Abbey Dean

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 registered manager had developed an open culture, empowering staff to raise safety concerns when they needed to. A staff member said, “I’m confident in how to report an incident we have a system in place which includes filling out forms with the details, but I would tell the manager or a senior staff member straight away.” A system was in place to track incidents and/or safety events which was then used to identify patterns and trends, these were learnt from and discussed at team meetings, and in staff one to one conversations, to reduce the likeliness of recurrence and improve people’s safety. A staff member said, “The manager promotes us raising concerns then talks to us about them and how they could be prevented, if I notice someone’s mobility has changed, I tell them and they address my concerns.”

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.

When people’s needs changed, they were supported to have specialist input from healthcare professionals. For example, a person who had experienced falls was referred to the falls team, this meant ways to reduce falls and improve their safety was prioritised. The Speech and Language Therapy team (SaLT) was also utilised by effective referrals to support people to lower the risk of choking and establish the most suitable diets, whilst keeping people’s preferences at the heart of any changes. The manager was proactive in supplying equipment people needed to promote their wellbeing such as pressure relieving equipment. A staff member said, “A person we supported was transferring to another service in three days but due to a change in their condition needed a pressure mattress, the manager got it without delay she’s really hot on this stuff and doesn’t wait.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff focussed 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.

A safeguarding policy was in place for staff to follow and at all levels knew their responsibilities relating to responding and reporting allegations of abuse. Staff recognised signs when something wasn’t right and told us what they would do to keep people safe. One staff member said when describing safeguarding, “Its protecting people’s wellbeing free from harm so they can live safely and happily, if had concerns I would tell the manager straight away and I’m confident it would be delt with.” Another staff member said, “It’s about keeping vulnerable people safe, I’d tell the manager who would tackle it and contact the local council safeguarding team.”

People consistently told us they felt safe and received support from staff who were kind and cared about their wellbeing. One person said, “I’ve never had a reason to think about my safety here it’s never been an issue.” A relative of a person told us, “I have no concerns about [loved one’s name] safety it feels 100% safe no worries at all.”

The registered manager tracked any safeguarding events and referred allegations of abuse to the local safeguarding team and submitted statutory notifications to the Care Quality Commission (CQC) meaning relevant partners could investigate these concerns.

Where needed the registered manager made Deprivation of Liberty Safeguards (DoLS) applications to ensure people who lack the mental capacity to consent are cared for in the least restrictive way possible. Conditions of these applications such as annual medication reviews were consistently being facilitated.

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 were involved in managing risks around daily life by a thorough assessment process that identified hazards related to people’s specific conditions including their mobility. Specific falls risk assessments gave staff clear guidance to reduce these risks. The registered manager and senior staff regularly reviewed people’s needs and updated care plans to reflect these changes which meant risks were monitored continually. A staff member said, “Care plans have all the information we need about how to support people safely, and there are personal profiles for new staff or agency staff to quickly see what people need support with like if someone uses a Zimmer frame to walk or needs a wheelchair.”

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

Audits of the environment were carried out to identify any potential risks to people, and a procedure was in place to address any issues found. Staff were aware of how to report issues with the environment. One staff said, “If we notice something is broken, we tell the manager and add it to the maintenance book then it gets fixed.” Risk assessments were in place to help control risks such as scalding from hot water and fire among others. The equipment people used, including hoists and profiling beds, were regularly checked by staff and external providers in line with Lifting Operations and Lifting Equipment Regulations (LOLER). Staff were confident about how to respond to environmental risks. A staff member said, “If there is a power cut, we have a procedure to follow, and we have practiced what to do if a fire happens, we have training and we do drills, so we know what to do.”

The provider made sure there were always enough qualified, skilled and experienced staff, who received thorough support, supervision and strong development opportunities. They worked together well to provide safe care that met people’s individual needs.

Staff training was regularly reviewed which included moving and handling, dementia awareness, first aid, health and safety, oral health care and pressure care among others supporting them to have the skills and knowledge to fulfil their roles. A system was in place to track training levels which showed a high-level of compliance within the team.

Staff were recruited in line with the providers policy and had the relevant checks carried out before the recruitment process was completed and they could provide people care. This was reinforced with a comprehensive induction period including completing training and shadowing established members of the team.

People were supported by a consistent staff who had worked at the home for some time, which meant the skills staff built over time were retained within the team who uniformly spoke about their opportunity to develop. One staff said, “[Registered manager name] encourages us to progress with NVQ’s, I’ve done my level 3, and they offered to support me with a level 4 when I’m ready.”

People told us there were enough staff and they knew how to meet their needs. One person said, “The staff are professionals, you can tell they know their stuff.”

Staff told us there were enough staff to meet people’s needs. One staff member said, “We have a good team here and can swap shifts when we need to, but if someone is sick or there is an emergency we use an agency to cover the shifts.” Staffing levels were established using a dependency tool and we observed staff supporting people in a calm unhurried way alongside responding promptly to people’s call bells.

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.

IPC processes were effective in preventing infection risks. The registered manager competed daily checks of the environment and involved staff in completing infection prevention and control audits, champions in this area were appointed to reinforce the process, and a cleaning schedule was in place. There was a dedicated housekeeping team, and duties were shared between roles. A staff member said, “At night we have spread sheets to work through including mopping and sweeping communal areas and cleaning the seats people use.” The service was clean and free from dust build up. Staff had received training in infection control and had personal protective equipment (PPE) available.

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 supported to access their GP when needed and arrange annual medication reviews, which meant changes to medication could be made in a timely manner promoting good health outcomes. Staff received training and competency checks in medication administration and shadowed experienced staff to build their confidence, before they could administer people’s medication. A staff member said, “I administer people’s medication, I had training, then was observed before being signed off. We have our medication competency review each year to check our practice.” To reinforce oversight, the registered manager attended annual training for assessment and competency, in order to assess the safe administration of medication and to confirm compliance.

Staff were involved in completing weekly audits of people’s medication with further oversight by the manager to identify any errors, this meant they could be responded to quickly and people were protected from risks around their medication. We observed people’s medication being administered in line with the nice guidelines by staff who were knowledgeable and understood people’s individual preferences. A staff member said, “A person we support doesn’t like the taste of certain medication, so they have a flavoured drink to help it go down.”