Eliot 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

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

This is the first assessment for this service under the new provider. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 78 (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.

Leaders and staff did not overlook or ignore risks. They maintained an incident log which was a record of all incidents which had occurred which provided the details, severity, type of incident and lessons learned which included actions to prevent recurrence. Leaders had access to systems and technology which provided them access to the latest incident and accidents records, which supported their thematic reviews of common themes.

Staff had a good understanding of what was meant by an accident or an incident. They knew how to respond to safety concerns, including how to respond to people who were likely to have epileptic seizures.

Staff knew how to report safety concerns and had no reservations about doing so as they were confident, they would be treated with compassion and understanding by their service leads if they did. Staff were confident that leaders would act swiftly to support and resolve any alerts.

Staff told us learning from safety events was discussed within handovers or in team meetings.

People told us they would raise any safety concerns with staff if they had them and felt comfortable speaking with management if required.

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.

The provider evidenced how they had safely managed people’s transitions into the schemes. People, staff, and leaders told us people engaged in discussions about moving to the extra care setting. Leaders told us about a person who had lived at one of the schemes for a considerable proportion of their life and following recent health issues, there were concerns raised they may need to move to another setting. The leaders spoke with the person at length and listened to their desire to stay where they were currently. Leaders fought for the person to remain, and the person felt adequately supported.

Staff said leaders provided them with enough information about new people moving into the schemes. Staff felt support plans and risk assessments were detailed enough to have a good understanding of a person’s needs.

People had hospital passports in place. A hospital passport is a personalised document which helps hospital staff understand a person’s needs, preferences, and medical history during a hospital visit or stay. We found one person’s hospital passport did not have a date identifying when it was competed and did not identify there was a ‘do not resuscitate’ (DNACPR) order in place. The hospital passport form being used had another person’s name in the footer of the document. This was raised with the leaders and resolved.

People told us their transition into the schemes had been unproblematic. A person said, “The move was straightforward.” It was also documented that another person had said, in relation to leaders meeting with them prior to their transition to the scheme, “They used to come to me and talk to me, not at me, they listened to what I had to say, they cared.”

The provider supported people who had been identified and commissioned as having an assessed need, to attend appointments. The support was incorporated and planned into the persons support plan and risk assessments.

Partners told us transitions into the schemes were managed with care, outlining how the provider took time to understand each person’s needs and circumstances and engaged well with other agencies. Partners told us the provider was proactive in making timely referrals to appropriate partners, including referrals for review and to specialist services.

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.

Staff had a good understanding of safeguarding and what would constitute a referral to the safeguarding teams. Staff were able to provide examples of indicators which would lead them to raising concerns with their leaders. Staff were aware of how to progress concerns.

People were supported to understand what safeguarding meant to them and knew how to raise concerns if they did not feel safe. Within people’s care records they had easy read safeguarding procedures. People told us they felt safe and did not have concerns about their own safety or safety of others.

The provider ensured there were effective systems, processes and practices which made sure people were protected from abuse. They had appropriate policies and procedures in place. Staff had completed online safeguarding training and had recently attended further training, facilitated by the local hospice, which was in person training.

Partners told us management and senior staff had a strong understanding of safeguarding principles and acted appropriately when safeguarding concerns arose.

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 informed about any risks and how to keep themselves safe. Staff assessed people’s risks regularly. There was evidence of person-centred risk assessments for people who were being supported. The risk assessments indicated goals and indicators for success, they clearly detailed the associated risks for the person and the controls to be taken. For one person who was at risk of falling, the controls included staff ensuring the person was wearing their falls pendant, them to engage the person in a conversation about how unsteady they felt and having seating arrangements in place should the person need to rest. There was further detail of how to respond if the person had fallen.

People’s care records had a section outlining their medical conditions including epilepsy, chronic obstruction pulmonary disorder, and atrial fibrillation. These sections of the care records were detailed and provided information about the condition, what symptoms to look out for and what specific treatment based on the individual should be sought.

Staff and leaders supported people who were in heightened states of emotion or distress. Staff told me how they were supporting somebody’s emotional needs who had gone through a huge transition in their lives due to health complications. Staff, with the support of leaders, had been gradually reintroducing the person to activities they previously did.

Staff ensured people had specific sections added to their care records dependent on their needs. A care record section was developed for a person who required lots of emotional support, mainly reassurance from staff. This detailed the response staff should take initially and following an escalation of alerts in line with the person’s tenancy agreement.

Staff had good knowledge of people’s care needs and knew what to do in the case of an emergency. The provider had also ensured staff had prompt cards to follow for events such as seizures.

People said staff knew them well and felt staff were competent to look after them.

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 lived in apartments which were managed by separate landlords and housing providers; therefore, the provider was not responsible for the maintenance and upkeep of the living environment. Staff raised concerns regarding repairs with landlords who then scheduled for work to be completed.

The provider and the housing provider worked in close partnership and had official monthly meetings which were minuted to discuss concerns or updates which included the environment and equipment. The housing provider also attended tenant’s meetings every other month.

The provider completed environmental assessments in relation to people’s apartments. These included where gas and electricity meters were located, the person’s escape route and the location of fire extinguishers and blankets in relation to their property. The provider also completed their own health and safety audits and had personal emergency evacuation plans in place.

The provider ensured people’s individual risks relating to the environment were also taken into consideration and control measures put in place to lessen or mitigate risks.

Staff did not raise any concerns regarding the environment. They said they had the appropriate equipment including personal protective equipment (PPE) and if there were any concerns regarding the environment or the equipment, they would raise this with the housing provider.

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.

The provider ensured staffing levels were in line with the funded hours provided by the local authority. On a review of the rotas for each scheme from the last 2 months, it showed a consistent trend of permanent members of day staff on shift. Leaders told us they were fully staffed and had the right skill mix with some staff being very experienced. Agency staff usage was below 3%.

People told us there were enough staff who they felt were well trained. They told us staff addressed their needs and were almost always on time for their scheduled visits.

Staff received training which was appropriate and relevant to their role. Mandatory training compliance was high. When staff started with the schemes, they completed the care certificate. Staff told us there were opportunities to progress professionally with one person explaining how they had completed their National Vocational Qualification (NVQ) for levels 2 and 3 since working with the provider.

Staff received the support they needed to deliver safe care. They completed regular supervision sessions and annual appraisals with senior members of staff.

Staff told us the induction process was helpful. A staff member, who had not worked in care prior to this role said, “The induction and the mandatory training were really helpful and at the end of it I felt much more competent. Following that, I had a month of shadowing before I was able to start on my own.”

There were robust and safe recruitment practices to make sure that all staff, were suitably experienced, competent, and able to conduct their role. Leaders recruited staff safely, with all necessary checks and documentation in place. UK disclosure and barring service (DBS) checks were completed to ensure staff were of suitable character to work with vulnerable adults.

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.

People lived in apartments which were managed by separate landlords and housing providers; therefore, the provider was not responsible for the maintenance and upkeep of the living environment. However, the provider ensured staff completed weekly and monthly monitoring checks which included personal protective equipment (PPE) usage and wheelchair cleaning.

Whilst completing a tour of Eliot Gardens, we noticed 2 of the shared kitchens and the laundry room were unclean. Since then, the provider had contacted the housing provider who have agreed to complete a deep clean of the kitchens and removal of all non-essential equipment in those areas. This demonstrates the positive working relationship between the provider and housing provider.

People who we spoke with had no complaints regarding the cleanliness of the apartments and were complimentary of staff who would help them tidy up and clean.

Partners of the organisation, who were frequent visitors, told us they had no concerns regarding infection, prevention and control (IPC) with one partner noting, “The buildings always appear clean, tidy and well organised.”

Medicine administration records showed on the whole people received their medicines as prescribed.

People who had been prescribed medicines on a ‘when required’ basis had written plans in place which on the whole informed the care staff on how and when it was appropriate to administer these medicines.

People were supported by the service to ensure they were able to administer their medicines when they were away from their home.

A system was in place for recording where on the body skin patches containing medicines were being applied. These records were able to show these patches were being rotated around the different skin sites to comply with the manufacturer’s guidance.

The provider had processes in place which ensured the supply of medicines arrived on time and clearly showed who was responsible for the ordering, collecting, storage and administering of medicines.

Staff that administered medicines had completed safe management of medicines training and had undergone an assessment to check their competency to administer medicines safely.