Foundation House

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.

People and staff were encouraged and supported to raise concerns and felt confident they would be treated with compassion and understanding if they did.

Incidents and accidents were recorded including the actions to further keep people safe. Staff we spoke with said they were notified of any changes in individuals care needs following incident investigations to help prevent future occurrences. One staff member said, “They [ provider] have a safeguarding team and they handle that aspect, they do a good job. Staff can follow up and see how things have been investigated, they are accessible.”

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 had their needs assessed before a package of care was agreed to ensure their needs could be met. Care and support was planned with people and their representatives and healthcare professionals, to promote continuity and ensure any transitions were well organised. People and their families told us they were given time to explain their needs and wishes to ensure the care they received was suitable and in line with their needs and preferences.

The service had information available to share if a person needed to transfer into a different setting. This contained information including communication needs, mobility and any medicines they were currently prescribed. This enabled people to have continuity of care between the service and other settings.

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 to have an awareness of what being safe means to them, and how to raise concerns when they do not feel safe, or they have concerns about the safety of other people. One person told us they feel safe with staff and know all the staff that support them.

Leaders and staff were knowledgeable in understanding people with a learning disability and autistic people can be at increased vulnerability to abuse and neglect. Safeguarding was a regular agenda item spoken about in team meetings, resident meetings and supervisions to ensure safeguarding awareness was maintained through regular dialogue. One staff member said, “They [people] may struggle to communicate or recognise unsafe situations, some may be over trusting and have difficulty understanding social cues, making them more vulnerable to abuse. It’s important to create a safe environment, staff training to make sure they can identify early signs of abuse.”

Staff had received training in safeguarding which was regularly refreshed and were able to demonstrate a good understanding of their role and responsibility in ensuring people were kept safe from potential harm or abuse. Staff spoke about knowing people well and being vigilant to recognise any changes in their presentation or behaviour that may indicate further support was needed. One staff said, “We look for signs such as bruises, scars, scabs, areas unwashed, if they are scared when doors are shut, emotional differences, conversations and watching people’s behaviours around others.”

Staff told us they felt confident to raise potential concerns and these would be taken seriously by leaders and investigated appropriately. One staff member said, “If you notice any signs of abuse, changes to physical appearance, bruises, scared, unsafe, talk with the resident and make sure they are safe. Report and record factually and report to safeguarding.” Another staff told us, “Safeguarding involves actions and policies designed to protect the person’s wellbeing, health and their human rights and enabling them to live free from harm, abuse and neglect.”

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.

Risks to people’s health, safety and welfare had been assessed and plans developed to manage those risks. Leaders told us staff report concerns about people’s home environment safety. They would visit and review the risk assessment and find ways to mitigate the risk.

People were supported by staff who knew risks and assisted them in the least restrictive way possible whilst minimising the potential for harm.People confirmed staff supported them in a safe and respectful way.

There was a business continuity plan to account for any factors that may impact on the delivery and running of the service. We saw the service had a plan about what support to implement during these times to minimise disruption to people.

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 assessments of people’s home environment to identify and reduce any risks which could impact on staff and the people they support. People’s personal environments had been adapted to suit their needs. Information in people’s care records listed what equipment they needed and contained guidance to remind staff to use the equipment safely.

The provider had systems to monitor people’s environments to ensure they remained a safe setting to receive care in. People had access to maintenance support as part of their home agreement. During our assessment we saw a member of the maintenance team visit a person’s home with permission, to support them with an issue they had raised.

Staff received training including essential fire safety, health and safety and food safety to equip them with the skills to help people to continue living in a safe environment. Staff knew what actions to take in an emergency, including fire evacuation procedures.

Staff were on site at all times and could be contacted to attend to people in their own homes if there was an emergency situation and help was required. This gave people who lived on their own an extra level of security.

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.

Staff were recruited safely to the service. This included requesting and receiving references from previous employers, right-to-work documentation and Disclosure and Barring Service (DBS) checks. DBS checks are carried out to confirm whether prospective new staff had a criminal record or were barred from working with people at the time.

The provider took into consideration people’s needs and preferences when staff were recruited, and what personal and professional qualities staff could bring to their work. Staff received a comprehensive onboarding and induction which gave them the skills and knowledge to deliver support in line with the providers expected standards of care.

Staff spoke positively about the training they had undertaken and felt it equipped them with the necessary competencies to perform their roles effectively. Staff told us they completed a range of different training subjects including, “Safeguarding Adults, Medications Training, Infection Control, Manual Handling, Recognising and Responding to Challenging Behaviours and Health and Safety in Workplace.” Staff told us they felt knowledgeable and skilled to meet the different needs of people within the service.

During our assessment we observed people’s needs being met by enough staff. We observed staff knew people well and people spoke positively and responded well to staff engagement.

Staff received regular opportunities to share and gather feedback at team meetings and individual supervision sessions. These included key themes which were covered on a rotational basis to ensure staff remained skilled and up to date with internal policies and best practice guidance. Action to support practice where needed was taken in a timely way.

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.

People were protected from the risks associated with the spread of infection because staff had received training and followed the provider’s procedures and best practice. People told us staff left their homes clean and tidy.

People told us staff wore appropriate personal protective equipment (PPE) such as aprons and gloves when visiting their homes and assisting them with care. Staff told us they had access to sufficient supplies of PPE. There were audits and checks to ensure staff followed correct procedures.

The provider had infection control policies. There were effective infection, prevention and control measures to reduce the risk of infection for people being supported and for staff.

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Medicines were administered safely and as prescribed. People had medicines care plans which provided staff with the information they needed to manage and administer people’s medicines in a safe way. The staff worked closely with local health agencies and the GP practice to support people with their medicines and health needs.

The staff received training and were competency assessed to handle medicine safely. Staff felt confident in managing people’s medicines. Staff understood and implemented the principles of STOMP (stopping over-medication of people with a learning disability, autism or both).The records we reviewed provided assurance that medicines were not being used to control people’s behaviour.

Medicines were stored appropriately and at correct temperatures. There was an adequate stock of prescribed medicines. There was a medicines policy that provided staff with clear guidance on medicines management practices.