Accede Support

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. 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 listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The service and staff displayed a person-centred culture which was embedded into assessments and support plans and evidenced in the care and support people received.

The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Accidents and untoward incidents were thoroughly investigated, used to inform any changes to the service, and the provider apologised when things went wrong.

Overall, staff told us they felt supported by management and within their roles.A member of staff told us, “I feel the culture is rich with empathy and mutual respect. It thereby encourages an open communication system whereby any concerns can be raised with managers with ease.”

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 required support from external agencies.

The service worked in partnership with other professionals such as GP's, specialist occupational therapists (OT) and speech and language therapists (SaLT) to support people to access healthcare when they needed it.

The management showed how when a person's needs had changed, they had promptly engaged with several health and social care professionals to ensure people’s needs were met and fully understood. Records detailed how staff worked effectively with GP’s, district nurses and other external healthcare professionals.

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.

The provider had systems in place to safeguard people from the risk of abuse including the training of staff in how to recognise and report abuse.

The registered provider had not ensured all referrals to the local authority safeguarding team had been completed. One recent safeguarding concern had not been shared with the care quality commission (CQC). We spoke to the manager who said they would ensure the appropriate notifications would be submitted in the future.

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 who used the service had a range of risk assessments in place relating to the support they received. These covered areas such as accessing the community, finances, activities in the community, eating, drinking and mobility. Where any risks were identified, there were control measures in place to keep people safe.

Staff knew people well and were aware of how to reduce risk to keep people safe. Some people using the service required support to manage difficult or distressed behaviours and staff received training and clear guidance on how to do this safely. Staff we spoke with were aware of people's individual risks and shared with us how they used techniques to reduce the likelihood of people being harmed.

The manager reviewed incidents and information about risks regularly. Care plans were frequently updated to ensure staff had up to date information about people's current needs.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. They carried out assessments which included checking equipment was safe. There were systems in place to ensure safe access when staff visited people to provide support.

Overall, 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. However, some staff expressed concerns with the rota system. For example, one person said,” On the rota mostly we work about 38 to 45 hours over 6 days. Yes, I agreed to get extra hours, but the problem comes when the hours are spread out and the extra hours should come as an option, so we can choose if you want them or not in any particular week. Another said, “I only used to have concerns about the rota when I worked 7 days in a row. It has changed now as they have more staff. The rota is stable now and they seem to be still working on it.” We discussed these concerns with the registered manager, who confirmed that a recent staff survey had identified issues with rotas. As a result, the manager had recently implemented a new rota system, and staff were in the process of embedding these rotas.

People receiving support and their relatives told us staff had the right skills to do their job. They told us staff were respectful and caring in their approach.

Staff were provided with relevant training and supervision, so they had the skills they needed to undertake their role. Staff told us they received the training they required and were supported to undertake additional training when this was needed. Staff completed competency tests alongside their training to reinforce learning and development.

The provider was passionate about providing a whole organisational approach to embedding positive behaviour support and reducing the use of restrictive practices. All the staff had a basic understanding of positive behaviour support and its value base.

Training was tailor-made to meet the needs of people using the service. This included training sessions that looked at the unique range of conditions people might be living with and how these conditions may affect their daily lives. Other training included communication tools, positive behaviour support, human rights and restrictive interventions. For example, staff attended bespoke intensive interaction training. Intensive Interaction is a practical approach to interacting with people with learning disabilities who do not find it easy communicating or being social. The registered manager told us how they had used this training to support a person to take small steps in getting used to accessing different places in the community and building relationships. The registered manager said, “Intensive Interaction is more than just a technique. it’s a doorway into someone else’s inner world. By tuning into subtle cues like gesture, facial expression or vocal rhythm, we build genuine connection where words fall short.”

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 protected people from the risk of cross infection through using correct infection control practices. Staff had completed training in how to reduce the risk of infection, and they followed good practice guidance. Staff told us they used personal protective equipment, such as disposable gloves and understood how to help prevent the spread of infection.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. People were not receiving support with medicines as they were supported by the relatives. However, the provider trained staff in the safe administration of medicines. This included checking each staff member's knowledge and skill through discussion to ensure they had the correct skills and understood how to administer medicines safely. The manager said this helped staff to identify when people’s behaviour may be controlled by excessive and inappropriate use of medicines and ensured people's medicines were reviewed by prescribers when required.