Agincare Enable Hampshire

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.

We observed staff listening to people and responding to their concerns. Staff knew what incidents to report and how to report them.

The provider investigated incidents thoroughly and shared outcomes with people and relevant stakeholders. We saw evidence of change as a result of incidents which had occurred. The provider shared learning with staff through staff communication channels and team meetings.

The registered manager told us they received safety alerts from the government, local authority and CQC which informed them of upcoming risks. This included themes and trends to ensure the provider could take appropriate action to mitigate these risks.

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 provider had a robust admissions policy in place. The registered manager was able to explain the process which included assessing people to establish suitability and compatibility prior to moving in, visits for the person to their potential new home, and ensuring any referrals for support and additional training for staff were in place.

People were consistently supported when they were distressed. There was a focus on planning for a good day and understanding what had caused people distress so positive changes could happen.

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 had access to easy read information, or staff who knew them well to help them raise concerns.

Staff knew how to protect people from abuse and who they would report any concerns to both internally and externally.

The service shared concerns appropriately by following the correct process and ensuring these were reported to the relevant agencies.

At the time of our inspection, no one using the service was subject to a deprivation of liberty authorisation by the Court of Protection. The provider understood their responsibilities under the Mental Capacity Act 2005 (MCA) and when to discuss with the local authority, whether and how to ask the Court of Protection to authorise a deprivation of liberty. They assured us that, where a person was potentially being deprived of their liberty, the appropriate authorisation would be sought, and people's care arrangements would be reviewed to ensure any restrictions were necessary and as least restrictive as possible.

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 supported people to manage risks whilst maintaining their independence by promoting positive risk taking. For example, people were assessed for risks of falls, risk of choking and risks related to medical conditions. When risk had been identified staff acted to keep people safe, for example, using specialist equipment to monitor their health condition.

The registered manager told us “All risks can be positive. People can make unwise decisions and we will support them. We take small steps. It is about building up someone’s skills to support them. Staff use social stories to help people and aid their understanding.”

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

We reviewed fire evacuation records which evidenced not all staff members had taken part in an evacuation in line with the provider’s policy. We spoke with the registered manager about this who assured us fire evacuation practices would be taking place involving the staff who had not yet taken part.

Health and safety and fire safety risk assessments were completed and checks made of equipment to ensure it was safe to use. Regular audits were undertaken to ensure the environment and equipment was safe. Any concerns were reported to the management team or appropriate person for further action.

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.

Relatives' views about staffing levels were mixed. Some reported short staffing which affected people's ability to undertake planned activities, and concerns were raised that staffing levels were not always sufficient to meet people's needs safely. We reviewed staff rotas which evidenced there were sufficient staff to meet people’s needs. Relatives were generally positive about the established core staff teams, describing them as caring and knowledgeable about their family members. Continuity of long-standing staff was particularly valued, although agency or newer staff were reported not to know people as well.

Most staff had completed statutory and mandatory training and competency assessments. The provider ensured staff attended bespoke training relating to supporting people with a learning disability and autistic people. This meant staff were able to meet people's individual needs. Where staff had not completed training, this was monitored and managed through internal processes to ensure the training would be completed in a timely manner.

The provider had recruitment processes which were fair and ensured there was no disadvantage based on any specific protected characteristic. The provider followed safe recruitment practices.

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 provider had a robust up-to-date Infection Prevention and Control (IPC) policy in place and staff attended IPC training.

Relatives gave mixed feedback about the cleanliness of people’s homes. While 1 relative was satisfied with cleanliness, others identified unclean, dusty or cluttered areas. One relative confirmed staff wore PPE when required and believed appropriate infection prevention practices were followed.

We observed people’s homes we visited were clean and staff followed good practice, with the exception of 1 home where we did note some dust. However, we were informed the person being supported did not like staff cleaning or touching their belongings. Managers shared with us what was in place to support the person with this.

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.

There was a robust medicines policy in place. Staff received medication training, and their competency was checked to ensure they understood the requirements for the safe administration of medicines. Staff supported and involved people to manage their medicines safely. The staff team were proactive at reporting any changes to people’s medicines promptly. People had received their medicines as prescribed.

The registered manager told us; during people’s annual health reviews, stopping over medication of people with a learning disability and/or autism (STOMP) was reviewed. This ensured people’s medicines were reviewed to ensure psychotropic medicines were not inappropriately prescribed or overused. This meant people were less likely to be at risk of chemical restraint.