Emerald Agency

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 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 positive culture of safety, based on openness and honesty. Staff spoke positively about support from managers, and all felt able to raise questions or suggestions to the managers including if things had gone wrong. There had been few accidents or incidents. However, there was a process to document these if they occurred. The registered manager confirmed they would look for any patterns or trends if similar incidents occurred more regularly. They reflected that this would not be about blame but about identifying what could be changed to reduce the likelihood of future similar events.

The provider worked with people and partner agencies to establish and maintain safe systems of care and ensured continuity when people’s needs changed or when they moved between services. Staff supported people to access healthcare services, including arranging and attending appointments where required, and sought additional support when needs changed.

There was evidence of effective collaborative working with external professionals to review people’s needs, plan support and respond to changes in circumstances. Professionals provided positive feedback about communication and engagement and described the service as responsive and willing to work in partnership.

The service demonstrated the ability to respond to significant events while maintaining continuity of care. For example, during a previous emergency relocation following local flooding, staff acted quickly to ensure people’s safety and continued to provide consistent support despite disruption.

The provider worked with people and external 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 told us they felt safe. One person said, “yes I’m safe”, and others spoke positively about the staff who supported them. Feedback from family members and professionals did not raise safeguarding concerns and described a safe and supportive environment. Safeguarding was understood in practice, and staff demonstrated confidence in recognising and reporting concerns internally and to relevant external agencies where required.

People were not subject to unnecessary restrictions. Individuals were able to come and go freely and access the community independently or with support, in line with their preferences. At the time of the assessment, nobody was subject to a community Deprivation of Liberties Safeguards (DoLS) authorisation. The registered manager was aware of the legal process should this be required.

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. People were involved in decisions about their daily lives and how risks were managed, and were able to make choices about their routines, activities and support.

Risk assessments were detailed, individualised and provided guidance for staff on how to support people safely. Staff demonstrated an understanding of risks and how to respond appropriately, including balancing safety with people’s preferences and independence.

There was evidence of positive risk-taking in practice, with people supported to access the community, pursue their interests and maintain independence, while staff were available to provide support where required.

The provider ensured that people were cared for in a safe and suitable environment, which was well maintained and appropriate to meet their individual and collective needs.

Staff took reasonable steps to identify and manage environmental risks. Risk assessments were in place and provided guidance to staff on how to support people safely within their living environment. Where concerns had been identified, actions had been taken to reduce risks and maintain safety. For example, one person’s ensuite bathroom had been adapted to a walk in wet room to reduce risks and promote independence. Systems were in place to monitor the environment and identify risks for escalation.

People were able to access all communal areas of their home. There was no evidence of unsafe restrictions within the environment, and people were supported to live as independently as possible while maintaining their safety.

While there were sufficient numbers of staff to meet people’s needs, systems to ensure staff were fully trained and competent were not consistently in place. For example, although staff had completed online moving and handling training, they told us they had not completed practical moving and handling training. Staff were supporting a person who required the use of a hoist and the registered manager took action to identify suitable practical training.

Care staff had completed learning disability and autism training however, the registered manager was not assured that this met the requirements of statutory guidance for this training. This indicated that systems were not always effective in ensuring staff training was aligned with current legislation and best practice, which limited assurance that staff had the appropriate knowledge and skills to support people.

Formal competency assessments were not completed to ensure staff were safe to undertake key tasks, including the administration of medicines. This reduced assurance that staff had the required knowledge and skills to carry out their roles safely and effectively. The registered manager took prompt action to introduce a system for these to be completed following the inspection visit.

There were enough staff available to meet people’s needs. Core staffing was provided throughout the day and night, with additional one-to-one support allocated based on individuals’ assessed needs and funding arrangements agreed with the local authority. This helped ensure people received the level of support required to meet their specific and individual needs.

Safe recruitment processes were followed. Staff files included appropriate pre-employment checks such as Disclosure and Barring Service (DBS) checks, references and proof of identity. Recruitment records demonstrated that staff were suitable to work with people using the service.

The provider assessed and managed the risk of infection. Staff demonstrated an understanding of infection prevention and control procedures and had access to appropriate equipment, including personal protective equipment (PPE), which staff confirmed was readily available.

The environment was clean and hygienic. During the assessment, communal areas and people’s living spaces were observed to be well maintained, and staff supported people to keep their own spaces clean as part of promoting independence.

A range of infection prevention and control policies and procedures were in place, and audits were completed to support good standards of cleanliness and hygiene across the service.

The provider ensured that medicines were generally managed safely. All staff had completed medicines administration training; however, staff competency assessments had not been completed to ensure they had the appropriate knowledge and skills to administer medicines safely. The registered manager acted promptly to address this during the assessment, and began implementing competency checks as required. Until these were fully embedded, this reduced assurance that medicines were always managed safely and consistently.

People received their medicines as prescribed and were supported by staff where required. Medicines were stored securely in people’s own rooms, and systems were in place to monitor medicines administration and reduce the risk of errors. This included regular checks of Medication Administration Records (MAR) and weekly stock counts to ensure records were accurate and any discrepancies were identified promptly.

People’s medicines had been reviewed by relevant health professionals, supporting safe and effective prescribing and ongoing monitoring of their needs. People told us they were happy with the support they received with their medicines.