Milford Del Support Agency

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 improved to Good.

Good: This meant people were safe and protected from avoidable harm.

The provider was previously in breach of the legal regulations in relation to safe care and treatment, safeguarding people from abuse and staffing. Significant improvements were found at this inspection and the provider was no longer in breach of regulations.

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.

Incidents, accidents and ‘near misses’ were clearly recorded and regularly reviewed by the registered manager.

The quality manager also analysed this information and provided a report to the provider, to identify and implement improvements.

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 service supported people and families to be fully involved when moving between services, completed comprehensive strength-based assessments and established core staff teams. We saw people had consistent person centred support and transitions went smoothly. A person told us, “I was worried about leaving hospital and being supported at home, but Milford Del were great, the staff visited me frequently in hospital and we got to know each other. I had trust in them and could look forward to going back home, staff have my back and support me to discuss my views with my clinical team”.

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.

There were appropriate policies in place to protect people from abuse and staff had training in safeguarding adults and children. Staff could describe actions they would take if they suspected or saw abuse. Contact numbers for the management team, the local authority safeguarding team and Care Quality Commission were also available to staff. The registered manager told us there was always a manager on call outside of office hours, in case of emergencies. The management team knew what action to take if concerns or safeguarding issues were passed to them. Records showed the registered manager had reported and investigated incidents appropriately and promptly when required.

Where restrictive practice was being used, they were legally justified, proportionate, necessary and as a last resort. There was a clear commitment to reducing them. All restrictive practices were recorded in people’s Deprivation of Liberty Safeguards. Deprivation of Liberty Safeguards (DoLS) are a legal framework within the Mental Capacity Act 2005 in England and Wales, designed to protect vulnerable adults who lack the mental capacity to consent to their care or treatment and who may be deprived of their liberty as a result.

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.

Risk assessments were clear, detailed, and reviewed often to keep people safe.

People were fully involved and supported to take positive risks. For example, a person who had long expressed a wish to live independently was helped to work towards their goal through small, manageable steps. The person and their core staff team held weekly meetings to track progress and carefully manage potential risks. Over time, the person had become able to spend half the day without direct support. Previously, they had required continuous staff assistance throughout the day.

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

People were encouraged to take part in checking the safety of their homes and the equipment they used. For individuals who felt anxious about fire alarms, tailored support was provided to build understanding and reduce fear. By involving them in alarm testing at home and the local office, one person successfully gained the confidence and ability to evacuate independently when the alarm sounded.

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.

The service had recruitment checks, in line with legal requirements, to make sure only suitable staff were hired. Staff were placed in teams and given training tailored to the needs of people they were supporting, this included suitable training in working with autistic people, people with a learning disability, positive behaviour support and person cantered care, This meant people were supported by skilled staff who understood their needs.

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 supported people to keep their homes clean and safe from infection. Staff used Personal Protective Equipment when needed, understood how to stop infections spreading and spot checks were completed regularly. Staff encouraged people to maintain their personal hygiene, keep their homes clean, some people had developed their skills and could tell us how to stop germs spreading and stay safe.

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

Staff safely supported people with their medicines and kept clear records. When people were prescribed medicines to take ‘when required’ for periods of agitation or distress, staff had clear, person-centred guidance on how and when to administer them. We saw evidence people were supported in line with this guidance, to ensure they were only administered as a last resort. Staff knew how to report medicine concerns and followed guidance. Creams were used with clear body maps to ensure people had creams administered safely. Staff were trained, competent, and regularly assessed to make sure best practice was followed and people received their medicines safely.