Elliot Avenue

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. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The provider had effective systems in place to record and monitor accidents, incidents and complaints. We saw examples of where lessons learned had been identified and all necessary action taken to prevent reoccurrence of similar issues. Staff understood their responsibility to report and record any concerns and told us they were confident the management team would listen and respond appropriately. Whilst staff debriefs following accidents and incidents were not formally documented, staff told us they felt well supported. A member of staff told us, “[Deputy Manager] is always there, and the door is always open.”

Relatives told us they felt listened to and if they had any concerns or suggestions, they would be confident to discuss them with the staff and/or the management team. A relative told us, “[Name] lives in a safe service and she has never been injured. [Staff] ask me my opinions and ring me for advice. It's managed well and I feel I can talk to the manager.”

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’s hospital passports included important information about the person that would travel with them for any hospital admissions. This helped ensure a continuity of care. This important information about the person included any known allergies, GP contact details, next of kin or relevant person’s representative contact information and communication needs. People’s medical and health conditions were also listed to guide external health professionals.

Staff contacted external health professionals when people needed support. Staff supported people when required, to external appointments including health appointments. The management team told us how they worked closely with a range of professionals to ensure 1 person was supported to have a recent medical concern investigated and treated.

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. However, the provider did not always share concerns quickly and appropriately. We identified an incident which had been followed up appropriately by the provider but had not been reported to the local authority safeguarding team in a timely manner. A referral was made by the provider during the assessment process. We also identified an incident of “unexplained bruising” which had not been referred to the local authority safeguarding team. We were informed by the management team that it was felt the injury was likely to have been the result of “known behaviour.” However, there was no information in the person’s care plan or risk assessments regarding this. The provider confirmed they would review this care plan following our assessment.

Relatives said they felt their family members were safe living at Elliot Avenue. A relative told us that their family member was in a “safe place” and “what I see is that they [staff] are good.” Staff were trained in safeguarding and understood the procedures in place to keep people safe.

Staff had training in the Mental Capacity Act 2005 (MCA) and could evidence their understanding. We observed and staff explained how they supported people’s rights to make choices.

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.

Staff were knowledgeable about the risks known to people. Information within people’s care plans and risk assessments guided staff on how to support a person to keep them safe, as far as possible, by mitigating known risks. Staff told us they worked alongside the management team to ensure care plans and risk assessments were current and reflective of the person’s needs.

The service worked with people to understand and manage risks whilst promoting their independence. Positive behavioural support plans, communication passports and sensory passports were also in place and provided staff with detailed guidance, particularly around supporting people during times of distress.

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

Utility checks were completed to reduce the risk of an unsafe environment. An external fire risk assessment had been undertaken and staff told us and records showed they had practice fire drills. The manager told us that all staff at the service had a responsibility when working, to understand the fire evacuation procedure. People had Personal Emergency Evacuation Plans (PEEPs) in place, to guide staff on how they needed to be supported in the event of an emergency such as a need to evacuate the building.

Records showed there were checks completed on safety equipment. These evidenced a window restrictor in 1 room had been broken for some time but had not been fixed. The provider addressed this during the assessment. The home environment was showing signs of wear and tear, but this had been identified by the provider, and a plan had been put in place for a full refurbishment of the property.

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.

There were enough staff available to cover the shifts and enough staff to support people safely. Observations showed that staff promoted people’s safety by being nearby and available to support when needed. One staff member told us staffing levels were “really good” and that “it is not often we are short.” The provider had robust recruitment practices in place. All necessary pre-employment checks had been completed for staff.

Staff told us they received a thorough induction and ongoing training appropriate to their role. This included training on supporting people living with a learning disability and autistic people. A staff member told us, “We get all the training we need. If we are not 100% sure about something we can go to someone to ask or get shown.” Relatives also told us they felt staff were well trained. Staff had supervisions and were encouraged to develop their skills. A staff member told us, “We have regular supervisions and if there is something we need to speak about we can speak.”

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.

We found environments to be clean and Personal Protective Equipment (PPE) was supplied for staff to use when required. Our observations showed that the service looked visibly clean. Staff encouraged people to help take part in cleaning, to promote independence, should they choose to do so. One family member told us, “[Name] gets the hoover out and dusts.” As part of the provider’s governance monitoring system audits, checks were completed to monitor the cleanliness of the service and good infection control practices.

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 received their prescribed medicines as intended. Staff received training in administering people’s medicines and this included how to safely administer specialist medicine in the case of a seizure. Staff competence was regularly assessed, and they worked closely with other healthcare professionals to ensure people’s medicines were regularly reviewed.

Detailed, person-centred guidance was in place for 'when required' (PRN) medicines, including rescue medicines for seizures, pain relief and laxatives. These included clear instructions on when and how to administer the medicines based on individual needs and behaviours.

Audits and checks were carried out to make sure people’s medicines were being administered safely. Staff were aware of the guidance ‘Stopping the Over Medication of People’ (STOMP). This is a national project in the UK that targets the over-medication of medicines such as sedatives, when a person with a learning disability and/or autism is showing increased anxiety or distress. Staff gave examples of techniques they used to help minimise distress without resorting to medication.