Creative Support - Sonali Gardens Extra Care Service

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 requires improvement. At this assessment the rating has changed to 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 positive culture of safety where staff and leaders learned from incidents and took action to reduce the risk of recurrence.

Incidents, accidents and complaints were recorded, investigated and discussed within team meetings to identify learning and improve practice. Leaders described learning from events, including reviewing emergency responses and improving communication with relatives following a medical emergency.

Staff understood how to escalate concerns and described how incidents were reviewed through root cause analysis, with care plans updated where required. There was a culture of learning embedded into the service. A senior manager said, “Any learning, we a have monthly team meeting where we discuss where we can improve.” Staff and leaders also described systems for sharing information through handovers, communication books and team meetings.

The provider worked with people and partner agencies to support safe admissions, transitions and continuity of care.

Leaders completed assessments before people moved into the service, gathering information about health needs, medicines, and personal preferences to ensure the service could meet people's needs. People were involved throughout the process, and consent was sought regarding decisions such as registering with healthcare services.

Reviews were carried out following admission to ensure support remained appropriate. Leaders told us they collaborated closely with social workers, healthcare professionals and housing providers to plan safe transitions and ensure people remained informed about changes affecting their care and support. Where people moved out of the service, leaders worked with professionals and the person to facilitate timely and coordinated transitions.

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 were protected from the risk of abuse because staff understood safeguarding responsibilities and acted when concerns arose. Staff received safeguarding training and leaders ensured staff had access to safeguarding policies, whistleblowing procedures and support from senior managers.

Staff demonstrated a clear understanding of how to recognise and report concerns and were confident to escalate issues if they felt an appropriate response had not been taken. A staff member told us, “I would report it to the manager and fill in an incident report. If I was unhappy with the manager’s response, I would attempt to escalate the situation and report it to the area manager or the safeguarding team”. Another member of staff stated, “Never stay silent — keep escalating until the person is properly protected”. Leaders described completing welfare checks, monitoring risks and making safeguarding referrals where required to help keep people safe.

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 involved in decisions about risks affecting their lives and were supported to balance safety with independence and choice. Risk assessments provided staff with guidance on how to safely support people with identified risks, including mobility, skin integrity and health needs. Staff encouraged people to make decisions, participate in activities and remain active within their local community.

Leaders described promoting positive risk-taking by encouraging people to access community facilities, social activities and opportunities to maintain independence. Records showed people walked around the local community visiting local markets and shops. Staff explained how they sought consent before using equipment and involved people in decisions about their care and support. Systems were in place to monitor changing risks through welfare checks and observations.

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 were supported in an environment where systems were in place to monitor and maintain safety. Staff received fire safety training and participated in regular fire drills. Leaders worked with maintenance services, equipment providers and occupational therapists to ensure equipment remained safe and suitable for people's needs.

Risks within people's flats were assessed and monitored, including the use of specialist equipment, hospital beds and fire safety measures. Staff described carrying out routine environmental checks and acting where concerns were identified. Leaders also maintained links with housing providers to address environmental risks and support continuous improvement of the premises.

The service was near the completion of an extensive renovation which included redecoration and providing new facilities for people using the service which could be easily accessed. People had been consulted around the decorations which demonstrated they were actively being involved in how their home should look.

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.

Staff received induction, training, supervision and competency assessments to support them in their roles. Leaders monitored staffing levels using dependency information and reviewed support arrangements when people's needs changed. Staff spoke positively about training and development opportunities, with one member of staff stating, “Yes, the trainings have been informative and useful. Fire safety, risk management and medication trainings have been the most useful”.

Recruitment records contained the appropriate employment checks, including references and Disclosure and Barring Service checks before staff commenced employment. Staff competency was monitored through supervision, observations and medication spot checks. Although one staff member raised concerns about time pressures and staffing deployment, most staff and leaders told us there were sufficient staff available to support people safely.

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 systems in place to reduce the risk of infection and promote a clean environment, observations confirmed this.

Staff understood infection prevention and control practices and described using personal protective equipment appropriately. A staff member told us, “Strict hand hygiene, clean environment, I practice safe waste and linen disposal. I use gloves, aprons and masks at all times”. Another stated, “I prevent infection mainly through handwashing before and after care, keeping spaces clean and well‑ventilated”.

Leaders described regular cleaning schedules, waste management arrangements, environmental checks and access to pest control services. Staff confirmed adequate supplies of personal protective equipment were available and understood how to dispose of clinical waste safely.

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. Medicines were managed safely and people received their medicines as prescribed. Staff completed medicines training and leaders carried out regular competency checks, observations and spot checks to monitor safe practice.

Staff understood procedures for administering, storing and recording medicines and knew how to seek professional advice when concerns arose. A staff member told us, “Controlled medication is kept in a locked cupboard and is only administered in the presence of two trained staff”. Another explained, “I always follow the five rights: right person, right medicine, right dose, right time, right method.”

Leaders described working with pharmacists, general practitioners and other health professionals when medicines changed and ensuring medicines records remained current. Systems were in place to review medicines incidents and share learning with staff where required.