8 Acres

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 Inadequate. At this assessment the rating has changed to 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.

There were multiple points of contact where staff would share learning. For example, following an incident, team leaders would carry out a debrief with staff, this would identify any immediate learning. The manager then held a weekly meeting where incidents would be reviewed again to see if there were any wider learning points to be shared and finally a monthly risk and governance meeting across services was held to further discuss wider learning and share ideas.

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. Staff contacted a variety of professionals, such as GP’s and psychiatric teams if people needed support. Any advice or guidance from these professionals was communicated to people, relatives and staff and recorded in care records.

At our last inspection, we found people were not being protected from the risk of harm, abuse and improper treatment and the provider was in breach of regulations in relation to protecting people from harm and abuse. At this inspection, improvements had been made.

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.

For example, the provider held regular meetings to identify any concerns that may require safeguarding referrals. Staff understood their responsibilities in relation to keeping people safe. One staff member told us, “We have created a culture where everything has to be reported every day, even a small scratch staff will report it straight away.” Another said, “Things are very much more open now with incidents and safeguarding. Everything was hidden before but now we explain and report, try to make things better. It is night and day to where we were a year ago.” We saw evidence of regular contact with the local authority safeguarding team.

At our last inspection we found records did not contain sufficient detail to ensure staff were aware of risks and issues to maintain people’s safety and staff lacked awareness of people’s risk presentation. The provider was in breach of the legal regulations in relation to safe care and treatment. At this inspection, improvements had been made.

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.

For example, care plans contained robust Positive Behaviour Support (PBS) plans that outlined stages of escalation and supportive methods to prevent distress, as well as strategies to reduce the risk of further escalation. Staff told us how the PBS team worked with people and staff to develop these plans and review them to ensure they were understood and effective. As a result of this approach in planning, the service no longer used planned restraint. Care plans contained robust and detailed risk assessments. These were person specific and highlighted specific strategies to keep individuals safe.

At our last inspection we found the environment was in need of refurbishment, there were health risks to people due to the environment and environmental risks were not assessed. At this inspection, improvements had been made.

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 ensured regular required health and safety checks were carried out and took prompt action following any recommendations from these checks. There had already been a significant amount of refurbishment completed in various areas of the service, which people had contributed to the design of, for example, choosing their own wall colours and furniture. We saw some areas of the service still required some redecoration, however there was an ongoing plan to address these areas in the service in addition to plan for the outside spaces.

At our last inspection we found people were not consistently supported by staff with the required knowledge, training and competency to meet their assessed needs and risks. At this inspection improvements had been made.

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.

We observed there were enough staff on duty to meet people’s support needs. However, we received mixed feedback from relatives in relation to staffing. One relative said, “The skill set is not always good. Not enough drivers to access the community.” Staff told us this situation was improving, and more drivers were being arranged. Another relative said, “They understand [Person’s] needs. They are good staff and have good training on [Person’s health condition].” Another said, “My key worker is good, and I am happy with the staffing.”

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.

We observed staff following correct infection prevention measures. Staff were trained in infection and prevention control (IPC), told us they had the necessary equipment to keep the service clean and had access to personal protective equipment (PPE). Overall, the service was clean and well maintained.

At our last inspection we found people were not receiving their medicines in a personalised way and identified examples of where peoples medicine was not being given in line with the prescription guidance in place. At this inspection, we found improvements had been made.

Overall, 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. Records we checked showed that people received their medicines as prescribed and that prescribers reviewed people’s medicines. The provider had assessed the risks around people’s medicines. There was detailed and person-centred information available for staff to refer to when giving people their medicines. A relative said, “Staff help them take medication orally with all the tablets on a spoon. If they refuse, staff give them space to take it later.” Staff regularly had their competence assessed around medicine management to ensure they managed people’s medicines safely. For people given their medicines concealed in food or drink who would otherwise refuse them (covertly) there was a lack of evidence that appropriate pharmaceutical advice had been obtained about this and to provide clear guidance for staff about how to prepare each medicine in this way. However, we found this had not impacted people and the provider who took immediate action and provided us with confirmation this had since been rectified.