Care Outlook (New Larchwood)

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 this newly registered service. 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. Lessons were learnt to continually identify and embed good practice. People knew how to raise concerns. They spoke positively about staff and leaders listening to them. Systems were in place to learn from lessons following accidents and incidents. Where incidents and accidents occurred, investigations were carried out and actions taken. A staff member said, “We receive feedback on lessons learned and changes implemented.” The provider had developed a culture of learning where lessons learnt were shared with staff to improve practice. Leaders were aware of the duty of candour and their legal responsibilities to be open and transparent when things went wrong.

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. People were supported to access other services when needed. People’s care plans included information about the key services and professionals involved in their care and support. Staff liaised with people, their families and health professionals, where appropriate, to ensure people’s needs were safely supported. The manager understood the importance of working with health and social care professionals to ensure people received appropriate support. Feedback from external professionals about staff and leaders was positive. Comments included, “There is good collaboration and [provider] considers all required areas of how they could meet individual outcomes during referral process” and “The care team reach out in a timely manner. This includes prior to a new person moving into the building if the service will be managing their care. They provide relevant information within the referral for the assessment need.”

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. People all said they felt safe with the staff. The provider had safeguarding and whistleblowing policies. Staff had training and understood their responsibilities for safeguarding. Where they had concerns, they had raised these appropriately meaning action could be taken if required. A staff member said, “I monitor for unusual behaviour, injuries or sign of distress. If I see something wrong, I tell [leaders].” Leaders performed competency checks to test staff’s knowledge. The provider shared events with appropriate external agencies quickly and had documented actions taken.

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. People told us staff were competent in supporting them to manage everyday risks related to their care. These included risks associated with medical conditions, medicines, behaviour, and moving and handling. A staff member told us how they supported an individual when they became anxious and distressed. They said, “The person is quite independent. The building was due to have a fire alarm test which stressed [them] out, so we just offered lots of reassurance about what [they] needed to do and where to go.” Potential risks to people’s health and welfare had been assessed. For example, for people at risk of malnutrition or pressure damage. Risk assessments had been reviewed regularly with people and their relatives.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People were supported to keep their environment safe and tidy. The provider carried out assessments of risk in people’s home environments, including risks related to falls, home safety and the equipment used during care. People told us they had the right equipment in place and that staff were competent in using it safely. Staff received fire training. They told us about environmental risk assessments and how they keep people safe. These included risks associated with people smoking in their homes.

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. Feedback from people about staff was positive. People told us they had support when they needed it. They said staff did not rush their care and knew what they were doing. A person said, “[Staff name] is a usual guy I have. He is great.” Staff were recruited safely with all appropriate checks undertaken to ensure they were appropriate individuals to work with people. They had training to ensure they understood the needs of the people they were supporting, which was checked through regular supervisions and competency checks. A staff member said, “I received a comprehensive induction and had e-learning courses to complete which helped me settle into the role. We receive supervision regularly. I feel well supported by the leaders and colleagues.”

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 told us staff used personal protective equipment (PPE). Staff had training in infection control and understood how and when to use PPE. The service had stocks of PPE, such as gloves, aprons and masks for use by staff when providing personal care. There were infection prevention and control policies and procedures in place. These had been developed in line with best practice, which helped to ensure staff were following guidance relevant to their role.Spot checks were completed by leaders to ensure staff demonstrated good practice.

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. People told us they received their medicines safely and in line with their preferences. Care plans reflected people’s decision-making capability for medicines. There was clear guidance around how people’s medicines should be administered safely, including any side effects staff should be mindful of. Medicines in extra care settings are stored in people's own flats in accordance with guidance. Medicines were stored as per people's capacity and preferences. For example, where people required full support, medicines were locked away. One person told us how they were supported to manage medicines safely. They said, “[Staff] come in everyday and give me whatever I need to take. [Medicines] are under lock and key.” Staff had received medication administration training. They understood actions they should take if they had concerns with medicines administration and had acted appropriately when this had occurred. Competencies were carried out to check staff knowledge and skills. The service had processes in place that aligned to the ‘Stopping over medication of people with a learning disability and autistic people’ (STOMP) programme. This is a national initiative aiming to reduce the inappropriate use of antipsychotic medication and focusing on holistic alternatives.