Stonecroft

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.

The service demonstrated a strong, kind and positive culture throughout the organisation. Leaders and staff embedded these values into everyday practice, creating a safe environment that reduced the risk of poor practice.

Accidents and untoward incidents were thoroughly investigated, used to inform any changes to the service, and the provider apologised when things went wrong. The service had a culture of open and honest discussions, so any issues were dealt with immediately and before they could turn into anything larger. Daily reflections gave people a forum where they could discuss anything, they were unhappy about.

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.

Where healthcare professionals provided advice about people's care, this was incorporated into people's care plans and risk assessments. People’s care records contained documents which they could take with them to hospital or healthcare appointments. These documents contained important information about people’s care and communication needs, including personal details, the type of medication people were taking, and any pre-existing health conditions. One family member said when their relative was admitted to hospital a team of staff was organised to stay with the person during each admission. Staff offered familiarity and consistency and worked alongside hospital staff to ensure the person's needs were understood and met.

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.

Safeguarding systems and processes were in place to identify, report and investigate allegations of abuse. Relatives told us people were safe. One relative said, "[Relative] is 100% safe living at the service. I have confidence in the care and support provided." A professional told us, "To my knowledge, carers have made safeguarding referrals as required. They have sought advice regarding safeguarding incidents. In my experience, they have responded appropriately to risks and made suitable referrals for support."

Staff demonstrated they were highly skilled at recognising when people were unsafe and were confident when challenging and reporting unsafe practice. They knew from people's body language and actions if a person felt unsafe or were worried about something. Staff told us they would give people time to talk and recognise if there were any changes in their behaviour they felt might need to be reported due to safeguarding concerns.

Any safeguarding concerns were investigated thoroughly and learning shared with staff at meetings or during supervision. The provider had logs and records that showed appropriate action had been taken where necessary. This information was then monitored by senior leaders and the provider to identify any themes or trends.

The service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty. People had their rights and freedoms respected as staff understood the importance of enabling people to make their own decisions, where possible. This meant care was provided in the least restrictive way. One visiting professional commented, “Carers follow up aspects, such as DoLS to ensure the person is fully informed and that their needs are being met. On occasion the person may not agree or be happy with decisions, carers remain honest and supportive.”

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.

Staff encouraged and supported people to take positive risks, which enabled them to live as unrestricted a life as possible. People had a range of risk assessments in place relating to the support they received. These assessments covered areas such as accessing the community, managing finances, participating in community activities, eating, drinking, and mobility. Where staff identified risks, they implemented control measures to help keep people safe.

Staff demonstrated a good understanding of people's individual risks and were able to describe the strategies used to reduce the risk of harm. Some people required support during incidents of distress, and staff had received training to enable them to provide this support safely and effectively. However, support plans relating to incidents of distress would benefit from further development to provide more comprehensive guidance for staff. For example, some plans contained limited information about potential triggers and lacked detailed, step-by-step guidance on how staff should respond at different stages of a person's distress. Whilst this had not impacted on people's care and staff knew people well, further detail would help to promote a consistent approach to support. Whilst this was a documentation issue and had not impacted the quality of care provided, as staff knew people well and understood their support needs, enhancing the level of detail in care records would help promote a consistent approach to support.

Staff regularly reviewed and evaluated risk assessments to ensure they remained current and relevant to each person's needs. The manager regularly reviewed incidents and risk-related information to identify trends, monitor safety, and ensure appropriate actions were taken.

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

People's bedrooms were well decorated and personalised. The décor throughout the home was clean, fresh, and well maintained, and the environment was free from obvious hazards. People had access to carefully maintained garden areas and took pride in helping to keep these spaces well cared for.

The provider ensured external contractors serviced and inspected equipment regularly to maintain safety. For example, fire safety equipment, gas systems, and electrical installations underwent the required safety checks in accordance with regulatory requirements. A fire risk assessment identified a number of actions required to strengthen fire safety arrangements within the service. The provider was aware of the findings and was in the process of addressing the identified actions.

Each person living at the home had a Personal Emergency Evacuation Plan (PEEP). This document outlined the support a person would need to evacuate the service safely in an emergency. Staff had access to these plans, and the service had a business continuity plan in place to provide immediate guidance on responding to emergencies.

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.

The provider followed safe recruitment processes and completed all necessary pre-employment checks before staff worked with vulnerable people.

Suitable staffing levels were in place to meet people's assessed needs, including the provision of one-to-one support where this had been commissioned.

Training records were up to date and clearly identified when refresher training was due. Staff told us they received effective support and development opportunities, and records we reviewed supported this. Staff completed regular training and received updates to ensure their knowledge and skills remained current. The registered manager monitored training compliance, identified any gaps or shortfalls, and took appropriate action to ensure staff completed required training within expected timescales.

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 supported in an environment that was clean and hygienic. Staff received training in infection prevention and control and had an ample supply of personal protective equipment available to them.

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 had their medicines managed safely by trained and competent staff. The service maintained an effective system to ensure medicines were accounted for, and medication records demonstrated people received their prescribed medicines as directed. However, we found Medication Administration Records (MARs) were not always signed to confirm topical creams had been administered. The registered manager was aware of this issue and had systems in place to monitor and address recording shortfalls.

Staff completed regular medicine reviews and carried out weekly medication audits to identify any concerns and areas for improvement. Staff understood and applied the principles of STOMP (Stopping Over-Medication of People with a Learning Disability, Autism or Both), supporting the safe and appropriate use of medicines.