Archived: Creative Support – Carlisle Services

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 service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 62 (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 management team discussed incidents within corporate meetings and lessons learned were recorded. Staff knew how to record and report accidents and incidents, and there was a process for escalating concerns. They knew people well and protected people from immediate risks of harm.

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 had access to a range of health and social care professionals, as needed, including GPs, mental health nurses and social workers. Initial assessments of people’s needs had taken place, and this information, along with information from family members was used to create people’s care plans. Care plans contained detailed information on how to support people accordingly and reflected both the physical and mental health needs of people. Policies and procedures were in place to ensure a consistency of approach in the management of risk. There was a good understanding of risk management within the staff team.

The provider did not always work well with people and healthcare partners to understand what being safe meant to them and how to achieve that. They did not always concentrate on improving people’s lives or protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider did not always share concerns quickly and appropriately. Safeguarding concerns and referrals were not always submitted in a timely manner to the local authority. The registered manager and other staff members were able to describe what action they would take if an incident should occur. Safeguarding processes and policies were in place and the staff we spoke with knew how to follow them. Staff received regular safeguarding training and were aware of their responsibilities and reported changes to people’s presentation to senior leaders.

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. Care plans and risk assessments were in place for staff to follow. These were up-to-date and regularly reviewed. Handovers took place between shifts ensuring people’s needs were met. The communication book contained information, that included, plenty of entries about different events, information about medicines, falls, food changes, updates to flooring and the building. A relative said, “Staff support day to day is utterly fantastic. They hugely care about [person] and know him well. He has incredibly good support from them and has a good quality of life.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Staff told us that they undertook the housekeeping duties as part of their roles. Areas of the building were being updated during our visit, which was done safely with an ongoing refurbishment plan in place. Staff had considered people’s needs and alternative rooms were provided so that people could continue to use lounge areas. A relative said, “[Person’s] home environment is homely, comfortable and very ‘[person]’, surrounded by all the things [person] likes and photos of family.”

The provider did not always make sure staff received effective support, supervision and development. They did not always work together well to provide safe care that met people’s individual needs.

There were policies and processes in place for staff supervision. However, we did not see regular supervision meetings documented for all staff. Some supervisions had taken place as had some appraisals. Some staff said that they did not regularly get a planned supervision even after asking for one.

Rotas showed sufficient staff on duty as per the provider’s staffing calculations. However, a staff member said, “There aren't enough staff to take everyone out and let them do what they want to do.” Staff felt it was difficult at times and some plans had to be changed last minute due to the lack of experienced staff on duty.

Feedback from relatives supported this view and told us of occasions when their relative’s visit had not been facilitated due to low staffing levels or appropriate staff on shift.

The provider followed safe recruitment systems and processes. Mandatory training was up to date and the use of agency staff was temporary whilst recruiting additional team members. The provider had received a gold award in the ‘Investors in People scheme’.

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 wore suitable personal protective equipment (PPE) while providing care to people. Staff took part in infection control training, and frequent checks were done to ensure they followed the correct procedures. Staff supported people to maintain a clean environment, undertaking housekeeping tasks. Previous feedback about malodours in some rooms, from carpets, had been listened to and acted upon by the management team. At the time of our visit there was an active refurbishment plan in place, with carpets and flooring being changed for more appropriate floor coverings. There were handwashing facilities at various places throughout.

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. People raised no concerns about how and when they received their medicines. All medicine was stored safely, documentation completed and staff supported people to order repeat medicines. One person was monitored for antipsychotic medicine and they were supported to attend appointments locally. Their relative told us, “[Person] is prescribed [medicine name] and requires monitoring appointments. Staff always facilitate them to attend.”