Creative Support - Morecambe Service

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 service 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.

Staff knew how to report safety incidents which were investigated by the management team and immediate actions were taken, where required. Learning from incidents was shared in staff meetings and one-to-one meetings with staff. One staff member told us, “When somebody has had a fall, they are checked over and we inform medical services where required. We complete an incident form and monitor the person.” The registered manager told us, “We share learning via team leader meetings, send memos to staff and use communication books.”

The service 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.

Where people required hospital treatment or visited dental surgeries, there was person centred information in the form of hospital or dental passports to guide external staff how to meet the person’s needs.

Where one person was being supported to move to another service, we saw evidence of the service working effectively with external professionals and sharing information to ensure continuity of care.

A member of the management team told us, “We do a lot of transition work with people moving into services. Our staff go and work at other services so people coming to our service get to know them.”

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that.

The service investigated safeguarding incidents and shared concerns quickly and appropriately with the relevant authorities.

Staff had received safeguarding training and knew how to identify and report abuse. One staff member told us, “I have had safeguarding training, and I let management know when there are safeguarding issues. I record everything and I am confident the managers would escalate safeguarding issues and report them.” Another staff member told us, “I am confident they [the management team] would deal with any safeguarding issues and if not, I would call head office. I have read the whistleblowing policy, and I would whistle blow if I felt the need to.”

Information about how to identify and report abuse was available to staff.

We saw evidence of the service providing additional staff to ensure people were not deprived of their liberty while awaiting legal authorisation from the Court of Protection. One staff member told us, “We can’t implement restrictions that haven’t yet been authorised. This is putting pressure on staffing, but we need to wait for the Court.” The service put a plan in place to ensure they could monitor people’s court of protection applications more effectively.

The service 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.

Where people had risks such as with swallowing, mobility, and behaviour, we observed staff supporting them safely and delivering care in line with their risk assessments, using specialist equipment, where required. Risk assessments in place contained enough detail and guided staff how to manage those risks and to escalate concerns, when required.

One relative told us, “Staff know [person’s] risks very well indeed and what problems they face and present with.”

Where we found one person’s risk assessments had not been reviewed in line with the service’s policy to review them annually or when there were changes in people’s risks, the service reviewed them straight away and showed us evidence of how they did this.

People had Personal Emergency Evacuation Plans (PEEPS) in place to guide staff how to evacuate people safely in the event of an emergency.

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

The safety of the premises, communal and personal spaces (such as bedrooms), and the living environment were checked and managed to support people to stay safe. Maintenance issues were logged and reported to the relevant housing association, where required.

People’s homes had fire safety equipment and guidance for people and staff about what to do in the event of a fire. Routine testing took place for fire alarms and evacuation procedures. Staff had received fire safety training.

People were cared for in safe environments designed and adapted to meet their needs. One staff member told us, “[Person] spends most of their time in the communal areas when at home. Due to their mobility difficulties, a room adjacent to the living room was converted to a toilet room to enable quick access when needed.”

The service 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.

The service ensured there were enough staff to ensure people were supported on a one to one or two to one basis to access the community and appointments or when people required support with their moving and handling needs. People also had access to core staff support.

Team meetings, one-to-one meetings and daily handovers were in place, to support staff to provide safe care to people.

Staff were safely recruited and received training to carry out their roles. Staff were encouraged to further develop their skills. One staff member told us, “I thought I needed training about a seizure medication, so I requested it and had the training.”

The service had a plan in place to ensure staff received diabetes training where required and for all staff to complete food safety training.

We found some inconsistencies with the service’s training records about how often refresher training was required. However, the service put a plan in place to ensure records included consistent information.

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.

People’s homes were clean and tidy, and staff were provided with personal protective equipment (PPE). One staff member told us, “We keep everything clean including touch points, we have a cleaner who comes in every Friday to do a deep clean. We encourage and support them [people using the service] to wash their hands and around food.”

However, we had some concerns in respect of fridge and freezer temperature checks in one home. When the inspection team informed the service about this, they took immediate action to rectify these.

The service 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.

Staff demonstrated good knowledge of people’s medicines needs, and for people with diabetes, their individual medicines needs were monitored and recorded regularly. However, care plans did not always have up to date, personalised information about how to support people with their medicines.

Medicines administration records did not always contain accurate, complete medicines information as outlined in their medicines policy and in national guidance. For example, people’s allergies, administration instructions, drug formulation and how much to give was not always recorded.

Information to support staff to safely give ‘when required’ medicines was in place. However, the outcomes following these medicines being given was not always recorded to ensure they were effective. There was one instance of a rescue medicine being unlabelled and the care plan contained conflicting information as to how and when this was to be administered. There was a risk that they would not get their medicine when they needed it.

Managers told us that staff had completed medicines training and had been assessed to ensure that they gave medicines safely. We were shown evidence of training records to confirm this. Medicines incidents were recorded, analysed and learnt from.

Medicines audits were completed each month. However, these were not always effective in identifying medicines-related issues occurring within the service.