128 Beech Hill

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 the service under the new provider. 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. Staff felt confident about raising safety concerns and said these were always addressed promptly. Lessons were learnt from accidents and incidents to continually identify and embed good practice and ensure positive outcomes for people. For example, reviewing medicine protocols and updating care plans following behaviour related incidents. Team meetings included discussions on accidents and incidents, and staff were able to add learning and reflection topics as agenda items.

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. Records showed clear planning for health appointments and transitions, including support for people’s specific and complex needs. Hospital passports and emergency packs were in place and up to date to support safe hospital admissions. Staff showed appropriate consideration of compatibility during new admissions to the service, and people living in the home were actively involved in welcoming new housemates.

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. The provider shared concerns quickly and appropriately. Staff had completed safeguarding training and demonstrated good understanding of how to escalate concerns.

Where people were deprived of their liberty, appropriate authorisations had been applied for and implemented in accordance with legal requirements, ensuring any restrictions were proportionate, necessary, and applied in the least restrictive way possible to protect the person’s rights and wellbeing.

People told us they felt safe and would speak to staff or family if worried. Comments included, “It’s very safe here because the staff help me to keep safe”. And “I enjoy living at Beech Hill, because it’s very safe”. Another person said, “If I didn’t feel safe, I wouldn’t stay”. The person told us they would go to the police if there were any concerns and demonstrated they knew how to contact them. Accessible safeguarding information was available.

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. Risks were assessed and managed with people’s involvement. Care plans and risk assessments reflected individual preferences and positive risk-taking, such as independence around the home and local community, physical activities and enabling a person to sleep in a tent in the garden during summer. People were encouraged to make choices about daily life, and staff understood how to balance independence with safety.

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

The environment was clean, well maintained, and homely. There were no trip hazards, and furnishings reflected people’s personalities without compromising safety. Safety checks for fire, gas, and electrical equipment were up to date. Following a recent fire safety audit, measures were implemented to reduce fire risks, including restricting tumble dryer use after 7pm. Staff had completed fire safety training, and people had emergency evacuation plans in place. Appropriate signage and equipment were displayed throughout the house to support good fire safety. This included “Get help faster in an emergency” signage and information, such as the property’s location using What3Words and the location of the nearest defibrillator.

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. People were supported by a constant team of staff who knew them well. There was evidence of safe recruitment processes including checks to ensure staff were safe to work with people, a comprehensive induction and competency checking to assess staff knowledge and practice. People told us staff were caring and supportive and knew how to support them safely and well.

Staff had completed mandatory training including training to support people with a learning disability. Staff understood the Oliver McGowan Code of Practice and were able to reflect on their training and how they have put this into practice. The Oliver McGowan Code of Practice sets out to ensure CQC registered health and social care staff receive high-quality, mandatory training on learning disability and autism aiming to improve care standards and reduce inequalities. The Oliver McGowan Mandatory Training on Learning Disability and Autism is the Government’s preferred and recommended training for health and social care staff to undertake.

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. Infection control measures were effective. The environment was clean and hygienic, and personal protective equipment (PPE) was readily available and used appropriately. Individualised Control of Substances Hazardous to Health (COSHH) risk assessments enabled people to access and use cleaning products safely and independently when cleaning their homes. Staff had implemented enhanced infection prevention and control (IPC) processes to safely support a person who was receiving medical treatment that required minimal exposure to infections.

Medicines were managed safely. The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff received regular training, and competency checks to ensure safe practice. Staff knew when to give ‘as and when required’ (PRN) medicines and when to seek medical advice. Medicines were stored and recorded safely.

People had person-centred medicine plans and were involved in planning and reviewing these including when changes happened. People were aware of the reasons their medicines had been prescribed. We saw a person requesting PRN medication for the appropriate prescribed reason. The person told us the medication had the desired effect and that they felt much better afterwards. “I am calmer now, I am not worried now, I am not anxious”. National best practice guidance was followed including the principles of STOMP (stopping over-medication of people with a learning disability, autism, or both). People’s medicines were regularly reviewed by prescribers.