HF Trust - Phillippines Close

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 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 were confident to report any accident, incidents or safety concerns. These were reviewed by the service manager and shared with other professionals as appropriate. Team meetings were used as an opportunity to discuss any improvements needed or lessons learnt about best practice.

Some people had anxieties which they may present verbally or physically. After any incidents staff and people had the opportunity for a debrief to discuss how they were feeling and if there were any concerns about their safety. This helped to foster a learning culture within the service. Some people with anxieties received additional support from the positive behavioural support team (PBS). PBS isa person-centred approach that aims to improve the quality of life for people who find it difficult to communicate their distress and anxiety.

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.

The service had established relationships with a range of health care professionals including community nurses, occupational therapists and dieticians. Referrals had been made to health professionals in a timely manner and professional guidance was followed.

Hospital passports were in place to support people when they needed to go to hospital or attend clinic appointments. These records contain all the necessary information for external professionals to know about the person’s health. Staff told us hospital passports had been given to health care staff when people had attended hospital. A relative told us about their family member, ‘‘He was in hospital. He only started to get back to normal when he got back home to Phillippines Close. They look after him well."

The provider worked with people and partners to understand what being safe meant to them and the best way to achieve that. Staff understood how to ensure people lived in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

Staff had received training in how to recognise and report abuse. They knew how and to whom they should report concerns both internally and also to external agencies should they not be listened to. The provider had reported safeguarding concerns to the local authority who is the lead agency for safeguarding. Safeguarding was discussed at team meetings and staff supervision.

Safeguarding and keeping safe was discussed with people at house meetings. People had been asked what they would do in specific situations and responded they felt confident to tell staff if something was wrong. When it had been identified people had specific safety needs, staff had acted to keep people safe. This included listening to people’s concerns and staff intervening appropriately when there were disagreements between people. People and their relatives told us they felt safe at the service. One person told us, “Yes, it is usually relaxed here.” A relative said about their family member, “Yes, he’s definitely safe.”

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that DoLS applications had been submitted to the appropriate authorising bodies where required. There were systems to monitor deprivations of liberty (DoLS) to ensure people were only deprived of their liberty to receive care and treatment when it was in their best interests and legally authorised under the MCA. The provider was aware of and complied with any conditions attached to authorisations.

The provider worked with people to understand and manage risks. Staff provided care to meet people’s needs that was safe and supportive.

People’s care and support records contained risk assessments relating to their health and social care. These included enabling people to pursue their interests, maintain relationships and be a part of their community through positive risk taking. There was guidance about how to support people with any equipment they needed to move around their home and about peoples’ health conditions. Staff knew how to put this knowledge into practice to keep people safe. For example, they were able to describe how they knew someone was affected by a specific medical condition and the steps they should take, as indicated in the person’s care records.

Risks relating to the management of constipation were well managed. NHS England has highlighted that people with a learning disability are at significantly higher risk of constipation than the general population. Some people were prescribed medicines if they did not have a bowel movement for a specific number of days. Staff made a record of when people at risk of constipation had had a bowel movement, to ensure medicines could be to be given as prescribed to minimise the risk of people being constipated.

Some people had risk strategies around their anxieties and emotions which had been developed by the positive behaviour support team (PBS). These set out how to recognise the early warning signs that a person was becoming upset and the actions staff should take to reassure them. PBS staff reviewed incidents in relation to each person and adjusted the person’s plan as necessary. The provider acknowledged there had been a reduction in the number of staff in their national PBS team and that reviews of people’s plans had not always taken place in the expected timescale. They were working towards increasing staff numbers.

Each person had a personalised evacuation plan with clear guidance for staff and emergency services on the support they would need to evacuate the building safely in the event of a fire. This information was easily accessible. There was also a portable kit of essential items for staff to grab by the front door in the event of a fire.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

There were regular visual checks of the environment to make sure it was safe and free from hazards. Staff said they were confident to raise any safety issues with the management team. Essential servicing had taken place such as the maintenance of gas, water and electricity. Regular checks and maintenance were carried out of fire fire-fighting equipment and moving and handling equipment. Staff practiced fire evacuation to ensure they were competent they knew what to do in the event of a fire.

Each house had wide corridors so there was adequate room for people to move around their home who required mobility aids or a wheelchair. Each house had 2 lounges which gave people the option of where they wanted to spend their time and helped people feel safe. A relative told us, “When she wants a quiet time, she just sits in the little lounge."

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.

New staff completed an induction, including shadowing experienced staff, completing essential training and the care certificate before working on their own. The care certificate are the standards employees working in adult social care need to meet before they can safely work unsupervised. Staff said their induction was comprehensive and they were well supported by the staff team.

Staff had undertaken training relating to the wide range of strengths and impairments that people with a learning disability and autistic people may have. Some people had specialist needs and the service had ensured there were sufficient staff available with these skills. The service manager regularly reviewed staff training to ensure it was refreshed regularly so staff kept up to date with best practice. A relative told us about staff, “They’re well trained.”

The staffing levels required for each person were assessed before they moved to the service in partnership with the funding authority. People had shared staffing hours and some people also had additional one to one hours to meet their needs. Although there was a high percentage of agency staff supporting people, the majority had worked at the service for a significant period of time. Comments from relatives included, “There are enough staff. A while back, there wasn’t, but they’re very good at trying to keep the same staff there”; “They do change staff quite a bit but they’re still very friendly”; and “I do recognise the staff: It's generally consistent. It’s mix of regular and agency.”

The provider had undertaken all necessary checks for new staff to ensure safe recruitment decisions. This included obtaining work references, explanations for any gaps in people’s employment history and Disclosure and Barring checks (DBS). DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

The provider assessed and managed the risk of infection.

The provider had systems and processes in place to assess and manage the risk of infection. Staff had received infection prevention and control training and understood what to do to mitigate infection risks. There was a daily cleaning schedule and checks to ensure all areas of people’s home were cleaned to an appropriate standard. The service was clean on the days of our assessment. Comments from relatives included, “It’s always clean and tidy” and “She has a lovely room. It’s kept so nice and clean.”

There was an adequate supply of personal protective equipment (PPE) such as gloves and aprons, to provide safe care. We observed staff using PPE appropriately throughout people’s homes. A relative told us, “They always wear gloves and full PPE if needed.” Relatives said people were involved in keeping aspects of their home clean and their bedroom tidy.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

People’s medication records showed they had been given their medicines as prescribed by their doctor. Staff who administered medicines had received training and had their competency checked. We observed staff giving people their medicines and then signing the medication administration sheet as a record that they had received their medicines.

Each person had a medicines record which contained essential information about the management of their medicines. There were protocols in place for people prescribed medicines to be taken when needed. Body maps guided staff to which part of a person’s body topical creams should be applied.

Medicines were stored securely and at the correct temperature to ensure they were fit for purpose. There was a clear audit of medicines coming into and leaving the service. This included medicines which are at higher risk of misuse and therefore need special storage and closer monitoring.