Sapphire House

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 66 (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. Robust systems were in place to investigate and review accidents and incidents. Where safety incidents occurred, there was a strong commitment to reflecting on them to reduce future risk.

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. The provider shared information appropriately with other health and social care services and advocated for people to ensure continuity of their care. One healthcare professional gave us positive feedback saying, ‘The fact that [person who used the service] has settled at [Sapphire House] attests, in itself, to the very particular skill set and clearly above average team approach.’

Although most of the provider’s processes were robust, systems to safeguard people from financial abuse required review. Financial recording was in place, but records and processes were not clear. It was not possible to be assured those people who required support with their money were fully protected. However, we did not find any significant impact at the time of our assessment, and the provider immediately took measures to review and strengthen their systems.

Other safeguarding systems worked well, and staff received training and were clear on how to escalate and report safeguarding concerns. Safeguarding incidents had been appropriately reported to the local authority and to CQC. Partnership working took place with other health and social care professionals to manage safeguarding concerns and reduce future risk. Where actions had been identified to keep people safe following incidents, these had been implemented.

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 supported to take managed risks. Activities and new experiences were risk assessed and broken up into small steps, which were often repeated multiple times. This approach helped people achieve their goals safely. We saw people were actively involved in preparing their own meals, accessing the local community and following their own interests and hobbies. One person told us they were going on holiday and staff planned to visit the holiday location to complete some onsite risk assessments prior to their arrival.

Where people’s distressed reactions could be extreme, plans were in place to manage these through clear positive behaviour plans. Staff knew these well and were confident in both de-escalation techniques and physical intervention should this be needed.

The environment was safe and suitable for the people who used the service. Safety systems such as the fire system, fire-fighting equipment, gas, and electrical systems were routinely tested and well maintained. However, we identified the 5-year inspection of the electrical installation in 2023 had highlighted several improvements were needed to ensure safety. 3 of these improvements were deemed to be serious risks. Records were not in place to assure us all the required improvements had been made promptly, although the serious risks had been addressed.

Redecoration and remodelling of the building was underway to further improve the environment for the people who used the service. A leisure and hobby room had been created, and further plans were in place. People were supported to use their environment safely and all had very detailedPersonal Emergency Evacuation Plans (PEEPs) which provided clear guidance for staff to refer to.

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. Staffing levels were appropriate to enable people to access the community, follow their interests and hobbies and keep safe. People were always supported by staff who knew them well.

Where the service had worked successfully with people to reduce their staffing needs in certain situations, these hours had been reduced and this was viewed as a positive step.

Staff were safely recruited and received training, support and supervision which met their needs. Staff told us they felt confident to carry out their roles. For example, one staff member told us, ‘Before, we used to have no positive intervention training, and we were never confident. We went to the training and now, worst case scenario, we can intervene confidently. We feel we have the support we need.’

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. The service had an infection prevention and control policy, and staff had received relevant training. The service was clean and staff followed good hygiene practices. There were regular checks of fridges, freezers and food probes to ensure food was stored and cooked safely. Appropriate personal protective equipment and colour coded chopping boards were in place to reduce the risk of cross contamination.

Systems in place were not always robust and some records were inconsistent. We identified a missed tablet and two other occasions where stocks held did not match records. Some issues were found to be a lack of care in recording, but the missed tablet could not be explained and had not been identified by staff. None of the incidents we identified had caused harm to any person and we had confidence in the provider to bring about the required improvements to systems quickly.

Staff received relevant training to administer medicines and had their competency checked. People’s preferences as to how they liked to receive their medicines were clearly recorded and were very detailed. There were clear protocols in place to guide staff when a person refused their medicines. This aimed to ensure people received their medicines as prescribed.