Nurtrio

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. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The service had a positive and open approach to safety. Staff were encouraged to raise concerns and felt confident to do so. Any safety issues were taken seriously, investigated, and reported appropriately. The provider used these experiences to learn and continuously improve how care was delivered.

The registered manager demonstrated a strong commitment to improving the quality of care. Learning from incidents and day‑to‑day experiences was a key focus. Staff were supported to reflect on their practice, with learning shared through regular staff meetings, weekly newsletters and daily handovers to help embed good practice throughout the service.

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.

Staff worked closely with everyone involved in people’s care, including GPs, social workers, case managers, community services and mental health professionals. Important information was shared with the staff team and used to make sure people received the right support.

Each person had a “hospital passport” in place. This helped other professionals quickly understand their needs, preferences and how they communicate. Staff often went with people to their appointments, especially when they needed reassurance or help to understand the information they were given.

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.

People received safe and respectful care because safeguarding and the protection of people’s rights were firmly embedded across the service. Systems were in place to keep people safe, and the management team consistently followed internal and external safeguarding procedures to ensure people were protected. People spoke positively about their experiences. Comments included, "I am very safe here, they [staff] know me well, know what I like and how I like things" and "The staff help me to keep safe. I love it here."

People’s right to safety, dignity and respect was understood by staff at all levels.

We checked whether the service was working within the principles of the Mental capacity Act, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. All legal applications had been made in accordance with Deprivation of Liberty Safeguards (DoLS). This meant people’s rights were fully respected. The manager kept a record of DoLS applications and authorisations, and this was regularly reviewed to make sure authorisations were current.

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 actively promoted positive risk‑taking so people could develop skills and lead safe, meaningful, and fulfilling lives. People were supported to understand risks in appropriate ways, helping them stay safe while building confidence.

Staff consistently balanced safety with choice, encouraging independence while respecting each person’s decisions. For example, one person wanted to begin administering their own medication. Previously, this task had been carried out by staff. In response, the staff introduced a structured programme of learning designed to build the person’s skills, confidence, and understanding, with the aim of supporting them to safely achieve their goal of greater independence.

Records relating to risk management were not always reflective of the work staff had already undertaken with people in relation to risk management. We fed this back to the management team who said this would be addressed.

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

Staff supported people to maintain a clean, tidy, and hazard-free home environment and ensured that any required repairs were reported promptly.

Staff carried out regular environmental safety checks, including routine inspections of fire safety equipment and fire drills, to ensure both people and staff understood the procedures to follow in the event of a fire.

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, relatives, and staff confirmed that appropriate staffing levels were in place. People who were funded for one-to-one support received this as planned, and staff were consistently available when support was needed.

The provider made sure staff received the right training to meet people’s needs. The registered manager explained that a tailored mandatory training programme was in place, so staff had the right skills for the people they support. This included additional training on learning disabilities, autism, and mental health needs. Staff were also supported to develop professionally through regular supervision, appraisals and opportunities to gain recognised qualifications.

The provider followed safe recruitment practices, including completing all necessary pre-employment checks, to ensure staff were suitable for their roles.

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 received training in Infection Prevention and Control (IPC) and were confident in the correct use of Personal Protective Equipment to help minimise the risk of infection. They supported people using the service to maintain a clean and hygienic living environment.

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.

People were supported by staff to take their medicines safely. Where people were prescribed medicines to be taken ‘as and when’ required (PRN), such as for pain relief, there were clear protocols in place to guide staff on when and how these should be administered.

The provider also had a comprehensive programme in place to support people to become more independent with their medicines administration, where this was their choice and assessed as safe to do so.

Systems were in place to audit medicines management, enabling any administration errors to be identified promptly and ensuring medicines stock levels were accurately monitored.