10 The Green

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 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.

Effective procedures were in place for analysing incidents and accidents and the complaints folder had no complaints entered for the past year. The registered manager explained their complaints process and how they would achieve a satisfactory resolution when handling a complaint.

Communication with staff was robust, with regular team meetings taking place. All appropriate information about people’s care, and any changes in risk or needs, was recorded on each person’s electronic and paper file, so staff could readily access this. All staff had appropriate induction training to ensure they understood how to identify and report concerns to the registered manager.

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 experienced well-coordinated transitions, with staff obtaining relevant information from family members and healthcare professionals to ensure a safe transition. A person described the process as “easy” and reported that this made the family feel “included and comfortable”.

Staff understood referral pathways and used them appropriately. This included making referrals to district nurses when people’s needs changed. The provider was able to evidence timely professional involvement for ongoing healthcare needs.

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 understood their safeguarding responsibilities and the processes to raise concerns which protected people from the risk of abuse. Staff received safeguarding training from the provider and confirmed they felt confident to escalate issues to the registered manager, local authority, and the Care Quality Commission. Staff told us if they had any concerns over a person’s safety they would contact the provider immediately.

No one was experiencing a deprivation of liberty due to their care arrangements at the time of our assessment. However, the registered manager understood the process for reporting any such restrictions to the local authority in order that any deprivation of liberty may be authorised by the Court of Protection, if appropriate.

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.

Care plans and risk assessments contained detailed guidance for staff to follow, including how to support people safely whilst providing personal care, through effective communication. Staff we spoke with understood risks to people and how to support them to remain safe. Staff understood how to meet the needs of people with complex health conditions. Staff had a good understanding of people’s care requirements and how they preferred their care to be provided.

Care plans and risk assessments were reviewed in line with the provider’s policy, as were individual goals set out for each person using the service. Annual reviews included the person, and family member where appropriate, and all changes to care plans were agreed with people and family members where appropriate.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The provider carried out annual assessments of people’s properties to ensure care was delivered in a safe environment. This included checking servicing dates on manual handling equipment used at the property. In addition to the annual assessment, processes were in place for care staff to report changes or concerns relating to the care environment to the office, which may require further action.

A relative described the annual reassessments process as “reassuring”, added that it, “eases my concerns”.

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.

Rotas showed consistent staffing levels, and staff described good teamwork and support from the registered manager.

People were supported by staff who had been recruited using safe recruitment processes. This included checking new staff’s employment histories and ensuring staff had a satisfactory Disclosure and Barring Service check (DBS) in place before they supported people.

Staff had completed appropriate training to care for the people using the service, including learning disabilities and autism training. Records showed staff received regular competency checks to check they applied their training in practice.

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 appropriate quantities of personal protective equipment (PPE) at the office for care staff to collect as and when required.

Staff confirmed there was always PPE available when they requested it and infection control training had been delivered. A member of staff confirmed PPE checks were included when competency checks were completed.

One person told us how staff made use of disposable gloves when providing their care and washed their hands before leaving their home.

The provider made sure that policies and training were in place to support people with medicines and treatments in a safe way.

Medicines were not being administered by staff at the time of assessment; however, the registered manager demonstrated staff received appropriate training to administer medication. They were able to explain the end-to-end process they would follow should they be required to support with a person with medication, including how records would be completed and audited in line with best practice guidance.