Outram Fields

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 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. Staff at all levels understood the need to learn from incidents. Systems were in place to document accidents and incidents and responses to these. Regular governance meetings analysed any trends and staff actively reported near miss incidents to support ongoing learning and improvement.

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 service worked proactively with health and social care professionals to share information and make referrals when required. When people needed to move between services, for example to or from hospital, the service ensured appropriate records were shared when needed and communication ongoing to support safe transfer. A relative told us, “The Registered Manager was excellent in meeting with the hospital staff.”

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. Staff were trained in safeguarding and understood how to identify and report concerns. People and their relatives told us they felt the service was safe. Managers understood their legal responsibilities in relation to people’s liberty. People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that the provider was able to identify when people were potentially being deprived of their liberty, complied with the principles of the Act, and made the appropriate applications in a timely manner.

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. The provider ensured that people and their relatives were fully involved in planning their care. People’s care plans included information about potential risks and how the person could be supported to manage these. For example, where people used equipment to support with mobility this was clearly documented within plans with guidance for staff on how to use this. Risk assessments were routinely updated and any changes communicated to the staff team.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The provider had ensured routine maintenance checks were taking place to maintain the safety of the premises and equipment. These included legionella testing, safety certificates for lifting equipment and fire safety checks. The service had identified that their emergency lighting system was not operating at expected levels and had a repair booked. Following the inspection, the provider took interim actions to mitigate risks associated with this whilst awaiting the repair.

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. Robust recruitment systems were in place to ensure staff recruited were suitable to work with vulnerable adults, these systems included reference checks and Disclosure and Barring Service (DBS) checks. Staff received an induction and ongoing training to support them to complete their roles well. Staff had opportunities to complete additional training and development, for example a member of staff told us they were due to complete dementia coaching training and following this would be teaching other staff at the service. Observations did not evidence a lack of staff at the service, however feedback from people, relatives and staff was mixed, with some people telling us they did not feel staffing numbers were sufficient. Records including call bell audits were reviewed by the registered manager, these did not evidence insufficient number of staff to meet people’s needs. Following the inspection the registered manager agreed to undertake work to understand people’s concerns in this area.

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. A team of domestic staff undertook regular cleaning of the service, which was clean, well maintained and well-presented throughout. Staff received training in regards cleaning protocols and infection prevention and control measures. Staff had access to adequate stocks of personal protective equipment (PPE) and understood how to use this effectively.

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. Staff received training in the safe administration of medicines and their competency in this area was reviewed regular. Records were clear and accurate, staff and managers undertook regular auditing of medicines, records and clinic rooms to ensure any issues could be identified and addressed quickly. Clinic rooms were clean, well-organised and secure.