Dignus Support

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 systems in place to learn when things went wrong. Incident forms were completed within the system, and these were reviewed by the management team. When learning was identified the registered manager shared this with staff and across the wider provider group to prevent incidents from happening again. We saw where an incident had occurred this had been discussed in a review meeting and learning had been shared with staff. The provider had plans in place to improve the incident management systems by using a different electronic system to give more opportunities for analysis. The registered manager was keen to continually improve systems. Staff confirmed learning from incidents was shared with them and they had the opportunity to discuss the incidents and learning within their meetings on a regular basis. Partners told us they felt the service adopted a learning culture at a local level and this was further supported at an organisational level. This meant the provider had a positive culture of safety where lessons were learned to continually identify and embed good practice.

The provider worked with people and healthcare partners to establish and maintain safe systems of care to ensure people had a smooth transition into the service and were supported safely. Leaders told us they had systems in place to support people to transition into the service. The systems included working with people, relatives and other professionals to carry out an assessment, develop a care plan and draw up a transition plan. Staff told us when people came into the service, they had information provided about people’s medical history, a recent assessment, and information about any health conditions. Staff said there were immediate care plans in place to guide them on how to support people and then this built up over time to a more detailed plan once they got to know people. Care plans were completed which had been co-designed with people, relatives, and other professionals to ensure people were supported safely.

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. Relatives told us they felt confident people were safe and they understood how to raise any concerns they had about people and felt these would be addressed. We saw staff received safeguarding training, and this was a regular discussion area in team meetings. Staff understood how to recognise abuse and could describe how they would raise any concerns. Leaders told us they had a policy in place which guided them to report any concerns to the local authority. The provider had systems in place to ensure all incidents of abuse were reported to the appropriate body. The provider also was a part of a local safeguarding forum to enhance their practice in this area. Leaders could describe how incidents were logged, monitored and how learning was taken from any incidents to help prevent issues reoccurring. Records supported what we were told.

The provider had systems in place to manage risks to people’s safety and staff understood how to manage risks. Relatives told us people were supported to maintain their safety. Staff could describe how they supported people when they experienced distress to minimise the risk of harm to people and those around them. Leaders told us individual risk assessments were completed for people in the electronic care records system, and these were reviewed between 1 and 3 monthly, depending on the risk. Records supported what we were told, we saw risks relating to oral care had been considered for 1 person, there was guidance in place for staff on the level of risk and how they could support the person, including how to escalate any concerns. There were specific risk assessments and management plans in place for some people who required medication which presented with risks and required monitoring. We saw plans in place to manage risks from distressed behaviour. All the management plans were reviewed regularly.

The provider ensured equipment, facilities and technology were in place and well maintained to support the delivery of safe care. Relatives told us people’s home were clean and well maintained. Staff told us about equipment in place to support people in their homes and how they used this to ensure people were safe. If people needed repairs completed, staff could seek these from the landlord and they were done promptly. Risk assessments were in place to manage risks associated with people’s environment.

The provider had systems in place to ensure there were enough qualified, skilled and experienced staff to support people. Relatives and staff told us they thought there was enough staff to support people safely. A staff member commented, “We have good staffing levels, we are currently slightly over staffed at present, and this helps to cover annual leave.” Leaders told us they used a matching process to match staff with the people who needed support. This meant staff would have similar interests to people and be able to engage with them well. Leaders told us people had individual and shared support hours agreed with the commissioners of people’s care. This meant people were supported safely by staff who understood their needs and had the right skills to support them. Staff were recruited safely. The provider had systems in place to check staff suitability for working with people and an induction, shadowing and training were given to all new staff. Records we saw supported this.

The provider had systems in place to detect and control the risk of infections spreading and shared concerns with appropriate agencies promptly. Relatives told us people had support to ensure their home was clean. Staff told us they had received training in infection prevention control, and they had access to protective equipment. Leaders told us there was a risk assessment in place for infection prevention control. They told us where people had any infections, a specific risk assessment and management plan would be put in place. Leaders told us there were infection prevention control procedures in place and staff had received training. A regular audit was completed to check on this and there was a policy in place to guide staff practice.

The provider had systems in place to ensure people received their medicines safely.Leaders told us everyone had a risk assessment and care plan in place for their medicines. They described all staff having access to medicines training and a policy was in place to guide staff on safe medicines administration. Medicines were stored safely in people’s homes and there were checks in place to ensure staff had administered medicines as prescribed. Medicine administration records were in place in the electronic system and were accurately completed. Where people had ‘as required’ medicines there was a protocol in place to guide staff on how and when to administer these medicines. People received their medicines safely. A relative told us, “Medicines are kept in a locked cabinet and [person’s name] knows when its due, so I guess they are getting it regularly at the same time.” Staff told us they had training to support them with administering medicines and guidance was in place to tell them the support people needed.