Edwardian

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 people were protected from abuse and avoidable harm. At our last assessment we rated this key question good.

This meant people were safe and protected from avoidable harm.

We assessed a limited number of quality statements in the safe key question and found areas of good practice. The scores for these areas have been combined with scores based on the rating from the last inspection. At this assessment the rating has remained good.

This service scored 78 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to accomplish this. 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 robust processes in place in relation to safeguarding. There were no indications of a closed culture. Inspectors were able to speak to people freely, and people appeared happy to be involved in the assessment. Staff also appeared to be open and relaxed talking to inspectors. [HB1][PR2]Care records also evidenced discussions around personal and sexual safety had taken place at appropriate intervals. Online safety was also considered by the service and noted in care plans. Staff delivered care and support in line with care plans which had been co-produced.

At the time of inspection nobody living at the service was subject to Deprivation of Liberty Safeguards (DoLS), however the Registered Manager was aware of the process.

Safeguarding concerns were appropriately recorded and reported, with information checked on site consistent with records of notifications held by CQC.

The provider always worked well with people to fully understand and manage risks by thinking holistically. Staff provided care which fully met people’s needs and was safe, supportive and enabled people to do the things which mattered to them.

Each person’s care plan was fully person-centred, with an excellent level of co-production throughout. The care plans were worded very clearly and simply, avoiding jargon and medicalised terms wherever possible so they were easy to understand for staff, people and relatives. This made a difference to reviews because people and families were able to recognise change, have a say in next steps and over time recognise genuine progress. A relative told us that this had led to an improvement in their loved-one's confidence and wellbeing.

All care plans were up to date, with flags in place to prompt co-produced reviews, undertaken monthly, to ensure that they represented people’s current needs. Changes between reviews were included in handover notes with highlighted sections to feed into reviews. This was important because some people’s needs fluctuated as all were experiencing change for different reasons.

The care plans included elements referring to risk, for example developing a person’s confidence to go out in a small group, then independently, then to potentially volunteer with an aim in the future to seek employment, when they felt ready. The care plans were realistic regarding risk; for example, a person who had experienced some antisocial behaviour discussed how they could remain safe and where to go if an incident was to happen again.

People were supported to make decisions about going out in small groups, pairs or alone if it was what they wanted to do. We observed discussions taking place between people and staff about where they would go, how they could travel safely, what time they needed to set off; how much transport and an activity plus refreshments would cost. At no time did staff impose their opinion, they guided gently by making suggestions like “do you think you might get hungry before you come back?” or “has your phone got enough charge?” as a prompt for people to act themselves.

A person told us, “I can do whatever I want when I choose to, but I like to let them know where I am going, I feel safer.”

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

The provider madesure there were always enough qualified, skilled and experienced staff, who received thorough support, supervision and strong development opportunities. They worked together well to provide safe care which met people’s individual needs.

The service had a small staff team appropriate in size for the number of people living at the service. The Registered Manager had thought carefully about a recent recruitment and employed a staff member with an excellent background in care as well as some IT and administrative skills to assist the whole team transition from paper to electronic records.

There was a low turnover of staff, with some having worked for the service since it started and had progressed to a senior level. Staff spoke positively about the culture at the service and were observed working seamlessly as a team.

Training and development records were appropriate and kept up to date for all staff. The Registered Manager identified new training opportunities for staff and discussed the advantages and disadvantages of these with the team and also key external partners. The service participated in Local Authority sector developmental opportunities, to share and learn from best practice.

The staff were from a diverse range of backgrounds, but all lived locally, so they had a good knowledge of the area so were able to provide reliable guidance about safety to people going out independently.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

The provider made sure 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. There were robust processes in place around medicines management and optimisation. Medicines were stored securely, logs were kept consistently and stocks matched these records. There was a protocol in place for the safe disposal of medicines. Emollient creams and diabetes medicines which needed to be refrigerated were stored at appropriate temperatures.

Care plans were consistent regarding medicines, with flags set up on the electronic record to alert if any dose was not recorded in good time. Care plans included notes of medicine reviews and any changes. The service had a longstanding relationship with the local pharmacy and was able to liaise well with the local GP surgeries.