Telscombe Road

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. Accidents and incidents were reported and recorded by staff. Discussions were had at handover meetings daily and any learning was shared with all staff through updated care plans and then at fortnightly team meetings. Relatives were kept up to date with changes and learning developments from when incidents occur. A relative told us, “I call every two days but they will always update us in-between.” Another relative told us about an incident involving their loved one where the police were involved and there were potential risks to the person’s safety. As a result of the incident, risk assessments and policies were updated and there had been no repeat of the incident since. The registered manager told us, “Learning lessons are on the care manager’s weekly agenda.”

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 worked with other health and social care professionals to make sure that people transitioned into the service smoothly. People were supported to visit the service when other people were out and then again when other people were present. Overnight stays would follow if people were comfortable. The process was supported by relatives, social workers, GP’s and other professionals involved in their ongoing support. A relative told us of recent changes in their loved one’s presentation and behaviours and that this required careful handling and support from several other professionals. These changes were managed well and the person was re-entering a period of stability.

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 the principles of safeguarding and were able to tell us what situations would amount to a safeguarding incident and the steps they would then take to protect people. A member of staff told us, “I would report, log in notes. I’ve had training. We’ve had to report things and it’s a simple process, only one occasion where I’ve had to do an interview.” The registered manager was aware of the process and was confident to raise concerns with the local authority and report risks. Relatives told us they were confident their loved ones lived safely at the service. Comments included, “Can’t think of any safeguarding’s at the home. He is very safe there” and “Yes he is safe.” Safeguarding and whistleblowing policies were in place and regularly reviewed. Whistleblowing is a process protecting staff anonymity when reporting concerns.

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 were known and were documented within care plans. Triggers, physical signs and de-escalation processes were all written down and were known to staff. Most people were supported by staff one to one within the home and two to one when out on trips or activities. Some people enjoyed linking arms with staff when in the community. This provided reassurance to them when in communal areas. Some people were at risk of leaving the building without support and a process was in place to escalate these incidents to the police if people had not been located by staff within a certain timeframe. These incidents were rare but processes were embedded and ensured people’s quick return to safety. Care staff developed close professional relationships with people and could detect the smallest changes in people’s presentation and mood. These were documented and then monitored to establish and identify any longer term trends. A member of staff said, “If they feel safe it boosts their confidence. We spend a lot of time with people and you get to know the body language and triggers and signs.” Care plans contained a ‘behaviour support plan’. These were documented and gave clear advice about people’s likes, dislikes, sensory needs and daily routines.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Relatives were positive about the safety and homeliness of the service one telling us, “The environment is good. They had their room decorated and a new carpet laid when they moved in, all their choice. The kitchen and common shared spaces are all roomy and clean. It does feel like home there.” All fire safety equipment was in date and a fire risk assessment had been completed and regularly reviewed. All safety documents relating to gas, electricity and legionella were in place. Wiring had been hidden and protected and there were no trip or other hazards apparent in people’s bedrooms or communal areas. A maintenance call out system was used when needed and issues were usually rectified within a day. An ongoing cycle of decorating was scheduled to co-inside with when people were away from the service during holidays. Personal emergency evacuation plans (PEEPs) were in place and were easily accessible in the event of an emergency. Each provided clear instructions relating to people’s understand and compliance if an evacuation of the service were needed.

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. There were enough staff on duty each shift to safely support people. The service was one of five small homes that fed into a local college and the registered manager told us that in the event of sickness or unexpected staff absence, that staff would be used from other services to cover. Staff rotas confirmed safe staffing levels. Staff had been recruited safely. We were shown staff files on a secure computer system and each contained the required documents. For example, disclosure and barring service checks (DBS), references and photographic identification. Staff told us that they received enough training in the key areas needed to support people including, positive behaviour support, safeguarding and de-escalation techniques. Staff induction was thorough and involved a week’s shadowing of more experienced staff followed by four weeks of being shadowed and supported to build confidence in supporting people. Ongoing staff support was provided through six weekly supervision meetings and regular team meetings.

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 service was clean throughout and staff were responsible for making sure cleanliness was maintained. Weekly cleaning schedules were in place and all had been completed, showing that all areas within the service had been cleaned each day. Personal protective equipment (PPE) was available and was used appropriately when required. There were sufficient supplies of PPE and cleaning equipment at the service. Infection prevention and control policies were in place and regularly reviewed.

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. Some people were supported with medicines however the principles of stopping the over medication of people with a learning disability and autistic people (STOMP) were in place and medicine administration was only given if absolutely needed. People were supported to take medicines themselves when needed, with support from staff nearby if required. People’s medicine regimes were regularly reviewed by their GP. A relative said, “They are very fit, never had a day’s sickness and not been on any medicines. We hope however that medicines will be reviewed following a referral. We think this might help them now.” Staff told us about medicine training which was described as “thorough” and with regular refreshers of their competency. Medicine administration was recorded accurately on medicine administration records (MAR), overseen by supervisors. Risk assessments were in place as were ‘as and when required,’ (PRN) protocols.