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Archived: Allens Mead Good

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All reports

Inspection report

Date of Inspection: 4 April 2012
Date of Publication: 9 May 2012
Inspection Report published 9 May 2012 PDF | 47.91 KB

The service should have quality checking systems to manage risks and assure the health, welfare and safety of people who receive care (outcome 16)

Meeting this standard

We checked that people who use this service

  • Benefit from safe quality care, treatment and support, due to effective decision making and the management of risks to their health, welfare and safety.

How this check was done

We reviewed all the information we hold about this provider and carried out a visit on 04/04/2012.

Our judgement

The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare

The provider was meeting this standard.

User experience

We spoke with people using the services but their feedback did not relate to this standard.

Other evidence

There was evidence that learning from incidents took place and appropriate changes were implemented.

At our inspection on the 1 December 2011 we saw that there was a lack of formal documentation that made it difficult to see how systems to monitor the quality of the service had been used to identify and action improvements. The provider wrote to us and told us that formal documentation will be revised to identify areas for improvements. At this visit we saw that records had been developed by the service to address this.

There was also evidence that learning from incidents took place and appropriate changes were implemented. We saw records to show that the deputy manager was reviewing accident and incident forms and records of behaviour that had been completed by staff. A record had been developed to review the number of incidents on a monthly basis to help monitor individual progress and identify any areas of concern. We saw staff recorded all incidents of challenging behaviour and that these were regularly shared with healthcare professionals to ensure that people were still receiving appropriate support. We saw that all accident records contained a documented review from the deputy manager to highlight any needed actions to staff. These systems helped to identify, assess and manage risks to the health, safety and welfare of people using the service.

The Area Manager also visited the service to perform regular quality checks and identify areas of needed improvement. We saw an action plan in relation to these visits that addressed areas of improvement and documented action taken. The provider may find it useful to note that the dates of the visits were not always being clearly documented.

We also saw that the home carried out regular internal audits in things such as health and safety and fire safety; certain members of staff took a lead in this. Records showed that appropriate action was taken for any identified concerns. This helped to make sure that the home was able to provide the right care and support for people.

The provider took account of complaints and comments to improve the service. The organisation had a nominated lead to regularly contact relatives to ensure they were happy with this. We saw records to show that this information was being shared with the service so that they were able to effectively address any concerns that may be raised.