South East London

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.

This is the first inspection of this service. This key question has been rated 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.

People told us they felt safe. The service ensured incidents and concerns were immediately investigated and changes made to people’s care and support where required.

Staff were involved in discussions about safe practice through supervisions, team meetings and other regular contact with the registered manager to ensure lessons were learned. Staff told us they received the information they required in a timely manner when there was any change in a person’s care and support needs.

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.

Staff liaised with healthcare professionals, such as GPs and district nurses, to ensure a joined-up approach to meeting people’s needs. They had regular meetings with healthcare multi-disciplinary teams to ensure they were meeting people’s needs effectively. People’s care plans included guidance for staff provided by other professionals.

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 were provided with information about safeguarding and knew how to raise any concerns they might have. Staff had received safeguarding training. They understood their roles and responsibilities in ensuring people were safe and reporting any incidents or suspicions immediately. Information about people’s capacity to consent was included in their care plans. Capacity assessments had been carried out, and these reflected the best practice guidance associated with the Mental Capacity Act 2005 (MCA).

The service reported safeguarding concerns to the Local Authority when they arose. They had also provided required safeguarding notifications to the CQC.

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.

People, and their relatives where appropriate, were involved in developing their individual risk assessments and risk management plans. These demonstrated a focus on enabling people to maintain and increase their independence. People’s risk management plans contained detailed guidance for staff on how to minimise risk while respecting people’s preferences. Risk assessments included guidance on supporting people to safely access the community where they required support to do this.

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

Individual risk assessments had been carried out for people’s homes and the immediate environment. Risk management plans included guidance for staff on minimising any identified risks. They included checks of any care and mobility equipment before and after every use.

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.

Staff were recruited safely. Staff received an induction before commencing work with people. Core training for staff was ‘refreshed’ annually. Training on people’s individual needs, for example, training on epilepsy awareness and specialist feeding systems, was also provided to staff when required. Staff spoke positively about the quality of the training and support they receive

People were supported by regular staff who knew them well. Most people receiving support with personal care were supported on a 24-hour basis and had their own care team. These teams were supported by a team leader who provided emergency covered for staff where there were unplanned absences.

The registered manager told us there was ongoing recruitment taking place to build capacity as the services grows.

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.

People’s risk assessments included guidance for staff on reducing and managing the risk of infection. This was supported by policies and procedures which reflected current best practice. Staff had received training in infection prevention and control, including food safety. They confirmed they knew what to do and how to report if they identified any symptoms of infection. People confirmed staff used personal protective equipment (PPE), such as disposable gloves, aprons and masks, when they were providing care.

The registered manager told us supplies of PPE were sent directly to people’s homes when staff alerted them to stocks running low.

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.

Staff had received training in safe administration of medicine. Where required, additional training was provided, such as in relation to providing medicines through, for example, a percutaneous endoscopic gastronomy (PEG) feeding tube where people had difficulties swallowing.

Risk assessments had been carried out for people who were supported to receive their prescribed medicines,

People’s medicines records were up to date and correctly completed. These were audited by the provider on a regular basis.