Brighton Road

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 inspection we rated this key question Good. At this inspection 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.

The provider had systems for monitoring and learning from incidents and accidents. The registered manager and area manager showed us an incidents and accidents log and told us these were monitored to identify any trends. They told us when trends, for example with specific behaviours, were identified they worked with staff and relevant health and social care professionals to support people to self-manage their behaviours. A staff member told us about an incident that had occurred, how the issue could be better managed was discussed as a team. They told us how the team put measures in place to reduce the risk of the same thing occurring again.

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.

Assessments of people’s needs, risks and wishes were completed upon admission and regularly reviewed to ensure they were reflective of their current needs. Information was available and shared with other health care services such as hospitals when this was required. For example, people had hospital communication passports which outlined their health care and support needs for 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.

The provider had procedures in place to protect people from abuse. Staff told us, and training records confirmed, they had received training on safeguarding adults from abuse. They felt confident any concerns they raised would be managed appropriately. One staff member told us, “IfI am worried about an individual, I will inform my manager. There is an external manager we can escalate concerns to. I can also use the whistle blowing procedure if I have any concerns.” A person using the service told us, “I feel safe because the staff care and l can speak to them if something goes wrong.”

Where people needed to be deprived of their liberty to keep them safe, the provider ensured a Deprivation of liberty Safeguard (DoLS) authorisation was applied for through the relevant local authority. All legal applications had been made in accordance with DoLS, this meant people’s rights were fully respected. The registered manager had oversight of DoLS applications, authorisations, and any conditions. Training records showed that all staff had received training on the Mental Capacity Act (MCA) and DoLS.

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 had individual risk assessments in place relating to for example choking, epilepsy, falls, accessing the community safely, eating and drinking, bathing and showering, risk to self and others and mental health relapse. People also had individual emergency evacuation plans in place which highlighted the level of support they required to evacuate the building safely in the event of an emergency.

People received safe care from staff who understood and managed risks effectively. A staff member told us how they supported people at risk of choking and with medical conditions such as epilepsy. They told us they helped people to eat safely by cutting up their food and monitoring them whilst they ate. They explained what actions they would take if someone was choking for example back slaps, abdominal thrusts and calling emergency services. This information was recorded in people’s care records. Where people were at risk of seizures, they followed the persons care plan. For example, making the surroundings safe, staying with a person when they had a seizure to ensure the person did not injure themselves, administering medicines if required and calling emergency services if deemed necessary.

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

The design of the premises was safe and met people's needs. People had their own bedrooms which they personalised with furniture and belongings. A person using the service showed us their room and told us, “I have all my things I like in my room, its nice.”

The provider made sure the environment and equipment used was safe and regularly serviced, for example, fire alarm system, portable appliances and gas safety. Checks were undertaken on window restrictors and regular fire drills were carried out. People had individual emergency evacuation plans in place which highlighted the level of support they required to evacuate the building safely in the event of an emergency.

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.

The registered manager showed us a staff rota and told staff numbers were arranged according to the needs of people using the service. If extra staff was needed for additional social activities or health care appointments this was included onto the rota. We observed there were enough staff deployed at the service to meet people’s needs and keep them safe. A person using the service told us there was always enough staff to support them. A person using the service told us, “I get the care and support I need and want.” A staff member told us, “Most of the time there is enough staff on shift, if we are short of staff, the manager will arrange to cover.” Another staff member said, “There isalways enough staff.”

People using the service were involved in recruiting staff to work at the service. The registered manager showed us records from interviews where people asked candidates specific questions about how they would care for people. The registered manager told us people’s opinions were important in deciding who they recruited to work at the service. The provider had safe recruitment procedures in place. Staff files showed all necessary pre-employment checks were completed before staff commenced employment. These included checks on employment history, right to work in the UK checks, references from previous employers and Disclosure and Barring Service (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.

Staff had the knowledge and skills required to meet people’s needs. The registered manager told us that all staff had completed an induction in line with the care certificate. The care certificate is an agreed set of standards that define the knowledge, skills and behaviours expected of specific job roles in the health and social care sectors. Staff had received training relevant to people’s needs for example dysphagia, epilepsy, and dementia awareness. They had also completed Oliver McGowan training; this is a training program aimed at improving the care and support provided to autistic people and people with a learning disability. Staff told us and records confirmed staff were receiving regular supervisions and appraisals from their managers.

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.

The service appeared clean throughout and free from odours. Daily cleaning routines were in place and staff told us they were provided with personal protective equipment (PPE) when they needed it. We saw records from infection control audits carried out by the provider. Training records confirmed that all staff had received training on infection control.

We observed a person using the service cleaning the bathrooms when we visited the service out of hours. They told us this was part of their routine and something they enjoyed doing. Another person using the service told us, “Thisisour house which isniceand clean.I’mhappy here.”

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.

People received their medicines safely and as prescribed. A person using the service told us, “The staff help me with my medicines, or I might forget to take them.” We saw medicines were administered by trained staff who had completed up-to-date medication competency assessments. A staff member told us, “I do medicines management training online. Themanager checks my competency, and Ican’tadminister medicines to people until this is done.”

Medication administration records (MARs) were completed accurately, with clear signatures and reasons for non-administration were recorded where appropriate. As and when required medication protocols were in place, these included guidance for staff on when to administer these medicines. Medicines were stored securely in locked cabinets within the service. Controlled Drugs (CDs) were stored in CD cupboards and managed in line with our regulations. Regular audits of medication practices were carried out by the management team. Where issues were identified, action plans were put in place and followed up to completion.

The registered manager told us the service was adhering to ‘stopping over medication of people with a learning disability and autistic people’ (STOMP). Thisis a national NHS England work programme to stop the inappropriate prescribing of psychotropic medications, an identified priority in the NHS Long Term Plan.