Eden 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 63 (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. However, staff always listened to concerns about safety and investigated and reported safety events.

Staff and leaders were open to feedback. However, systems for capturing learning were not always recorded or up to date. Staff told us they received constructive feedback during supervision. One staff member said, "We also get told in a nice way." However, some oversight tools, such as the training log and care plan audits, had not been updated recently. This meant the provider could not demonstrate how learning had been monitored over time.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. However, they had not adequately made sure there was a recorded continuity of care, for example, when people moved between different services.

People had health passports, to enable them to be supported in the best way suitable for them when they attended medical appointments. However, these were not always reviewed regularly. One person, who had recently moved to the service did not have a fully completed care plan. The provider explained the person was living at the service pending an assessment. However, they took immediate action to ensure all paperwork relating to this person was completed. Staff confirmed the provider had shared with them all the information about this person and they felt well-informed about their needs. This was confirmed by the person who told us they felt well-supported with their needs.

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 told us they felt very safe. There were robust arrangements to safeguard people from abuse and neglect. This included information about the Mental Capacity Act, Deprivation of Liberty Safeguards (DoLS) and referrals to the local authority and CQC. The service took a balanced and proportionate approach to safeguarding practice. Staff had completed safeguarding-related training and were confident any concerns raised would be immediately dealt with.

The provider did not always work well with people to understand and manage risks. However, 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 positive risks and were involved in everyday decisions, but written risk management was not consistently robust or up to date. Staff and leaders described a clear ethos of positive risk-taking. The provider explained, "We always take measured risks, otherwise no one is going to learn."

People were supported to travel independently, attend events and maintain friendships in line with Right support, right care, right culture principles. However, there were very few recent individual risk assessments on file. One person was self-administering medicines without a current risk assessment, which meant some decisions about risk were not formally documented or reviewed in line with the service’s own policy. The provider took immediate action to ensure these were in place.

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

People lived in a homely, well-maintained environment with up-to-date safety checks and certificates. Current fire safety documentation, including regular fire drills and equipment checks, as well as valid gas safety, electrical installation and legionella controls were in place. Staff were able to describe the fire evacuation plan and personal emergency evacuation arrangements for each person. Repairs and renewals were logged over many years, and staff described routine room checks and monthly house checks. However, the provider acknowledged there was limited evidence of formal, documented environmental audits beyond these established routines and had plans to rectify this.

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 was stable, with a small, long-serving team who knew people very well and could provide flexible cover to meet people’s needs. Staff described a good work-life balance and mutual support. One staff member told us it was the "most rewarding job ever." Another described the flexibility and explained colleagues were “always happy to swap shifts”.

Although the overall training monitoring system had not been fully updated, staff had completed a range of relevant training and certificates showed these were up to date. Staff received regular supervisions and the provider worked alongside staff to ensure their competency.

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 home was visibly clean and homely, and people and staff described everyday practices that supported good hygiene. Staff changed out of their shoes and wore slippers indoors. People confirmed staff wore appropriate personal protective equipment (PPE) when appropriate. People were supported to keep their own rooms clean and tidy, and staff had completed infection prevention and control workbooks. One person proudly showed us their bedroom and explained how they helped with cleaning. Another person explained, "I do cleaning, dusting, vacuuming, tidying."

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

Medicines were generally managed safely in day-to-day practice. However, weaknesses in medicines governance, risk assessments for these, and oversight meant the provider could not consistently demonstrate safe systems were in place.

Medicines were stored securely in a locked cupboard and individual locked boxes. Stock records and medicine administration records (MAR) charts were completed appropriately. Staff described a clear system for weekly medicines preparation, including for people who self-administered their medicines. Staff understood people’s medicines and how these related to their health needs. However, medicines audits had not always been regularly completed and there was no recorded monitoring of medicines cupboard temperatures. One person self-administered medicines without a current, documented risk assessment, despite the provider’s policy requiring a regular review of self-medication risks. Training for 1 prescribed rescue medicine had been delivered informally by the person, and through an online video. However, there was no recorded competency assessments. We discussed this with the provider who was able to confirm they had sourced formal training for this and was seeking guidance about how to mitigate risks in the interim.