Sagecare (Laburnum House)

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.

People told us staff responded promptly to incidents and accidents, providing support and seeking professional or medical advice when needed.

The provider had effective systems to learn from incidents and improve care. Staff understood their responsibilities for reporting and recording incidents, using the electronic care planning system to raise concerns and alert senior staff. Senior staff investigated incidents, updated care plans where required and worked with people and professionals to improve safety. Staff completed reflective practice to help them learn from safety incidents. This helped to reduce the risk of reoccurrence.

Senior leaders had effective oversight of incidents, such as, safeguarding concerns, medicines errors, missed visits, and complaints. This helped them identify learning and implement changes to systems and processes to reduce risks and improve the quality of care.

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 registered manager understood the range and complexity of needs the service could support. They worked closely with commissioners, the housing provider, and other stakeholders to ensure referrals were appropriate with the service model at Laburnum House.

The provider had improved systems to reduce the risk of failed hospital discharges. Following experiencing previous issues, they introduced a hospital tracker to monitor admissions, discharge plans, and whether updated assessments had been completed before care services recommenced. This helped ensure staff had the information needed to support safe and well-coordinated transitions between services.

The provider effectively supported people during their transition into the service, which improved their wellbeing and engagement with care. Staff worked with people to build trusting relationships and promote independence, including reducing their reliance on relatives for care and support. This promoted people’s dignity and wellbeing. Staff also encouraged people to participate in communal activities, helping to reduce the risk of social isolation and support successful transitions into their new living environment.

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 with professionals.

People told us they felt safe receiving support in their own homes. They knew the staff who provided their care and said they were supported by familiar staff. People described positive and trusting relationships with staff.

The registered manager and staff understood their responsibilities for recognising, reporting, and responding to safeguarding concerns. The provider had introduced electronic trackers to improve oversight of safeguarding alerts. This enabled senior staff to monitor and ensure appropriate action were taken.

The provider took a proactive approach to safeguarding. Staff identified and reported concerns appropriately and worked with people and relevant stakeholders to reduce risks. For example, staff raised concerns about a person’s ability to maintain their safety at home, which led to additional support being put in place to help keep them safe.

The provider had effective systems to promote people’s safety and security at home. This included procedures to check on people’s wellbeing when they could not be contacted at agreed visit times. Staff promoted people’s safety by discussing common scams, encouraging the secure storage of keys, and remaining vigilant to unfamiliar visitors. This helped protect people from exploitation and maintain their safety.

Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People told us they felt safe with staff, who competently supported them to manage risks associated with moving and handling, personal safety, and health conditions.

Staff proactively monitored risks and referred concerns to relevant health and social care professionals. For example, staff followed guidance to support a person with risks relating to skin integrity, escalated concerns appropriately, and acted on advice from occupational therapists. Staff understood how to manage identified risks, helping the person maintain good skin health. The provider reviewed and updated care plans and risk assessments as people's needs changed. This helped ensure staff had current guidance that reflected people's risks and support needs.

The provider had effective business continuity plans to support safe service delivery during emergencies. These covered staffing shortages, infection outbreaks, loss of access to electronic systems, and emergency accommodation needs. As part of a wider network of local extra care services, the provider could share staffing resources, maintain oversight, and arrange alternative accommodation when necessary. This helped ensure people remained safe during unexpected events.

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

The provider assessed people’s home environments to identify and manage risks, including falls, fire safety, and people’s ability to remain safe at home. People had personalised evacuation plans, staff received training in emergency procedures, and the registered manager made referrals to the fire and rescue service where required. This helped improve safety for people and staff.

The provider assessed care-related equipment to ensure it remained safe and suitable for people’s needs. Care plans detailed guidance for staff on the safe use of equipment, and staff sought advice from relevant professionals when equipment was faulty or no longer met people’s needs. They updated care plans when equipment changed or became unavailable. For example, when a person joined the service with unsafe equipment, staff promptly raised concerns with the occupational therapist and implemented interim measures to maintain safe moving and handling until a replacement was provided.

The provider supported people to raise tenancy-related concerns with the housing provider. For example, they worked with people and the housing provider to coordinate interim arrangements while repairs were carried out to the service's lift. This helped to minimise disruption and maintain people's safety and wellbeing.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development.

People told us they were happy with their staffing arrangements. They said they had not experienced missed or significantly late visits and knew the staff who supported them.

The provider had enough staff to meet people’s needs. The provider used the electronic care planning system to schedule visits, helping to ensure calls were prioritised appropriately, delivered at consistent times, and allocated to regular staff.

Staff completed training relevant to their role, including in supporting people with a learning disability and autistic people.[KW1] The provider’s in-house team delivered additional training in response to changes in people’s needs. For example, the registered manager arranged for additional epilepsy training when a person with this condition started using the service.

Staff completed a structured induction and received regular supervision and competency assessments. These arrangements helped senior staff monitor performance and ensure staff provided effective care. Staff spoke positively about the training and support they received. A staff member told us, “If I felt I needed any further training, I would just ask and I know that I would get support.”

The provider had effective staff recruitment processes to help ensure only suitable staff were employed.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading.

People told us staff followed good infection prevention and control practices. They said staff wore appropriate personal protective equipment (PPE), including gloves and aprons, when providing personal care.

Staff completed infection prevention and control training and told us they understood their responsibilities for maintaining hygiene standards and reducing the risk of infection. Facilities were available for staff to wash, shower, and change clothing during shifts where required. This helped minimise the risk of infection spreading.

The provider had infection prevention and control policies and procedures that reflected current guidance and gave staff clear information about expected standards. The provider’s business continuity plan included guidance for managing infection outbreaks. This helped ensure staff could respond effectively and the service could continue to operate safely should this occur.

The provider made sure that medicines and treatments were safe and met people’s needs.

People told us staff supported them to manage their medicines safely and in line with their needs. Two relatives felt their family members would benefit from additional support to manage their medicines. However, the registered manager demonstrated in these examples how staff provided support that balanced people’s rights to make choices about their care with their safety.

The provider assessed people’s medicines needs and recorded their preferences in care plans. Where people chose to take medicines differently from prescribed instructions, staff respected their choices while ensuring any staff-supported alternative was agreed by an appropriate healthcare professional. For example, one person chose to take their medicines with food. Their care plan reflected appropriate assurances had been sought this was safe.

Although most people managed their own medicines, the provider introduced a medicines tracker to monitor prescription renewals and reduce the risk of supply issues. This enabled staff to remind people to request repeat prescriptions when needed. The system benefited people who wished to remain independent but required occasional prompts to manage their medicines safely. Where people requested, the provider took on additional medicines management responsibilities. Effective systems were in place to ensure medicines were managed and administered safely.

Medicines policies reflected current best practice and covered areas such as topical medicines, homely remedies, time-sensitive medicines, and medicines prescribed on an ‘as required’ basis. Staff understood how to administer medicines safely, helping to ensure people received their medicines as prescribed.