CSL Alford

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 72 (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. When safety events happened, staff investigated them properly and made sure they were reported.

Lessons were learned from incidents, and good practices were shared and used to make care better. They used a clear system to report and track incidents, which helped them spot patterns and respond quickly. Complaints were also used as learning opportunities, and changes were made to improve communication with people using the service. This helped to keep people safe and improved the service over time.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was monitored and managed. They made sure there was continuity of care, including when people moved between different services. They regularly reviewed care plans, carried out risk assessments, and made sure staff followed safety procedures. They also helped people get the care they needed, even when they moved between different services. This included making sure important information was shared during hospital discharges, arranging follow-up appointments, and supporting people during transitions between care homes or community services.

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. Staff showed a good understanding of safeguarding.

They had systems and ways of working to protect people from harm. People were supported to understand what being safe meant to them and how to speak up if they felt unsafe or worried about someone else. They shared concerns quickly and appropriately, such as reporting concerns to the local safeguarding team without delay. They listened and found the best ways to help people feel safe. People were treated with respect and care. This helped keep people safe and made sure action was taken straight away.

There were no restrictive practices used by staff, but the provider understood the need to follow the principles of the Mental Capacity Act 2005 (MCA) and only deprive a person’s liberty when it was in the person’s best interest. They provided staff with training and guidance about how to use alternative methods to support people experiencing distress. Some staff were unsure of the processes to follow and required refresher training to ensure they upheld people’s rights in relation to restrictions.

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 told about risks and how to stay safe. Staff understood the risks and took a balanced approach. They respected people’s choices and made sure care plans were person-centred and reviewed regularly. When people showed distress, staff responded in a kind and respectful way. They tried to understand the cause and learn from it. One person told us this approach had meant they had not experienced feeling distressed in a very long time.

The provider detected and controlled potential risks in the care environment. Security of the premises was checked. They made sure equipment, facilities and technology supported the delivery of safe care. For example, 1 person used artificial intelligence apps to remind them to drink enough throughout the day. Everything was well looked after and worked properly. Staff had systems in place to check safety and keep equipment and facilities in good condition. The provider, who also acted as landlord for the person’s tenancy, ensured any repairs identified were fixed promptly.

The provider made sure there were enough experienced staff, who received effective support, supervision and development opportunities. Staff knew people’s likes and dislikes well and they worked together to provide safe care that met people’s individual needs. Staff received training in all areas relevant to their roles. However, some staff needed to refresh their knowledge to ensure awareness of best practice guidance. For example, they had not heard of STOMP, which stands for ‘Stopping Over-Medication of People with a Learning Disability, Autism or Both’. This is a national NHS campaign in England. The aim is to make sure people are not given too many medicines, especiallypsychotropic medicines(used for mental health), unless they really need them. STOMP encourages providers to look at other ways to support people, like using alternative support or talking therapies.

Staff told us they had also not heard of CQC’s policy on ‘Right Support, Right Care, Right Culture’. This sets out how care providers should support autistic people and people with a learning disability by offering the right model of care (Right Support), person-centred and respectful care (Right Care), and a positive, inclusive service culture (Right Culture). Some staff did not know the Mental Deprivation of Liberty Safeguards (DoLS) applied to people living in Supported Living services.

The service had systems in place to make sure staff were recruited safely. Checks were carried out to make sure staff were suitable for the role. There were some gaps in employment history, but most of these had been followed up. New staff were supported with an induction that included shadowing experienced staff and having their skills checked. Staff also received regular supervision to help them do their job well.

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. They followed national guidance to keep people safe. The premises and equipment were clean and hygienic, helping to reduce the risk of infection.

Staff worked together with people to understand how to reduce the risk of infections. This helped make sure that action was taken quickly and that people using the service were protected. The provider took infection prevention seriously and worked well with others to keep people safe.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in decisions about their medicines and supported them to take part in planning, especially when changes happened. People were helped to understand their medicines and were included in reviews about the support they needed to manage them safely.

Medicines were prescribed, given and stored safely, following legal and national guidance. Staff followed best practice and professional advice when working with medicines. There was no evidence that medicines were used to control people’s feelings or expressions in the wrong way.