Yourlife (Taunton 2)

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 66 (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.

Systems were in place to record accidents and incidents, review trends, and share learning. Staff confirmed they received feedback after incidents and learning was shared. One staff member said, “If something happens, we talk about it in meetings and learn from it.”

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.

The registered manager and staff liaised with health professionals and other providers when needs changed or when people required alternative support. Emergency care records were in place to support people if they required transfer to hospital.

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, avoidableharmand neglect. The provider shared concerns quickly and appropriately.

People told us they felt safe being supported by staff and their relatives confirmed this. One person said; “I always feel safe with the carers – it's the same 7 days a week.”

Staff understood safeguarding and whistleblowing procedures and training was provided. They were confident to report concerns and escalate if needed. A competency assessment was carried out to verify staff’s understanding of the training they completed.

One staff member said, “[Safeguarding] means keeping people safe. I would report any issues to the manager or higher if needed.” Another explained, “[Whistleblowing] is speaking out about things that don’t seem safe.” Policies and escalation routes were visible in the staff room.

The provider did not always work well with people to understand and manage risks. However, staff provided safe care which met people’s needs, wassupportiveand enabled people to do the things that mattered to them.

People were involved in decisions about their care and risk management. Care plans were signed by people and included details about personal preferences, health conditions, and some risk measures. Risk assessments covered falls, nutrition, medication, and environmental safety. Staff encouraged independence while mitigating risks. For example, 1 person was supported with positive risk-taking by continuing to walk outdoors with monitoring and guidance to ensure safety.

However, care records did not always consistently provide staff with the same level of information in relation to people's medical conditions and did not always provide staff with information relating to risk mitigation regarding some medical conditions. Information was not always available for staff in care records which related to risks about skin integrity and support people required to maintain this and support required if people became anxious.

Staff knew people well and they were supported by a small consistent team. The registered manager took immediate action to address some of these shortfalls during the assessment.

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 and reviewed regularly. Servicing schedules were maintained for safety equipment.

Individual risk assessments were in place in relation to flammable emollients which people were using.

The provider made sure there were enough qualified,skilledand experienced staff, who received effective support,supervisionand development. They worked together well to provide safe care that met people’s individual needs.However, some improvements were needed to safe recruitment processes.

Staffing levels were sufficient to meet people’s needs, and rotas were planned to ensure continuity.

Staff received induction and shadowing opportunities when they started in their job role. Systems were in place to ensure staff received training suitable for their role and that they have the required qualifications. Staff were receiving supervisions and their practice and competencies were checked.

Recruitment checks were being carried out before staff commenced their employment. However, in situations where the reason for leaving and conduct in previous roles working with children and vulnerable adults was not verified, records did not show how the provider assessed any potential risk and made sure the person had appropriate supervision until they could demonstrate competence.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns withappropriate agenciespromptly.

People were protected by effective infection prevention and control (IPC) measures. Personal Protective Equipment (PPE) was available, and staff understood donning and doffing procedures. One staff member said, “Plenty of PPE, aprons, gloves, masks, if needed.” Spot checks confirmed compliance with IPC standards.

The provider did not always make sure that medicines and treatments were safe and met people’s needs,capacitiesand preferences. Staff involved people in planning, including when changes happened.

Systems were in place for medicines management, but some improvements were needed. For example, protocols were not always in place for when required medicines. Topical medicine administration records (MAR) did not always provide staff with robust information about people's creams and ointments, such as frequency of administration. Pain relief medication administration times were written on the medication administration records without considering the minimum time ranges between administration. Were medicines were prescribed in variable doses; there was not always a protocol in place to guide staff when to give which dose. We found no one had been harmed.

The registered manager acted on feedback during the inspection and began implementing changes to strengthen oversight and ensure safe administration.

Staff received medicine training and their competencies were verified. A staff member explained how they followed the MAR chart and report if someone refuses medication.