Monaveen (Care Outlook)

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

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 Requires Improvement.

This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

This service scored 59 (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 did not always have a proactive and positive culture of safety based on openness and honesty. Staff did not always listen to concerns about safety and did not always investigate and report safety events. Lessons were not always learnt to continually identify and embed good practice. Incidents and accidents were not always monitored and reviewed to help ensure there was oversight and any actions were implemented. However, staff have been receiving further training with identifying reportable incidents so that the provider can facilitate more effective learning. This meant learning from incidents are improving to and staff were kept up to date with changes in people’s needs. One staff member told us, “We are much better in recognising reportable incidents now as a whole. We always cared for people in the right way but needed to understand that the office need involving more.” People and staff were able to raise concerns outside of the management team to help prevent the development of a closed culture. One person told us, “I know who I can speak to, if need be, and I can always talk to CQC or my social worker too.”

The provider did not always work well with people and healthcare partners to understand what being safe meant to them and how to achieve that. The provider did not always share concerns quickly and appropriately. Incidents at the service were not always reported effectively or in a timely fashion. This meant the provider could not be assured that incidents were being shared with the relevant authorities such as the local authority safeguarding team and the Care Quality Commission (CQC). Since the provider took over care at Monaveen, we have seen improvements with the reporting of incidents and subsequent notifications to the relevant parties had increased. The local authority told us that the communication between them and the service has been improving because of measures put in place by the provider, however, these systems and processes are yet to be fully embedded, and the provider has an improvement plan in place to ensure these are monitored. People told us they felt safe when they received care. One person told us, “I feel safe here, they know what they are doing.” Staff could describe to us what they thought a safeguarding incident was, one member of staff told us, “Safeguarding is very important. People should not be abused whether its physically, emotionally or financially.”

The provider did not always work well with people and healthcare partners to understand what being safe meant to them and how to achieve that. The provider did not always share concerns quickly and appropriately. Incidents at the service were not always reported effectively or in a timely fashion. This meant the provider could not be assured that incidents were being shared with the relevant authorities such as the local authority safeguarding team and the Care Quality Commission (CQC). Since the provider took over care at Monaveen, we have seen improvements with the reporting of incidents and subsequent notifications to the relevant parties had increased. The local authority told us that the communication between them and the service has been improving because of measures put in place by the provider, however, these systems and processes are yet to be fully embedded, and the provider has an improvement plan in place to ensure these are monitored. People told us they felt safe when they received care. One person told us, “I feel safe here, they know what they are doing.” Staff could describe to us what they thought a safeguarding incident was, one member of staff told us, “Safeguarding is very important. People should not be abused whether its physically, emotionally or financially.”

Managers and staff identified and controlled potential risks in the care environment. They helped to ensure equipment, facilities and technology supported the delivery of safe care. The provider assessed people’s homes for risks and took action to ensure people, staff and visitors remained safe.

The service worked closely with the housing association to help ensure the premises were maintained appropriately. Where actions were required, they engaged with the housing association to help make sure these were completed in a timely way.

Managers and staff identified and controlled potential risks in the care environment. They helped to ensure equipment, facilities and technology supported the delivery of safe care. The provider assessed people’s homes for risks and took action to ensure people, staff and visitors remained safe.

The service worked closely with the housing association to help ensure the premises were maintained appropriately. Where actions were required, they engaged with the housing association to help make sure these were completed in a timely way.

The provider did not always make sure there were enough qualified, skilled and experienced staff. They did not always work together well to provide safe care that met people’s individual needs.

Although there were enough staff deployed, some staff did not receive effective support to recognise when certain incidents needed to be reported to senior management. This meant that the service could not always be assured that people's care and treatment was as effective as it could be. However, during the assessment the provider was able to demonstrate that steps were being taken to provide extra support and training.

Policies and procedures were in place to help recruit staff safely. Checks on the suitability of potential staff were completed. This included obtaining references and checks with the Disclosure and Barring Service (DBS). The DBS helps employers make safer recruitment decisions and help prevent unsuitable people from working in care services. Records showed that staff had received training in areas relevant to their roles. Staff received supervision sessions which provided an opportunity for them to discuss their performance and professional development.

Systems and processes were in place to protect people and to prevent and control the risks of infection. Staff were trained in infection control and food safety awareness and there was an IPC

policy and procedure in place which staff could access. When supporting people in their homes and providing personal care, staff used the appropriate personal protective equipment, (PPE) such as aprons and gloves. The provider ensured that staff had access to enough PPE.

The provider completed spot checks on carers to ensure good hand washing techniques and that uniforms met standards that promoted good hygiene management. The provider worked closely with the housing provider, who maintained the management and cleaning of the communal areas of the service.

Effective medicines management systems were in place. People's medicine support needs were documented in their care plans. The service used Medicine Administration Records (MARs). MAR charts were completed fully indicating medicines were administered as prescribed. Staff received training to administer medicines to help ensure they had the appropriate knowledge and skills. Medicines in extra care settings are stored in people's own flats in accordance with guidance. Medicines were stored in this way and people had a lockable cabinet in their flat where they stored their medicines. Where people were prescribed medicines on a when required basis (PRN), there were appropriate protocols in place to advise staff on what circumstances and how to give these medicines.