Availl (Norwich)

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 inspection 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.

At our last inspection the provider was in breach of regulation in relation to management of risk. At this inspection the provider had made improvements and was no longer in breach of regulation.

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.

Staff told us they felt supported and able to speak up, describing managers as “very approachable” and “always available when I need to talk”. Learning from audits was evident, including medication spot checks, monthly feedback audits and regular staff file audits. These identified small administrative issues and the provider took steps to address them.

The provider discussed incidents in team meetings and staff were encouraged to request additional training where needed.

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.

Systems for monitoring safety were embedded, including [Red, Amber Green] RAG rated risk assessments, weekly or monthly audits, and daily checks for people with higher needs. Staff understood escalation procedures and followed them appropriately. Transitions with health professionals were managed well; for example, medication changes were recorded and communicated promptly, and district nurses were contacted where needed.

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 and staff were confident the service was safe. Staff understood safeguarding and could explain the signs of abuse and how to report concerns. Staff told us, “Safeguarding is protecting people from harm and ensuring their dignity and wellbeing,” and described strong confidence in managers to take action.

The safeguarding policy was clear, and staff had completed mandatory safeguarding training.

There was no evidence of unmanaged safeguarding concerns. However, safeguarding themes were not routinely reflected in team meeting minutes. Strengthening this would help embed learning and quality improvement.

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 now robust and captured people’s strengths and independence. Staff encouraged safe mobility, supported decisions about personal care, and used clear communication strategies where people needed support to express their wishes.

People were involved in decisions about their safety and care planning wherever possible. Care plans showed strong person-centred practice, with clear descriptions of people’s preferences, routines and what mattered to them. Staff involved families appropriately, particularly where people had reduced capacity or communication needs.

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 received care in their own homes, and the provider had completed environmental risk assessments for each property. These included checks on fire safety equipment, gas and electricity shut off points, access routes, pets, and any home specific hazards. Staff were familiar with emergency arrangements and knew how to support people to evacuate safely.

Staff used appropriate equipment such as hoists and mobility aids, which were serviced and used in line with training.

Records showed that health and safety checks were consistently completed. We did raise however, minor improvements could be made by strengthening documentation around follow up after environmental incidents, such as falls, to show how learning was applied.

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.

Recruitment practices were safe and robust. Staff files contained Disclosure and Barring Service [DBS] checks, verified references, interview notes, identity documents and training records. Any gaps in employment had been explored.

People told us staff arrived on time, were reliable and knew them well. Staffing levels met people’s needs, and the provider monitored availability and rota planning through the access app. Staff said rotas were fair and they felt supported.

Staff received mandatory and specialist training, including medication, moving and handling, MCA, dementia, PEG care and safeguarding. Training compliance was high, though a few courses were approaching renewal dates. Staff received supervision and said they felt valued by management.

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.

Infection prevention and control (IPC) procedures were well established. Staff followed clear instructions on hand hygiene, Personal Protective Equipment [PPE] and cleaning routines relevant to people’s homes. Care plans included guidance for catheter care, PEG feeding, continence support and skin integrity.

People told us staff were clean, respectful and followed safe hygiene practices. For example, carers supporting PEG feeds used strict hygiene protocols and recorded daily checks. Staff understood how to reduce infection risks and when to escalate concerns.

Environmental risk assessments included IPC considerations such as safe waste disposal and cleaning expectations. The provider had a PPE policy and cleaning rotas in place.

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, and staff followed clear medication policies. Only trained staff administered medication. MAR charts were completed accurately, with daily and monthly audits showing strong practice. Where an error occurred, staff reported this immediately and the provider took appropriate action.

People with complex needs, including PEG administration, had detailed guidance in place. Medication changes were recorded and communicated appropriately. Staff understood PRN protocols, topical applications and allergy information.