Saivi House

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 understood how to report any incidents or accidents. There were systems for the registered manager to review any incidents and share learning. Incidents or accidents that happened were discussed with staff during handovers and meetings. Staff were able to share their thoughts on how to help prevent recurrence of incidents. Any concerns were also shared with external professionals such as social workers and learning disability specialists.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored.

There were clear referral systems in place when the home had a vacancy and was accepting new referrals. People had a full assessment of their care and support needs prior to moving in. This included all aspects of people’s physical and emotional needs as well as any risks. This helped ensure the service could meet their needs and helped form the basis of people’s individual care plans. People were able to visit the home prior to moving in to make sure they liked it. The home worked with people’s external care teams to make sure any transfer of care was appropriate and met people’s needs.

People were kept safe from avoidable harm because staff knew them well and understood how to protect them from abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse, and they knew how to apply it. People and those who mattered to them had information about safeguarding in a form they could use. They knew how and when to raise a safeguarding concern. Staff understood how to ask for consent before providing care. Staff knew people well and we observed staff asking people what they wanted in a way the individual understood.

The provider requested legal authorisations where restrictions amounted to a deprivation of liberty for people who did not have the capacity to consent to these. Decisions about people’s care were made in their best interests and for their safety.

The provider worked with people to understand and manage risks. 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 robustly assessed to ensure people were kept safe. Risk assessments contained detailed information for staff on how to work effectively with people to minimise risk. Staff assessed people’s sensory needs and did their best to meet them. Risks assessed included swallowing difficulties, mobility and periods where people may experience distress. When a person was at risk of falls, there was a ‘crash mat’ with a sensor linked to the office to alert staff the person had fallen. Fire risks were assessed. People had personal evacuation plans (PEEPS) which detailed what support the person would need in the event of a fire. There were regular checks of fire systems and equipment.

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

Saivi house is a terraced house. There were downstairs bedrooms which were wheelchair and hoist accessible. The communal lounge was large enough to allow people to move freely around, and staff regularly checked for hazards. Windows had window restrictors to prevent accidents. There were processes in place to monitor the safety and upkeep of the premises. This included water safety, general buildings checks, fire systems, and gas and electricity safety. Equipment, such as hoists, were checked and maintained regularly.

There were enough suitably experienced staff to meet people’s care and support needs. Prior to the CQC assessment, the local authority had raised concerns following a visit to the home, that there were not enough staff to adequately meet people’s needs. At the time of the assessment, we found the provider had increased staffing by an extra staff member daily. A staff member told us this had helped staff workload and meant they were able to spend more time with people. Staff rotas reflected the increase in staffing.

Staff were recruited safely and there were appropriate checks on staff before they started working at the home. Staff received regular supervision and appraisal to support them in their role.

The registered manager had reviewed staff training following the local authority visit. We saw refresher training on subjects such as dysphagia, moving and handing, safeguarding and infection control had been completed or scheduled.

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.

The home used infection, prevention and control measures to keep people safe, and staff supported people to follow them, such as hand washing. The home had good arrangements for keeping premises clean and hygienic. We saw staff cleaned the premises using colour coded equipment and appropriate cleaning products. Staff used personal protection equipment (PPE) whilst engaged in cleaning activities and preparing food for residents. A relative commented, “It is always immaculately clean, as far as I see and I don’t always tell them when I am coming. I just turn up.”

The provider made sure that medicines were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

People were supported by staff who followed systems and processes to administer, record and store medicines safely. Staff followed effective processes to assess and provide the support people needed to take their medicines safely. This included where there were difficulties in communicating and when assessing risks of people taking medicines themselves. Where people had been prescribed ‘as needed’ medicines, there was information for staff on when these medicines should be offered and administered. As needed medicines are medicines such as pain relief or to help with anxiety. The service ensured people’s behaviour was not controlled by excessive and inappropriate use of medicines. Staff understood and implemented the principles of STOMP (stopping over-medication of people with a learning disability, autism or both) and ensured that people’s medicines were reviewed by prescribers in line with these principles. People’s care plans documented how people wanted to take their medicines which met their needs. For example, ‘I require assistance from staff to have my medication administered. I take my medication as a whole with a glass of water. I prefer to have my medicine in my room’.