Opportunities for Adults and Children

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 requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

The provider was previously in breach of the legal regulations in relation to safe care and treatment, and staffing. Improvements were found at this assessment, and the provider was no longer in breach of these regulations.

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 investigated all incidents and reviewed records to help identify any trends or action to reduce the risk of recurrence. Senior staff followed up incidents with people and relevant stakeholders, ensuring people’s care plans were reviewed and updated in response.

Since the last assessment the provider had implemented a clear lessons‑learnt framework to support reviewing and learning from accidents, incidents and complaints. This included, conversational debriefs, competency assessments, spot checks and targeted training updates. Leaders told us how they had worked to move the service away from a previous culture of blame and towards a transparent, learning-focussed approach. They had established an open-door culture where staff were supported to discuss and explore emerging themes, with learning routinely shared to reduce the risk of reoccurrence. Most staff told us they felt listened to and that action was taken when they raised concerns. Some staff, however, described a more mixed experience, noting that while several leaders were approachable and accountable, this was not always consistent across the office team. Leaders acknowledged the importance of maintaining consistent openness and remained committed to fostering a culture where all staff felt heard and confident that learning would lead to meaningful improvement.

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. They completed comprehensive initial assessments with people and their representatives and supported safe transitions into the service, including from hospital. Staff stayed in contact with health professionals to support people safely back to their home. While most staff felt information flowed well, some noted that updates about hospital stays were sometimes delayed. The provider had systems in place to communicate changes promptly, including the use of instant messaging to notify staff of hospital admissions and updates. This supported timely information‑sharing, and leaders continued to reinforce the importance of using these systems consistently.

Care plans were updated regularly to reflect changes in people’s health, mobility, or mental wellbeing. Professionals were positive about the continuity of care.

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 protected from abuse and neglect while still being treated with dignity and having choice and control. Staff and the registered manager knew how to recognise the signs and what to do if they suspected someone was at risk of abuse or neglect.

The provider had effective policies and procedures in place to promote people’s safety. These included procedures around handling people’s money, supporting safe internet use, Easy Read safeguarding information (a clear, simple format designed to help people understand important information) and named safeguarding leads. People felt comfortable and safe using the service. One relative described how the safeguarding process had been effective in resolving a concern; they met with the registered manager and were satisfied that the issue was addressed appropriately.

Staff told us they were listened to when raising safeguarding concerns. The introduction of an electronic system had strengthened accountability, and staff said it had improved the responsiveness of safeguarding processes.

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 were actively involved in managing risks to their safety. Individualised risk assessments assessed and mitigated people’s risks in relation to manual handling, finances and skin integrity.The registered manager told us, “We make sure we are talking to people on a regular basis about their lives, what they want to achieve and work on.”

Staff had a good understanding of people’s risks and the actions needed to reduce them. They supported positive risk‑taking, enabling people to maintain independence and pursue what was important to them, while ensuring they felt fully informed and involved in decisions about their safety. Staff shared examples of supporting people to understand risks and agreed plans to mitigate them. For example, when planning a holiday.

The provider had effective systems to reduce risks related to monitoring care remotely. This included, lone working policies and electronic call monitoring, which helped assure senior staff people were safe as they were receiving their care visits as planned.

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 provider carried out assessments of people’s home environments to identify and reduce any risks related to the delivery of care. These included risks linked to clutter or hoarding and worked with people to reduce these where possible.

People had the equipment they needed to support safe care, and staff had a good understanding of how to use and maintain it. The registered manager understood who to contact when people may benefit from additional aids or equipment. Staff were trained and routinely observed when using equipment in people’s homes. This included making sure the equipment had been serviced and was safe.

Risk assessments included practical safety information such as the location of water stopcocks, gas shut‑off points and electricity isolation switches. This meant staff knew what to do in an emergency and helped to keep both people and staff safe.

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 received training relevant to their role and systems were in place to promote their ongoing learning and development, including regular supervision, checks of their competency and shared learning through team meetings.

The registered manager had a training matrix in place which evidenced most staff had completed all their training and competency assessments to ensure they were able to meet people's individual needs. This included training on learning disabilities and autism in line with latest legislation.Relatives were positive about the induction and training for staff. One relative told us, “It’s a lot better. The staff do shadow shifts for a long time.”

The provider also incorporated ‘lived experience’ perspectives into their training, enabling staff to learn directly from people who had personal experiences of disability or health conditions. This enhanced staff understanding, empathy and insight into the impact of their practice.

The service had a system to identify people who would require priority support in an emergency, helping senior staff plan staffing safely and ensure those at highest risk continued to receive essential care.

People’s relatives mostly told us they received support from consistent staff at the agreed times and staff were well trained and competent in their role. Although, some relatives felt communication could occasionally be improved, particularly regarding being informed consistently of changes or receiving more timely responses to contact attempts.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading. People and relatives raised no concerns in relation to infection control. They confirmed staff wore appropriate personal protective equipment (PPE) whilst they were providing care. The provider had effective infection control policies and procedures in place. The leadership team carried out spot checks on staff to ensure they were following correct infection control procedures and wearing PPE safely. Staff confirmed there were appropriate supplies of PPE available, which helped enable them to follow good hygiene practices in people’s homes.

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’s medicines administration records showed people had received their routine medicines safely and staff had a good understanding of best practice in medicines administration. Staff had received training and had been assessed as competent to provide medicines safely to people in their homes. Relatives told us staff managed medicines safely and kept them informed when anything changed. The provider had policies and procedures in line with national guidance, to help ensure staff were following best practice when administering people’s medicine.