Your Life Your Home

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. People were supported to take positive risks and given information to make informed choices. People’s environments were personalised and met their specific needs. There were enough staff to meet people’s needs, and they had received training appropriate to their role. People received their medicines as prescribed.

This service scored 62 (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 did not always have a proactive and positive culture of safety based on openness and honesty. Lessons were not always learnt to continually identify and embed good practice. There were processes in place to record accidents and incidents. When incidents had happened, action had been taken, and staff had been involved in discussing the concerns. However, incidents which could affect different people living in the building had not been reviewed. For example, there had been an incident involving 2 people, the management team had not reviewed the risk to other people living in the building. We discussed this with the provider, risk assessments were completed and sent to us following our onsite visit.

Staff told us they were kept up to date when people’s needs changed. Staff attended regular handover sessions during the day to discuss people’s support.

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. There were systems in place to make sure information about people’s care was sent with people when they attended hospital.

People who wanted to move into the building and receive support were assessed and their support agreed.

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 management team had recognised incidents which needed to be reported to the local authority safeguarding team and the police. The provider had worked with external agencies to make sure people were safe.

Staff understood their role in reporting safeguarding concerns and how this should be done. Staff confirmed the training they had received, what signs they would look for and the action they would take. Staff were confident the management team would take them seriously and act on their concerns.

The provider did not always work well with people to understand and manage risks. People had support plans, however, the review process was not clear. Reviews were completed yearly but there was limited evidence people’s risk assessments had been reviewed and updated at other times to make sure they accurately reflected people’s needs. Staff had not completed risk assessments for environmental safety risks which may not be specific to the person. We discussed this with the provider and these risk assessments were sent to us following the onsite visit.

People’s support plans contained information about what people could do for themselves and what they needed assistance with. Some people displayed behaviours which could put themselves or others at risk. There was guidance for staff to manage the risk including what triggered the behaviour and how it would present.

Staff understood their role in making sure people made informed decisions about risk. Staff described how they would give people information, for example, about the risks of an activity. They told us they would respect the persons decision if they still wanted to complete the activity but would act to reduce the risk.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. There were processes in place to report any maintenance concerns about people’s flats. There was a maintenance team who were supplied as part of people’s tenancy agreement. The team was present at the building, they completed regular maintenance and any emergency work.

People’s flats were personalised, and the communal areas were designed so everyone could access them and the garden safely.

The provider did not always make sure there were enough qualified, skilled and experienced staff. They did not always make sure staff received effective support, supervision and development. They did not always work together well to provide safe care that met people’s individual needs. There were processes in place to recruit staff safely. However, appropriate action had not always been taken when staff applications were not straight forward. We reviewed a staff file, they had not given a reason for leaving a previous job and a reference had not been requested. There was no record this had been discussed and there was no risk assessment in place. We discussed this with the registered manager, they had not discussed this with the staff member at interview. They spoke with the staff member during the assessment and recorded the additional information.

Staff told us they received an induction including training and working with more experienced staff. Staff thought there was enough staff and would cover any gaps when staff were sick or on leave. Staff received appropriate training for their role and received regular supervision to discuss their needs.

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 flats were clean and odour free. Staff disposed of soiled items following national guidance.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. People’s medicines were not always managed safely. People’s medicines were stored in their flats in a locked cupboard. Staff completed a record sheet when they had administered the medicines. Some people were prescribed medicines on a ‘when required’ basis such as pain relief. There was guidance for staff about when to give the medicine, how often and what to do if the medicine was not effective. However, this guidance was not always up to date. When there had been changes made it was not clear who had authorised these changes. Some people had been refusing their regular pain relief as they had not needed it. Staff had not requested a review from the GP to change the medicine to ‘when required’. There was no impact as people had received their medicines as prescribed.

Staff told us they had received medicine training and had been observed to make sure they were competent to administer medicines. Team leaders checked staff competency, but there was no process in place to check the team leaders were still competent.