Advance Newham Domiciliary Care and Supported Living Services

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 and this key question has been rated good. This meant that people were safe and protected from avoidable harm.

This service scored 72 (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 these were discussed in team meetings. We saw information which highlighted cases where mistakes and poor practice had occurred in other parts of the organisation. The provider had proactively shared these across all their services for staff to be aware of and to discuss what lessons could be learnt from similar mistakes were to occur in their service. The registered manager told us how this was informative for staff and how it helped to embed good practice in their service.

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. Whilst most people had lived in the service for many years one person moved in within the last year. We heard from a family member how their loved one had previously lived in a place that did not suit their needs. They told us about the smooth transition their relative had in moving and how they soon settled in their new surroundings.

The provider had a referrals process, they told us, “People are referred through the local authority, they would send information about the person’s current support, and we would go and carry out our own detailed assessment to make sure we can meet people’s needs before they moved in.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff told us about the training they received and how they understood the different types of abuse people might face. They added they were confident they could share their concerns with their manager and other people within their organisation as well as statutory bodies such as the local authority. There was a culture within the service where staff felt they could talk openly about people’s safety if required.

When asked whether staff kept loved one’s safe, a family member told us, “[relative] is very safe, the staff do an amazing job. [Relative] can be seriously challenging towards the staff. They can handle this and keep themselves and [relative] safe”. They went on to add, “The staff protect them from any harm that might come to them. There are staff 24 hours a day to help and keep [relative] safe, but they also know when to back away to allow them space. I have no concerns over safety and whilst [relative] has been supported by these people, I have never had any concerns.”

The provider worked with people to understand and manage risks. Risks were clearly identified, keeping people safe whilst balancing people’s need to remain as independent as possible. Information written about people was clear and part of an overall care plan which demonstrated the depth of knowledge about each person. The information ensured people received the support they needed, and that staff were equipped with the information to be able to keep people safe.

Risks people faced differed depending on their needs and the provider was able tailor the appropriate support accordingly. One person was able to use the local community independently whilst others required staff to be with them when they went out.

Some people required restrictions in place to keep them safe such as a locked front door. These restrictions on people’s liberty were in line with legislative requirements and kept those safe who needed it, but it did not restrict those who were deemed to be safe to leave the building.

The provider did not always detect and control potential risks in the care environment. We noted that kitchen doors in all flats were held open with rubber stoppers. We raised this with the London Fire Brigade, and we passed on their advice to the provider who acted immediately by raising it within their organisation. We advised the provider to bring forward their independent fire risk assessment to seek a qualified, professional view of whether the construction of the kitchen doors constituted a fire door. We fed back to the provider that it would be good practice to find an alternative method to balance the need for fire safety and the staff’s ability to be able to monitor the wellbeing of people whilst they were in the kitchen.

The environment was generally safe, there were no other obvious hazard noticed during our visit and the provider undertook a range of health and safety checks that included such things as electricity, water safety, equipment and fire safety.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support. Staff felt well supported and they received regular supervision that covered both their wellbeing and their professional development. The provider had a comprehensive training package that equipped staff with skills required to support the people in their care.

There were safe recruitment practices which were well organised and easy for the provider to monitor. There were many staff members with a long association with the service and the people who lived in it which meant there was consistency and good knowledge of people’s support needs.

The provider assessed and managed the risk of infection. They detected and controlled the risk of infections spreading. There was a plentiful supply of hand washing facilities for everyone to use. The communal environment was clean and tidy, and people were supported to clean their own flats as part of their responsibility of maintaining their tenancies.

The provider made sure that medicines and treatments were safe and met people’s needs. People’s medication was kept securely in their flats. Medicines were in a blister pack system which was easy for staff to manage. Creams and lotions were clearly labelled and dated, and the medicine storage was easy for staff to understand. Temperatures were monitored to ensure medicines were stored at a safe temperature. Records were completed correctly by staff and administration was routinely checked by management to avoid errors.