West Lancashire Short Break Services

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 72 (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 service appropriately investigated and reported safety incidents; and was open and transparent when things went wrong, using information as an opportunity for learning. A relative told us, “[Staff] don’t try to hide [incidents] at all. It’s all written down, they are very honest about it.”

Staff could confidently explain systems and processes for responding to and recording incidents or accidents, and confirmed information was discussed in staff meetings or debriefs.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, and ensured there was continuity of care when people moved between different services.

The service worked with people and their relatives to establish a plan of care prior to initial stays. The manager shared a new starter pack; including guidance about referrals and a service user guide, and several processes helped gather information about people. For example, reviews of local authority assessments, meetings with relatives and observations at day centres or colleges.

People were supported with introductory visits to help ease their transition into the service. A relative told us, “We had tea visits and went to an open day. It was a gradual thing, staying for an afternoon then a first night.” Another added, “The transition was done very slowly, it was excellent.”

The provider 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 service shared concerns quickly and appropriately.

The service had clear safeguarding systems and processes to protect people. Concerns were reported, recorded and responded to appropriately, and safeguarding was discussed as an agenda item in staff meetings. Staff had access to safeguarding training and the service’s policies advised them on how to respond to different situations such as unwitnessed falls, medicines errors, abuse and neglect.

Relatives confirmed people were safe from abuse and neglect. A relative said, “[Person] is definitely safe, they are totally at ease there.”

The service ensured people were deprived of their liberty lawfully, when in their best interest. Where necessary, Deprivation of Liberty Safeguards (DoLS) were applied for and renewal dates were tracked.

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe and supportive.

Staff did not ensure information about risks to people was robust, so we could not be assured care always met their needs safely. A person displayed behaviours which communicated a need, emotion or distress including potential aggression towards staff. Behaviours had been noted in their support plan but there was a lack of detailed strategies to ensure they could be supported consistently in a safe, agreed and positive manner. Records relating to restrictive practices they had in place had not been reviewed in 2 years and did not cover all restrictions in place, or the associated risks.

People’s support plans guided staff on what a good day or a bad day may look like for them, but information did not always include the support people needed to help minimise bad days.

However, systems were in place to record, analyse and share learning following any behavioural incidents. A staff member told us, “On arrival I will look in the communication book which will highlight any issues [behavioural incidents]. Records are kept in the office, and we usually have conversations in team meetings to discuss what’s worked well or what’s not worked. We will try to identify any triggers.”

A multi-disciplinary approach had been taken in response to a person’s behaviours, including involvement from the service’s positive behavioural support lead, social worker and learning disability nurse. Other mitigation had been put in place in the interim to reduce risk.

Following our feedback, the manager provided assurances that information had been reviewed and updated, with involvement from relatives and external partners.

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

Staff could explain what they would do if an emergency evacuation was required and told us they took part in regular fire drills. People had detailed personal emergency evacuation plans in place.

The safety of the premises, communal areas and bedrooms were checked and managed to support people to stay safe. Staff undertook several regular safety checks of the environment, and there were systems in place to ensure external servicing was carried out within the required time frames.

Elements of the environment had been designed specifically to improve people’s safety. For example, a self-contained annex was available to facilitate stays for people requiring their own space and blinds were built into glazing to prevent incidents.

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 service had recruitment processes to make sure all staff were recruited safely and had the necessary checks in place prior to starting to work with people. Managers completed induction checklists, and probationary meetings were held to ensure staff had the skills and capabilities to meet people’s needs.

Staff they had access to appropriate training, received regular supervisions and felt well supported. A staff member told us, “There are good levels of training and supervisions are monthly, more if needed.” Personalised training plans detailed the service’s expectations for staff to complete mandatory and refresher training, and any specific courses needed to meet the needs of people.

However, a couple of relatives fed back occasionally, there were not enough staff to safely facilitate placements.

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.

There was an effective approach to assessing and managing the risk of infection. Housekeepers were available most days, and the service was observed to be clean and tidy throughout. A person told us, “It’s always clean and tidy. They have a cleaner Monday to Friday and staff do it at the weekends.”

Staff had access to annual infection prevention and control (IPC) training and an IPC champion supported the team. Personal protective equipment, soluble laundry bags and hazardous waste bins were provided to ensure good levels of hygiene.

Staff supported people to maintain their personal hygiene when required. Care records evidenced people received regular support with personal care.

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

Relatives were contacted prior to stays to discuss changes to people’s health or medication; and appropriate systems were in place to record, store and return medication safely. People’s medicines were carefully checked on entry into the service and records were completed clearly, often double signed and checked by the manager to minimise the risk of errors.

Staff had a good understanding of Stopping the Over Medication of People (STOMP). They explained how they would try to reduce potential triggers or utilise non-clinical methods of managing people’s behaviour, reducing the need for medication. For example, attempting to deescalate a situation, offering a distraction or redirecting people to a quieter area.