Martin Grange

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 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 provider had effective systems in place to review and investigate accidents, incidents and safeguarding concerns. The registered manager explained that team meetings were used to discuss any areas where lessons could be learned or improvements made. Staff reported that they felt confident raising concerns, knowing that the provider would take appropriate action in response.

The registered manager said the service actively learnt from the experiences of other services within the organisation and applied these lessons to improve practice. Staff signed to confirm they had reviewed and understood any lessons learned from incidents, to ensure that improvements were embedded across the team.

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.

People’s needs were assessed before they began receiving the service. This ensured that the care and support provided was safe, appropriate, and tailored to each individual’s requirements. One relative told us, “We were very involved with her care plan. They reviewed everything and have adapted her plan to how she is.”

The registered manager explained that people’s care plans were readily accessible and would be made available if they were admitted to hospital, ensuring continuity of care. They said they also worked closely and effectively with the local hospital to ensure coordinated care.

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.

People were supported by staff who had the knowledge and confidence to recognise and respond to safeguarding concerns, ensuring their safety. Clear policies and procedures guided staff on the steps to take if they suspected any abuse. Staff received training in safeguarding vulnerable adults, with training records confirming their completion and ongoing competence. A staff member told us, “To raise a safeguarding alert or concerns with care I would immediately get in touch with my line manager. I would consider whistleblowing depending on the situation. I would raise concerns using the North Yorkshire County Council website and ensure I’ve documented all my concerns.”

People told us they felt they were receiving a safe service. One person told us, “I'm very grateful to be here to be honest. I can be independent, but I feel safe because I know there is always someone I can ask for help.”

The Mental Capacity Act 2005 (MCA) sets out the legal framework for making decisions on behalf of people who may lack the capacity to do so themselves. It requires that people are supported to make their own decisions wherever possible, and when they cannot, any decisions made for them must be in their best interests and use the least restrictive option.

The service operated in line with the principles of the Mental Capacity Act (MCA). When people were unable to make specific decisions for themselves, best interests meetings were held to ensure decisions were made appropriately and in their best interests.

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’s needs were assessed before they began receiving the service. Care plans gave staff clear guidance on how to provide safe and responsive care and support. Risks were carefully assessed and managed to keep people safe, with person-centred risk assessments regularly reviewed and updated as needed. One staff member told us, “We support people with positive risk taking by ensuring there is a risk assessment in place for each person about their own care and support, wishes, choices and decisions making. We can offer advice and explain the risk in certain situations, but they are allowed to make unwise decisions; it can also make them more independent.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Environmental risk assessments were in place to ensure staff were safe whilst supporting people.

Environmental risk assessments were in place to ensure staff were safe whilst supporting people.

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 followed robust recruitment practices to make sure all staff were suitably experienced, competent and able to carry out their role. Disclosure and Barring Service (DBS) checks were carried out. These provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

Staffing levels and skill mix were appropriate to ensure people consistently received safe, high-quality care that met their individual needs. One relative told us, “The staff are lovely, really caring, we've got to know them pretty well. They tend to stay put, there’s obviously little turnover.”

Staff received training that was appropriate and relevant to their roles. They completed an induction when they joined the service, followed by additional core training. The registered manager and care team leader monitored and recorded all training to ensure staff maintained up-to-date knowledge and skills.

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.

The provider had effective systems to assess and manage the risk of infection, in line with current national guidance. An infection prevention and control policy was in place, and staff received appropriate training in this area. Unannounced spot checks were carried out by the care team leader to ensure staff wore appropriate personal protective equipment (PPE) and followed hand hygiene guidance. A staff member told us, “We have to have handwashing competency tests. We do training on infection control. We have PPE, aprons, gloves and masks.”

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.

Systems and policies were in place to support the safe management and administration of medicines. The registered manager carried out regular audits to ensure people received their prescribed medicines correctly, on time, and in a safe manner. Audit findings were reviewed to identify any trends or patterns, such as missed doses, so that lessons could be learned and improvements made. Where medicines had not been administered, appropriate action was taken. For example, in one instance where a person had not received their medication, records clearly reflected this was due to their admission to hospital.

People were encouraged and supported to maintain independence and retain control of their medicines where they were able to do so safely. One relative told us, “She is able to do all her medicines herself, not that she has many.”

Staff completed appropriate training and underwent annual competency assessments in the safe handling and administration of medicines before being authorised to support people with their medication.