Crimson Hill Support

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. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to 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. Managers and staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Systems for reporting and investigating incidents, such as accidents and safeguarding concerns, were effective. There was prompt communication with external agencies when referring concerns and staff demonstrated a clear understanding of their responsibilities. Staff told us a learning culture was well established.

All staff recognised the importance of learning from incidents and near misses. Records showed appropriate action was taken by managers when dealing with incidents and accidents to keep people safe. For example, in July 2025 the provider carried out a staff survey in relation to 1 person’s support. This covered what worked well, any concerns staff had about incidents which had occurred and the sharing of ideas for improvement. One staff member said, “Incidents reported by staff online are addressed within 24 hours. Staff are interviewed to determine if they need any support and to implement any measures to minimise future incidents.”

Accidents and incidents were also reviewed as part of the provider’s quality monitoring process to ensure there was sufficient oversight and people and staff remained safe.

The service 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.

A comprehensive assessment of people's needs was completed by senior staff prior to any service starting. The assessment process considered the needs of each person, and a specific plan was developed to ease the transition of new people into the service.

People were supported by a range of external health and care professionals to help maintain and improve their well-being, including GPs, speech and language therapists, dieticians, and behavioural nurse therapists. Professionals involved in people’s care told us information sharing and communication with them was very good. This ensured continuity of care for people.

Staff 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. They shared concerns quickly and appropriately.

At our last inspection we found people were not always fully protected from the risk of harm because incidents were not always being effectively managed. People had plans in place guiding staff on how they should support people if they became anxious or upset. These planswere not always detailed, up to date or reviewed regularly. Staff had, on occasions, used unplanned and inappropriate restraint for 1 person. At this assessment, we found the necessary improvements had been made.

People had detailed, up to date plans in place if they became anxious or upset and challenge the service being provided. These plans included details about why behaviours might happen. They contained clear information to help staff avoid triggers and respond to people using the least restrictive methods, such as giving people time and space or helping them to focus on a different subject.

Some people had a form of restraint included in their care plan which staff could use in certain circumstances. This would always be a last resort and used for the least possible amount of time. Approved restraint methods were clearly described and could only be used by staff trained in each technique. This ensured unplanned or inappropriate restraint could not be used. It was noted during our assessment restraint had not been used by staff to support any individual for over 12 months. This showed improved care planning, staff training and awareness had been effective.

People’s relatives told us safety was prioritised by staff at the service. One relative told us, "Definitely no problems with safety, [name’s] been there for years, no problems. [name’s] is happy to go every day and he’s a happy lad.” Another said, “Yes [name is] definitely safe.” People and their families were aware of how to report any concerns and told us they would be confident to raise concerns with staff or management if they needed to.

Staff demonstrated a good understanding of safeguarding policies and procedures. Staff told us they were supported through the induction process and received ongoing training to understand their safeguarding responsibilities. The service had a clear process to record concerns which staff followed, and a clear escalation process was in place to ensure safeguarding concerns were referred to the local authority, when necessary. One staff member told us, “Safeguarding is an area we take very seriously and will investigate promptly taking all steps necessary to protect the individuals involved.”

Health professionals who supported people had given positive feedback about how people were safeguarded by staff. One professional said, “I have been very impressed with the response to safeguarding issues.”

Person-centred planning, consent and capacity assessments, and Deprivation of Liberty Safeguards applications were also in place to ensure people’s human rights were promoted and protected. Where assessments concluded a person had been deprived of their liberty, relevant legal authorisations were in place.

The service 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.

Risks were generally well managed. There were care plans in place for people who could become anxious or upset and challenge the service being provided. Some people’s plans contained approved restraint techniques. However, people did not have individual restraint risk assessments. This could potentially put people at risk of harm. This was discussed with the registered manager during the assessment who then implemented them for the individuals concerned.

Risks were communicated by the service in ways that were accessible and understandable to people, including those with specific communication needs. People had a range of communication methods and used many aids such as photos, pictures, symbols, objects, gestures and sign language.

Relatives told us risks to people were well managed. Staff supported people to take risks, such as trying new activities or increasing their independence, in line with their individual lifestyle. One relative said, “Some staff have brilliant ideas; they enhance his life. [For one specific trip], staff came up with that idea, it was risk assessed, and he went, and it worked brilliantly.” The risk assessments in place for people were detailed, up to date and had been reviewed regularly or updated when a person’s needs changed.

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

Relatives and staff told us people’s homes were safe and well maintained. One relative said, “We did a drop in visit 3 to 4 weeks ago. [Name of person] was out. We were able to look around, and we reported back we were delighted how clean and tidy it was.” There were clear systems for reporting and managing environmental risks. People were supported to raise issues with landlords when this was needed. One staff member told us all staff, “Provide a safe environment for both the service user and staff, for example hazards are recorded and reported.”

A staff survey was carried out in July 2025 for 1 person being supported; this person had caused some damage to their property. The survey suggested the environment was not always safe for the person or staff. Changes had therefore made to improve safety. Their relative said, “Yes [it is maintained] to a standard, but lots of broken things. We thought it would be home from home but it’s not quite that yet.”

Regular audits were conducted by the provider’s quality assurance manager of people’s homes and the office base to assess health and safety, fire safety and general maintenance/cleanliness. If any issues were identified, an action plan was put in place to improve things.

Personalised fire risk assessments were in place and up to date for each person, and regular checks of fire safety equipment was carried out and recorded. Personal emergency evacuation plans included details about each person’s mobility, understanding, and support needs. Staff participated in fire drills and understood their roles in an emergency.

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.

People’s relatives spoke highly of staff, both in relation to the care and support they provided and their caring nature. Comments included, “They’re [staff are] lovely, got a good team, happy with all the team” and ““They’ve [staff have] been lovely. [Staff are] interested in us and us in them.”

People were supported by enough staff to meet their individual needs. For example, 1 person was always supported by 3 staff; another person had 2 staff to support them. A relative said, “I’ve not come across any issues [with staffing]. Two staff, no issue. [There has always been] 2 staff on when we arrived [at his home].”

Relatives told us staff were well trained and knowledgeable. Staff told us they were well trained and well supported. Staff had completed training in areas such as health and safety, first aid, person centred care, how to care for autistic people or those who had epilepsy or who might challenge the service being provided. Where staff needed to complete training or required a refresher, this was organised for them. One staff member said, “Crimson Hill provides absolutely great in-depth training that covers every need of each service user and multiple shadow shifts to build the knowledge and confidence of staff members to ensure proper support is given to a service user.”

Staff were surveyed by the provider regarding the training provided to them. The results were very positive. Comments included, “I’m impressed with the training, it is detailed and interactive” and “Professional and covers all areas required to perform our role correctly.” Some staff had also written specific compliments to management staff praising the support and training they had received.

Formal supervision meetings with staff, spot checks and observations of their care practices and regular staff meetings were held. Records of staff meetings showed these were well attended, covered a range of topics and staff were encouraged to raise any issue they wished to discuss.

People were supported by staff who had been recruited safely. Appropriate checks were carried out on all new staff to ensure they were able to work in the UK, of good character and safe to support vulnerable people. The provider had been successful in recruiting staff from overseas. They had the relevant licence to sponsor staff and provided ongoing support for them.

Staff assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Staff encouraged and supported people to participate in the cleaning of their own homes. The provider had an infection prevention and control policy in place and staff had received appropriate training. A relative said, “They involve [name] to clean [their home] under [staff] supervision.” One member of staff told us, “We follow the infection control policy which guides us on things like food preparation, disinfecting surfaces, hand washing and also the use of protective clothing like gloves and aprons where necessary. We also promote independence for the individuals we care for by engaging them in daily activities like house chores.”

Systems were in place to reduce the risk of cross infection; this included the use of personal protective equipment (PPE) where necessary. People’s relatives told us staff regularly used PPE and were aware of safe hygiene and infection control practices.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people and/or their relatives in planning, including when changes happened.

Medicines were managed safely, and people were supported appropriately. Some people looked after their own medicines or were supported by family members. One relative said, “No they don’t do that [give medicines]. [Name] has medication in the morning and at 7pm. We give the medication before they [staff] come.”

Relatives of people who received support from care staff with medicines told us it was administered appropriately and at the right time. Comments included, “No issues with medication. I told them how I give them at home, and they do the same there [in the person’s own home]” and “[Name] has to have full support with medication and is on a lot of medication. Everything is full support. I’ve not known any issues.”

When people needed medicines administered in a certain way or if people declined their medicines, this was handled well by staff. One relative told us, “[Name] doesn’t take liquids, so they get dispersible tablets to go in [a certain food]. I sent letters to them from the paediatrician to say it’s allowed. It is the only way [name] takes them.” This method was clearly described in the person’s care plan. Another relative said, “No problems with Crimson Hill staff, they go the extra mile. Seniors from the office help as well if there’s an issue and [name’s declining] his medication. They go out at mealtimes, and they get him to have medication. I’m impressed with them. They do that so not to get into difficulties.”

There were clear guidance and policies for staff to support people with medicines. Staff told us they had received training in the safe handling of medicines and had competency checks completed. There were audits in place to ensure safe and consistent practice. One staff member said, “Staff support service users to take their medication so that they remain in good health. Staff help them and remind them to take their medication."