The Piers

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 service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Staff reported accidents and incidents in line with the provider’s policy, and these were investigated by management. A staff member told us following accidents or incidents, “Staff receive feedback through regular team meetings and supervisions, where we approach all the topics and come with suggestions and things that can be changed for the future.”

The service 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.

People’s information was kept up to date through regular reviews. There was a process in place for sharing information when people moved between services, for example when they went into hospital. The registered manager explained if people were admitted to hospital, staff would continue to support them to help reduce anxiety and ensure their needs were met in line with their wishes. A guide was in place to support people when moving into the home.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They 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 registered manager told us there had been no recent safeguarding concerns. This was because people were supported by staff who knew them well and provided care in line with their preferences. When a safeguarding concern had occurred previously, the registered manager explained that they learned from it and made changes to prevent a recurrence.

Policies and procedures were in place. Staff had received safeguarding training and knew how to identify and report potential safeguarding concerns. Staff told us they felt confident raising safeguarding concerns with management.

We checked whether the service was working within the principles of the Mental Capacity Act, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty. The registered manager had oversight of these applications and authorisations, which ensured people’s rights were respected.

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People and relatives told us they felt people were safe living at The Piers. One relative told us their loved one was safe because staff were “very aware of their needs.” Potential risks to people had been assessed and measures were in place to reduce the risk of harm. For example, around behaviour support and choking. Risk assessments were reviewed regularly. Staff told us care plans and risk assessments were updated when people’s needs changed, and staff were informed of these changes so they could support people in line with their wishes.

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

People were protected from risks within their environment. The provider had environmental risk assessments in place, for example around fire safety and legionella. Health and safety checks of the environment were carried out. Staff knew how to report concerns, including when people’s needs changed.

The service 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 had the skills and knowledge to meet people’s needs. The provider ensured staff received appropriate training and their competency was checked to ensure they worked safely. For example, medicines competency assessments were completed. Staff also received regular supervision.

Pre-employment checks were completed before staff started work. New staff completed an induction, where they were allocated a buddy, shadowed the management team, completed a workbook and relevant training. Night staff also worked in the day to help build relationships with people. The registered manager had focused on developing the induction process and supporting staff. As a result, staff turnover was low, agency staff were not used, and people were supported by staff who knew them well.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People were protected from the risk of avoidable infections. Staff had received infection prevention and control training. This meant they knew the importance of working hygienically and using personal protective equipment (PPE) to keep people and themselves safe. Staff had access to sufficient PPE and the registered manager carried out weekly stock checks to ensure there was enough PPE in line with the provider’s policy.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened.

Staff had completed training, and their knowledge and practice were regularly checked. Medicines audits were caried out and were used effectively to identify shortfalls.

PRN (as and when required) protocols were in place to guide staff on when to administer these medicines. People were supported to have regular reviews of their medicines with their GP. The provider was working in line with published guidance to ensure people were not over-medicated.