Creative Support - Cecil Gardens

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

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 69 (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 took immediate actions to respond when an accident or incident happened and reported these appropriately. The management team reviewed accidents and incidents to ensure appropriate actions were taken and identify any themes or trends. This helped to promote safe care for people. Lessons were learnt to continually identify and embed good practice, at both a local level and across the provider’s other services. For example, following several moving and handling incidents at another service, a professional was commissioned to review these and consider how staff practice could be strengthened. These recommendations were then implemented at other services including Creative Support – Cecil Gardens.

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. Assessments were completed to understand people’s support needs, and this information was shared with other services. Referrals were made for specialist input, such as speech and language therapists or occupational therapists, and their advice recorded to guide staff practice. Information was available to support people in the event of a hospital admission. We discussed with the provider the need to ensure this information was regularly reviewed and up to date.

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 and maintained an overview of concerns, reviewing each one to ensure appropriate actions were taken to promote people’s safety. A safeguarding policy was in place and helped to inform staff practice. Staff undertook safeguarding training and felt confident in their knowledge of when to report abuse.

We checked whether the service worked within the principles of the Mental Capacity Act (MCA) 2005. This piece of legislation provides a framework when supporting people, who may lack capacity, with decisions regarding their care, treatment and finances. Mental capacity assessments and associated best interest decisions were completed where this was required. We discussed with the provider the need to ensure all the principles of this legislation were promoted, for example including all relevant people in the decision-making process. An MCA workshop had been held at the service to further develop staff understanding of this important piece of legislation.

People and their relatives told us they felt safe and able to share concerns. For example, one person told us, “I feel very comfortable here. I have had meetings with the manager.”

The provider did not always work well with people to understand and manage risks. Staff didprovide care to meet people’s needs that was safe, supportive and enabled people todo the things that mattered to them.

Whilst in most circumstances risk assessments were completed for identified risks, there were, however, instances where these not been updated or completed when a person’s needs had changed, or when staff became aware of new information. Examples included changes in the condition of a person’s skin, or their mental health needs. This presented a risk staff may not have all the relevant information to safely support the person. This was acknowledged by the provider and actions were taken during the assessment to complete this documentation.

Recognised risk assessment tools, for example to assess skin integrity, were not used. We discussed the benefits of using these tools with the provider, as they give clear results and easy steps for staff to follow.

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 manage their home environment. However, we noted some inconsistencies in the standards of cleanliness and laundry support provided by staff. Staff completed assessments of people’s environments to consider potential risks and required actions which could address or mitigate these risks. People had access to a variety of equipment to aid their independence and promote their safety. For example, pendants to request support, or equipment for alerting them in the event of a fire. Maintenance concerns were shared with the housing provider for them to address.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked well together to provide safe care that met people’s individual needs. The provider recruited staff safely to ensure they were suitable for the role, and there had been a reduction in the number of agency staff used.

Staff received training specific to their role which included a tailored programme for those taking on more leadership responsibilities. The provider maintained an overview of training, and this was discussed within team meetings and supervisions to ensure staff were properly equipped. Staff confirmed the training was of good quality with one staff member stating, “I believe the service has been doing its best to ensure all staff receive high-quality training to effectively support service users.” Training specific to people’s needs was not always in place, in areas such as dementia care, skin integrity and catheter care, which the provider acknowledged and agreed to address.

Supervisions were completed with staff to monitor their performance, well-being and development needs. New staff were supported to ensure they had important information about the service and people who lived there.

People and their relatives told us staff came at the right time and were reliable but noted consistency of staff could be improved. For example, one person told us, “I often do not have a clue who is coming to help me, so I need more consistency.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of infections spreading and shared concerns with appropriate agencies promptly. People told us staff wore personal protective equipment when they supported them with their personal care. An infection prevention and control policy was in place and staff undertook training to keep their knowledge and practice current.

The provider did not always make sure medicines were administered safely. People were involved in planning their medicines, including when changes happened. People’s needs and preferences were considered.

Prescription instructions had not always been followed for time specific medicines. We found several examples of this for different people. This had not been identified through the provider’s checks of medicines. This presented a risk to people in receipt of medicines support. The provider took immediate actions after our feedback, including contacting other health and social care agencies to make the necessary adjustments. People were also consulted as part of this process and there was wider organisational learning.

Staff members undertook medicines training, and their competency was assessed to ensure their practice remained safe. Medicines records were well-maintained. Further information was available to guide staff for administration of as and when needed medicines, or to understand the risks associated with emollient creams which are flammable. The provider had appointed a medicines lead for the service, with a member of the management team telling us, “The improvements around medicines are palpable.”