DLS SW England Regional Office

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 newly registered service. This key question has been rated 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.

Effective systems were in place to ensure all safety events were investigated and actions were taken. For example, when a person had a fall, strategies were put in place to prevent recurrence and communicated to staff through team meetings and handovers. Care and risk plans were updated and relevant parties were informed of the changes. The provider shared multiple examples of how learning from safety incidents was managed. Team meetings showed how safety events were discussed and actions followed up by the team.

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 clear guidance in place to ensure people’s transfers between care settings was done in a robust manner. The provider shared several examples of people moving between different care settings and how these were managed by the team. For example, when a person was discharged from a hospital setting to their home the team kept in regular contact with the medical team. There was a clear and structured process in place focusing on a safe discharge. People were re-assessed and safety checks were carried out. The registered manager made sure that discharges were done safely. In 1 example when a person returned from a hospital setting, they became unwell once at home. The team responded immediately referring them to the GP, asking for a review of their medicines and a review of the care package to ensure their needs could still be met. The provider kept all relevant parties up to date and continued to monitor the situation.

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. For example, a recent concern was raised by the team about a person who was at risk of neglect. The team worked alongside the local authority to address the concerns and find solutions. The team continue to monitor the situation and record any changes. Staff demonstrated a good understanding of safeguarding and how to protect people from harm or abuse. One staff member said, “Safeguarding means protecting people from harm, bullying. If any problems complete a form and tell the team leaders”. Staff have been trained to identify signs of abuse and understand how to report their 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. Risk plans were in place for people. Care plans reviewed showed that people were aware of risks to their health and wellbeing. Staff supported people to manage their health risks. Risk plans showed that any identified risks of harm were mitigated. For example, if a health risk was identified, a person would be supported by staff according to their care plans and preferences.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Environmental risk assessments were carried out by the provider. Staff had training in health and safety covering areas such as fire safety and moving and handling. Where risks were identified actions were taken. For example, the fire authorities were asked to come and offer advice to people when concerns were raised. In addition, the team contacted the safeguarding team following an assessment of a person’s environment which was causing concerns. Service records reviewed showed this situation was monitored. People could be confident that the provider was prioritising people’s health and well being.

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. Recruitment checks were robust and staff were safely recruited. Inductions were carried out and staff had the opportunity to shadow experienced staff before being left to work independently. Staff had regular meetings and were able to seek guidance. Training was provided in a range of subjects to enable staff to do their role effectively. Staff told us they felt supported and valued by the management team.

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. Care records reviewed included details of what support people needed to maintain their personal hygiene. Staff had training in infection, prevention and control. Spot checks were carried out by the provider which included checks on staff using personal protective equipment, (PPE) appropriately. Robust infection prevention and control guidance was in place for staff should it be required. People could be confident that their well being was a priority with the provider.

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. Medicine records reviewed showed medicines had been administered appropriately. Where people required ‘as and when required’ medicines, protocols were in place, detailed guidance for staff was available when needed. Robust medicine policies were in place for guidance.