Business Hub, Simms Cross

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 good. At this assessment the rating has remained 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 provider had a strong culture of learning from past events; critical messages regarding safety events were shared across the staff team from senior leaders via email. The provider established a risk and safety group who met quarterly to review serious incidents, discuss risk management, look at health and safety concerns, monitor infection prevention and control measures and review findings from quality assurance audits. Learning from this meeting was consistently shared via a newsletter, distributed to all staff across the organisation.

The provider had an electronic system for recording accidents and incidents which automatically shared the event with relevant managers and leaders. We saw evidence of learning from past events through analysis and investigation. A debrief meeting was held between staff and managers after events, recording what went right and wrong so this learning could be shared with the wider team supporting the person, ensuring support was improved for them.

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 provider had a clear assessment process to identify people’s needs and determine whether these could be met before they moved in. The assessment checklist ensured the person was eligible for the accommodation and, where relevant, compatible with others living in the service. Following this, a move in plan was developed with the person, their relatives and other key individuals to support a safe and well coordinated transition, taking account of tenancy requirements and the person’s health and wellbeing needs.
This process was underpinned by a Move In and Move On policy. Staff visited people in their current accommodation to begin building relationships, and people were supported to visit the service several times to meet others and familiarise themselves with the environment. Each person received a Welcome Pack containing key information, including contact details and safeguarding 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.

The provider had effective safeguarding arrangements in place, supported by clear policies for staff and managers outlining processes for reporting and staff training. When incidents occurred, investigations were thorough and learning was always shared. Safeguarding concerns were reported to the local authority in a timely manner. The registered manager was always transparent with the local authority regarding any challenges they were facing.

The provider held a workshop during Safeguarding Week on the theme ‘Creating Empowering Environments.’ People were supported to discuss how they make choices, what helps them feel proud, and what would enable them to speak up if something was worrying them. The group also explored how staff could help them feel confident, safe and listened to.
 

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 involved people in understanding and managing risks through a range of accessible and engaging activities. Policy pop up sessions enabled people to review and discuss key organisational policies in a way that made sense to them. People were supported by staff to attend meetings to discuss and contribute to the local authority’s Learning Disability Strategy, ensuring their voices influenced wider safeguarding and risk management priorities. Creative approaches, such as producing a video drama series on the subject of hate crime, supported people to recognise risks and know how to respond. A self advocacy training session further strengthened people’s confidence in speaking up. Monthly themed workshops, covering topics such as sun safety, bowel cancer, men’s health and breast cancer, helped people build knowledge to keep themselves safe and well. People were empowered in different ways to understand, manage and respond to risks, increasing their confidence, knowledge and influence over decisions affecting their safety and wellbeing.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.
The provider demonstrated an established approach to maintaining safe and well managed living environments for people. Staff and managers consistently carried out routine health and safety checks on a daily, weekly and monthly basis. A monthly environmental audit process, led by the manager, provided an additional layer of oversight.
Equipment essential to people’s safety, including moving and handling devices and adjustable beds, had been serviced within required timescales. The provider worked closely with the housing association to ensure repairs and maintenance were completed as appropriate and in a timely manner, escalating concerns when necessary. A fire risk assessment was completed by a fire risk consultant to ensure a safe environment for people.
 

The provider made sure there were always enough qualified, skilled and experienced staff, who received thorough support, supervision and development opportunities. They worked together well to provide safe care that met people’s individual needs.
The provider had robust recruitment processes, supported by comprehensive risk assessments and pre employment checks. When recruiting new staff, the provider involved people in the process where possible, whether that was in the interview or in the short-listing stage. Regardless, each person had a person-centred matching sheet to ensure their interests, hobbies and skills were matched to the potential staff member’s skills and experience. A recently revised thorough induction programme was given to new starters covering training, work environment and expectations, processes and reporting procedures. Staff told us they received regular supervision which they found supportive and beneficial. Training was a mix of face to face and online learning, and staff reported it was effective and appropriate for their roles. Training covered a wide range of topics appropriate and tailored to the people staff were supporting. For example, the Oliver McGowan training on Learning Disability and Autism, a recognised and government backed training programme. People were involved in training staff, sharing their stories as someone with lived experience of being supported.
Managers had progressed from support worker positions, demonstrating a culture of development and internal progression. Staff knowledge was reinforced through team quizzes covering topics such as human rights, values, professional boundaries and safeguarding, and competency assessments were completed for key tasks including medication administration. Staff we spoke with could demonstrate their knowledge of raising concerns, supporting people with a learning disability and discussed how training felt relevant and appropriate for the people they were supporting. It was evident during our visits; staff knew people well and could describe what the person’s needs were and how to vary their support based on how the person is feeling. A family member told us how their loved one had been through a traumatic time in the past, but now, due to consistency and a well-trained staff team, they are in the best place they’ve ever been.

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 were provided with infection prevention and control training, and we observed pictorial cleaning charts in people’s homes, being used to support people to know what needed doing. People were supported to maintain their home and complete cleaning tasks, promoting independence. Managers completed bi-monthly audits which included checking the environment and general cleanliness of people’s homes.

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.
Medicines were managed safely, supported by thorough bi-monthly audits completed by managers and reviewed by internal quality assurance team to ensure actions were tracked and completed.Recently auditing processes had been strengthened following additional training for managers, and team leaders from another area had carried out audits to provide an independent oversight. External oversight was also in place, with input from a social care consultant and the local authority’s medicines management team. Staff had good compliance with medicines training, and most had up to date competency assessments. Medication was accurately recorded in care plans and hospital passports, with no gaps in administration records, and time critical instructions were followed. Topical medicines, such as creams, ointments and patches, were supported by body maps to ensure they were applied correctly. Medicines prescribed on an 'as required' basis (PRN) and covert medicines (where medicines are administered in food or drink) had appropriate protocols, risk assessments and authorisations in place. Medicines were stored safely in clean, secure areas.
The provider had a structured process for responding to medication errors. All incidents were reviewed and risk rated by the registered manager, with high risk incidents triggering a formal investigation and safeguarding referrals where appropriate. Medicines policies for staff and managers were detailed and clearly set out safe medicine processes.