Anchor Point Neurological Centre-Inspire Neurocare (Southampton) Limited

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.

Records of incidents and accidents showed they were investigated and lessons learned were recorded and shared with the wider staff team. Staff signed to confirm they had read the outcome. A staff member said, “We review the lessons learned, they’re discussed at the daily meeting, and also in staff meetings. We have a ‘lessons learned’ folder too.”

The management team were open with us about recent challenges and were keen to show us how lessons learned had improved care and support for people.

A health professional told us, “The management team have been responsive and transparent regarding challenges within the service, and willing to engage positively with investigations and professional discussions.”

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.

Records showed the service was supported by a range of health care professionals. There was an on-site physiotherapy team and links with local services, such as the local GP who visited weekly, or more often if needed. This meant people’s ongoing health and rehabilitation goals were monitored and their medicines were regularly reviewed.

People and their relatives told us they had good access to GP’s and other health professionals, and care plans included relevant assessments and clinical guidance.

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 and understood their responsibilities to keep people safe from harm and abuse. Staff knew what to report and how to do it. A staff member said, “In terms of residents and staff, if there were any concerns for a resident’s wellbeing and the care that they are receiving, or if you see something, you can raise a concern.”

Records showed safeguarding concerns were raised with local agencies and notifications were submitted to the Care Quality Commission.

People and their relatives told us they felt safe. A person said, “It’s seriously improved since [manager] has arrived and my care is better.” The management team worked proactively with staff to ensure records were maintained and that correct procedures were followed.The manager told us, “I do feel confident people are safe here. The staff are really good at escalating concerns and anxieties."

Health professionals told us the service was open, transparent and demonstrated a willingness to learn.

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 service provided support and rehabilitation for people with multiple needs. People were assessed for risks such as choking, skin damage, falls and other areas. When risks were identified, care plans provided guidance for staff. For example, choking care plans included guidance such as what position the person should be sat in, what type of cutlery to use, and any textured dietary requirements. Staff told us only permanent staff supported people at risk of choking, to reduce the risk of an incident occurring. Care plans for people at risk of skin damage included details of pressure relieving equipment and how often people should be supported to change position. Air mattresses we looked at were set correctly, and position change records showed people were supported in line with care plan guidance.

All staff we spoke with were aware of risks to people’s safety. They knew how to reduce the risk of harm and understood the importance of this. For example, some people had specific risks related to their health condition. Staff knew what these were and were able to describe them to us in detail and how they supported people to keep them safe.

Some people told us they wanted to be able to access the local community more. The manager told us how they worked closely with the multidisciplinary team to ensure people’s choices could be met wherever possible, alongside making sure people were safe from avoidable harm.

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

Regular safety checks were carried out across the service. This included gas, electrical and fire safety checks, and equipment such as hoists and lifts. Personal evacuation plans reflected people’s support needs in the event of needing to evacuate the building in an emergency. The service was well maintained, and there was a responsive system to address any issues as they arose.

There was a well-maintained secure garden area for people to use, and we observed people using the outside areas to enjoy the warm weather.

However, cupboards containing cleaning chemicals did not have signage in place. The management addressed this with immediate effect.Not all food and drinks in communal kitchenette areas were labelled with the date of opening, which meant there was a risk of staff not being aware when items had expired. Wefed this back to the management team who advised they would review the labelling with staff.

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.

During a recent period of instability, the service had relied on high use of agency staff. The manager told us this was being addressed with ongoing recruitment, including an upcoming open day for potential new staff. As more staff had been employed, the provider was now using fewer, regular agency staff who were more familiar with the people they supported.

There had been a recent focus on providing enhanced training for staff, including agency staff, and a review of competency assessments, specifically in relation to people with a high level of need due to their health condition. We reviewed records of the training competency assessments and spoke with staff who told us they felt competent and confident to support people. A staff member said, “The clinical educator came and did training and assessed us and our competencies. Staff have had so much training. Everyone is so well trained now.”

People and their relatives told us they felt staff training and knowledge had “improved.” A person said, “I am not worried about the support with my [health condition]. The staff are very good at looking after my equipment. My care is all ok.” A person’s relative said, “Staff have always been diligent but lacked confidence, but the staff now are better trained, and very competent and they understand [name] and their [condition and equipment].”

Although staff told us they felt there were enough of them to meet people’s needs, we received mixed feedback from people and their relatives. Most people told us call bells sometimes took a while to be answered, or there weren’t enough staff to support them with personal care when they wanted it, such as having a bath for example. Some concerns were raised about skill sets at night. The service used a dependency tool to calculate staffing levels, and the staff rota reflected this. Throughout the inspection, staff did not appear rushed, call bells were answered in a timely manner, and we observed staff spending time with people. We fed back people's comments to the management team.The manager told us they reviewed night staff competencies and some of the day staff were working night shifts to provide continuity of care.

Staff told us they had regular supervisions. Safe recruitment procedures were followed.

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.

Staff had infection prevention and control training and knew when and how to put on and take off personal protective equipment (PPE). There was enough PPE available for staff to use. Housekeeping staff were on duty 7 days a week, and the service was visibly clean and odour free. Infection prevention and control audits were carried out. The provider told us they had commissioned an independent external infection prevention specialist company to carry out an audit of the service to provide assurance of current practices and identify any areas requiring improvement.

People and their relatives told us they were happy with the level of cleanliness. One person’s relative told us, “It’s always clean and tidy.”

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 who administered medicines had completed training and had their competencies assessed. During a medication round, we observed the nurse informing the person they had their medicines and taking their time to administer it. Medicines were stored safely, medication rooms were temperature controlled and records of temperature checks showed rooms and medicine fridges were at safe temperatures. Records showed people had their medicines administered on time as prescribed.

Protocols were in place for when people needed additional medicines on an as required (PRN) basis. The service had good links with the local pharmacy. Records showed people’s medicines were regularly reviewed.

However, topical creams and lotions were not dated when opened. This meant staff might not know when these had expired. We fed this back to the management team, and it was immediately addressed.