Clervaux Trust

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 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. Staff discussed incidents in handovers and meetings in a way which focused on openness and improvement. Accidents and incidents were investigated and analysed. Audits routinely generated actions, which staff completed and monitored to embed safer practice.

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. Staff escalated concerns promptly, such sudden changes in physical health and worked effectively with GPs, learning disability nurses and other professionals.

People received support during transitions, which included healthcare appointments such as annual reviews and dental checks where appropriate. Care plans included essential information to guide staff, and where changes occurred, staff ensured records were updated accordingly.

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 and relatives said they felt the service was safe. Staff understood safeguarding and felt confident to raise concerns. One staff member told us, “I feel confident raising safeguarding and whistleblowing concerns because staff are encouraged to speak up when concerns arise. I understand the reporting procedures and know that safeguarding is everyone’s responsibility.”

The service worked with external professionals where safeguarding-related risks were identified, including around behavioural and clinical needs, physical health issues and mental capacity. Incident reporting processes ensured the management team reviewed events and followed up with people and families.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. Deprivation of Liberty Safeguards (DoLS) authorisations were in place for people where appropriate.

The provider always worked well with people to fully understand and manage risks by thinking holistically. Staff provided care that fully met people’s needs and was safe, supportive and enabled people to do the things that mattered to them.

People were fully involved in identifying and managing risks in ways that promoted their safety, independence and choice. A person said, “I do things now that I could never do before because it wasn't safe, but now it is."

Risk assessments were personalised, regularly reviewed with people and those important to them, and reflected people’s preferences about how they wished to live their lives. Staff used this information to support positive risk-taking, enabling people to take part in work-based activities such as volunteering in a charity shop, driving tractors, mowing the grass and activities that mattered to them, such as looking after the animals on the farm, pottery and weaving, while reducing avoidable harm. One person was supported to take part in an activity which had previously been deemed too risky. This person now experienced less frustration and anxiety and their quality of life had improved as a result of this.

This positive approach to risk taking was embedded across the service and had a consistently positive impact on people’s confidence, control and wellbeing.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Safety checks of the premises and equipment were completed regularly and appropriate action was taken when needed. Procedures were in place for emergency situations and these were reviewed and updated regularly. People who lived at the service were involved in checking the safety of the premises where appropriate.

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 on duty and people’s needs were responded to promptly. Staff were recruited safely and there was a stable staff team which ensured consistency. Staff members confirmed they had opportunities for training and development and they felt supported. Staff described a culture of positive teamwork, and relatives said staff appeared skilled and knowledgeable.

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 followed safe infection prevention and control practices and used personal protective equipment (PPE) to help prevent the spread of infections. Staff had completed infection prevention and control training. The environment was visibly clean.

Medicines were administered safely and effectively. Records and checks of stock levels confirmed medicines had been given as directed, so we were assured that people received their medicines as prescribed. There were appropriate arrangements for ordering, storage and disposal of medicines. Suitable temperature monitoring was carried out to make sure medicines storage was safe and effective.

However, where people were prescribed ‘when required’ medicines, such as pain relief or medicines to support good bowel health, care records to guide staff on this had not been reviewed in a timely way. Also, care records regarding this needed more person-centred detail to guide staff when these should be administered.

Where homely remedies were in place advice had not been sought from health professionals whether these were appropriate. Homely remedies are over-the-counter medicines used to provide prompt relief for minor conditions such as a cold or headache. The provider’s medicines policy did not adequately cover the safe management of homely remedies. One person self-administered some of their prescribed medicines, but this had not been risk assessed appropriately. We advised the management team to rectify these issues which they agreed to do.