Stonewood Complex Care

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 newly registered service. This key question has been rated 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.

The management and office team took responsibility for escalating and investigating all incidents, accidents and near misses. They ensured lessons were learned and shared any learning to reduce the risk of reoccurrence and keep people safe. The provider had policies and procedures in place for managing accidents, near misses, complaints and compliments. Managers monitored incidents to identify themes, trends or any increase in occurrence. This oversight supported the identification of training needs and opportunities for improvements.

Staff understood how and when to report accidents and incidents. They told us they felt confident to raise concerns and said managers would listen and provide timely information or advice.

Managers shared guidance, new and updated information, and strategies with staff through a range of communication methods. These included regular discussions, daily handovers, monthly newsletters, staff appraisals, individual feedback and supervision. This helped to maintain safe practice and consistent standards of care.

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.

Managers assessed people’s care and treatment needs before accepting them into the service. This ensured the provider could meet people’s needs and prepare for a safe and well‑planned transition. Managers arranged pre‑admission visits where required and involved people, families, external professionals and staff in transition planning. This included staff shadowing the person’s existing support, such as care provided in hospital, over a number of weeks.

The provider prioritised continuity of care when people were admitted to hospital. People had hospital passports that specialist NHS teams had completed. The provider ensured these documents were printed and available in hospital grab bags when needed. Staff maintained close contact with people’s medical teams to ensure information was accurate and up to date.

Staff acted promptly to make referrals to external professionals and to arrange health appointments. They recorded referrals, supported people to attend appointments where necessary, and made reasonable adjustments in line with the Equality Act 2010. These actions ensured people received timely access to appropriate professional support.

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.

All the people we spoke with, and their families, told us they felt safe while receiving care from Stonewood Complex Care. One person told us, “Oh yes I feel very safe with them.” Another told us they were, “Very safe in their care.” A relative told us, “It was a big thing for me to trust somebody with caring for (person), …but with this company I know that (person) is safe.

We checked whether the service worked within the principles of the Mental Capacity Act 2005 (MCA). The service did not support anyone under a community Deprivation of Liberty Safeguards (DoLS), this is where people are deprived of their liberty in their own homes to keep them safe. However, managers understood their responsibilities under the MCA and had appropriate processes and procedures in place. Staff supported people in ways that upheld their rights and demonstrated an understanding of the principles of the Act. Staff understood the need to obtain consent and told us they would report any changes in a person’s capacity to managers.

All staff received safeguarding training. They told us they were confident in recognising and raising safeguarding concerns and understood the procedures to follow. Staff knew who to contact and what action to take in emergency situations. They told us managers would listen to concerns, act on them appropriately and provide advice quickly.

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 received support to maintain or improve their independence where appropriate. Care plans and daily care records monitored goals and achievements and supported people to develop and maintain skills. People completed daily care tasks as independently as possible, with staff providing support only when required. Staff completed thorough risk assessments.

Care plans were personalised and included comprehensive information about people’s medical conditions and care needs. They also outlined potential triggers that could affect people’s behaviour and identified strategies to support them effectively.

Staff worked in small, consistent teams and often supported people for extended periods during the day and night. This enabled staff to develop a strong understanding of people’s needs and circumstances, as well as those of their families. Combined with detailed documentation, this approach ensured people received the right level of support in line with their assessed 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.

People received care in their own homes. The provider completed environmental risk assessments to identify any potential hazards within people’s homes that could affect people or staff delivering care. Any identified or potential environmental risks were discussed with people receiving care and with care staff. This ensured appropriate actions were taken to maintain safety for everyone involved.

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 operated a safe recruitment process and completed appropriate checks before staff started work. These checks included verification of identity, obtaining references and completing Disclosure and Barring Service (DBS) checks. This helped prevent unsuitable people from working with vulnerable adults and children. The service made very limited use of agency staff and used its own suitably trained staff to provide emergency cover when required.

The service delegated some health care tasks to carers under the oversight of registered nurses. Staff were skilled in supporting people with complex needs and received training tailored to the individual people they supported. The provider offered a comprehensive training programme which, depending on people’s needs, included specialist off‑site training delivered by external services and specialist professionals. Staff also completed training in the provider’s fully equipped training room and received on‑site training in people’s homes.

Managers and staff told us training was ongoing and included regular refreshers, updates and checks on practice. One staff member told us, “They do call me up and I have to come back in for training and sometimes I think oh why I can do this, but they just want to check what I'm doing. And also, if there's any new skills or new techniques we need to learn, they always contact me. I feel very confident in what I'm doing.”

Staff told us they felt confident in their roles and supported effectively. One carer told us there was, “Always someone on hand, and a nurse on hand should you need it, sometimes we call and get advice or just talk something through.” One person told us, “On the whole yes the staff are trained well, sometimes it might take a bit of time to do a task, but that’s them making sure everything’s done properly.”

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 received appropriate training in infection prevention and control (IPC) and had access to personal protective equipment (PPE). The office team ordered PPE and ensured it was delivered directly to people’s homes.

The provider completed IPC checks as a standard part of standard checks. Staff received regular IPC refresher training. Records from checks and audits showed carers consistently followed IPC guidance and remained compliant with required measures.

The provider shared seasonal IPC information, updates and reminders with staff through monthly newsletters when required.

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.

Care staff completed medicines training, including additional training to support the administration of medicines through different routes, where required.

The provider used an electronic medicines management system. The information within the system was clear and easy to understand. The system included safety prompts, such as maximum doses and time intervals between administrations, which helped to reduce the risk of errors. The provider told us there had been no recent medicines errors.

Records did not always include the reason for administration or the outcome of ‘as required’ (PRN) medicines. PRN medicines are not administered on a regular schedule and are given when needed, such as paracetamol or laxatives. The provider told us this information had been recorded within the medicines administration records. Managers had immediately reminded carers to ensure information was consistently recorded in the appropriate section of the system.

Staff managed controlled drugs safely. Risk assessments were in place where required to support safe management and administration.