on what was involved with the job. I was introduced to the house and shown around and had time to go through people’s care plans. I then completed a week shadowing other staff.” Another member of staff said, “When I first started, I had a whole 5 days and just read care plans and risk assessments.”

The provider and manager had completed a staff and training needs analysis and were focusing on developing staff skills to support people. We saw staff were receiving training from the provider’s positive support training practitioner. They informed us they had been working with the manager and provider to upskill staff and revisit previous training. This training was being delivered face to face in the form of workshops which were supplemented by eLearning.

Staff were being provided with regular supervision to discuss their performance and any training needs they may have, and the manager was holding regular staff meetings. From minutes of meetings, we saw staff discussed the general running of the service, any lessons learned, policies and processes as well as individuals they were supporting.

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 had received training in infection prevention control (IPC) and safe food handling. The provider had policies in place to support IPC practices at the service. Cleaning schedules were in place along with regular audits to monitor the service.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff had received training in medicine management and had their competency to support people with medicines checked. The provider and manager understood the principles of STOMP (stop over medication of people with a learning disability, autism or both). People living at the service had reviews of their medication with the appropriate healthcare professional to ensure this met their needs.

Medication documentation we reviewed was in good order and included clear directions for medicine prescribed as and when required (PRN). Where staff needed specialist training to administer some medicines this was provided to staff to ensure they had all the skills needed to safely administer medicines.