4 Futures

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

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 69 (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.

There were systems and processes in place to ensure people’s safety. This consisted of reviewing individual incidents, embedding changes to practice to avoid recurrence, and routinely analysing information to identify themes and trends to learn lessons when things went wrong.

Reports were produced following this analysis and shared with the staff and people to ensure learning was embedded across the service.

The provider did not always work well with people and healthcare partners to establish and maintain safe systems of care.

There were systems in place to ensure people would experience a smooth transition between services, for example, use of emergency services or a hospital stay.

The provider had agreed to undertake a delegated health care task for an individual requiring support with a specialist clinical intervention. We found that there was not robust clinical oversight in place, however, the provider did work with the delegator intermittently to ensure the persons needs were met.

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. However, the provider did not always share concerns with all the relevant external agencies.

The provider had a robust system, process and policy in place around safeguarding. Staff received regular training and had good knowledge of their responsibility around safeguarding and were comfortable and confident to raise concerns. One staff member told us, “I know all the steps and feel confident that I would be backed 100 per cent by the [colleagues] around me. I know what to do and I would do it.”

We found some occasions where the provider had not notified us in line with their statutory duty to inform us when certain events take place, however, on these occasions they had taken thorough and effective action and worked alongside other agencies, such as the Local Authority to safeguard people using the service. The provider acknowledged this shortfall and embedded change immediately to ensure this did not happen again, during our assessment.

The provider ensured that where necessary, Community Deprivation of Liberty Safeguards were in place.

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 and care plans included information and guidance given to the provider by external professionals, and it was evident that people were involved in managing and establishing ways to mitigate risks.

Risk assessments provided clear guidance for staff on what actions to take to support people to manage risks. Staff told us they found the information helpful in enabling them to do their jobs safely. One staff member told us, “[Risk assessments] are informative,” and “I feel all the information you need is in the care plans.”

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 had robust systems and processes in place to monitor the safety of the environment. Where possible, people were also involved in maintaining the safety of the environment. Staff were knowledgeable in their role to achieve this, including with emergency situations such as a fire. The provider completed practice evacuations intermittently, to ensure plans in place worked for people using the service, and staff retained knowledge about these processes.

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 provider did not always check staff were competent to complete all tasks.

The provider ensured staff completed mandatory, and additional training, to support them to do their roles effectively. Staff were recruited safely, and where staff did not have a background in health and social care, the provider worked closely with them to provide additional training exercises, before they were able to work within the service.

People told us that they really liked the staff team, and relatives fed back that all the staff were “lovely.”

The provider did not routinely check staff were competent to complete all tasks within their roles and refresh their knowledge by retraining them, however leaders did have regular presence within the service and would sporadically observe staff, but there was no structured process or system around this. This meant there was a risk staff would develop poor practice over time.

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.

We found the service to be clean. There were processes in place for staff and leaders to complete to ensure it remained hygienic. Where possible, people were involved in maintaining the cleanliness of the home.

The provider completed audits and checks on the environment routinely and ensured any areas that needed attention were actioned promptly.

Staff had good knowledge about their role and responsibility in relation to infection prevention and control.

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. People’s involvement in their medicines varied dependent on their level of need. There was regular oversight and good practices in place around supporting people with their medication.

During recent heatwaves, the provider had prepared and implemented interim measures to ensure medicines were stored at the correct temperature. The provider could not show evidence that this had been thoroughly risk assessed, however, we were assured that risk had been considered. The provider had identified that there was a better way to manage these situations and already implemented a different process for the future.