The Porthouse

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 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.

Processes and systems were in place to monitor incidents. Staff completed an incident form following any incident or accident, which was then reviewed by management. Appropriate actions were agreed as required, such as making referrals or implementing changes to care delivery. Trends were monitored on an ongoing basis and reviewed at an individual level. The small size of the service supported effective oversight and facilitated prompt and appropriate responses.

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 service accepted referrals from a range of sources, provided individuals were compatible with those already living at the service. This included individuals transitioning from children’s services. Transition arrangements varied according to individual needs and consisted of assessments completed with the individual, their family, and involved professionals, such as college staff. Introductory visits, weekend stays, and a gradual, planned transition to full placement took place to support a smooth and person-centred transition.

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.

We observed that people appeared relaxed in the presence of staff and felt confident to ask questions, seek help, and request reassurance when needed. Family members’ feedback included comments such as, “I definitely feel that [my relative] is safe living there.”

Staff demonstrated a good understanding of safeguarding procedures. One staff member told us, “Safeguarding is about the safety and wellbeing of the [people] at the home, making sure they are kept safe. I would definitely report abuse, speak to management, and then raise it further to the safeguarding team if managers are not doing anything.”

Systems and processes were in place to monitor and respond to safeguarding concerns. At the time of the inspection, there were no active safeguarding investigations taking place.

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.

Care records included relevant risk assessments identifying individual risks and outlining control measures to support people safely, including during personal care and community access such as using public transport. Positive Behaviour Support (PBS) plans were in place to guide staff when individuals became anxious or distressed. A staff member told us, “We are good at deescalating, such as taking people away from the situation, changing the staff member, or just talking to [people] sometimes to figure out what the problem is. We do not use physical restraint here.”

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 service demonstrated a person-centred approach in supporting individuals to live safely and independently. People received the necessary support to have individual tenancy agreements and to understand any changes to their tenancy rights. Based on people’s preferences and choices, the garden had been adapted to engage and stimulate individuals when spending time outdoors, including the provision of appropriate seating areas and meaningful activities. Personal Emergency Evacuation Plans (PEEPs) were in place to help ensure people were kept safe in the event of a fire.

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.

Skilled and knowledgeable staff were available in sufficient numbers to meet people’s care needs. A family member told us, “[Staff] appear to be patient and responsive to [my relative], so I assume they have the skills and knowledge needed.” People were familiar with staff, calling them by name and asking who would be on shift, which reflected continuity of care.

Safe recruitment processes were in place, including interviews, references, and DBS checks. DBS checks provide information, including details of convictions and cautions held on the Police National Computer, to support safer recruitment decisions. DBS checks were completed every 3 years. Where staff were not subscribed to the annual update service, additional measures were taken to verify their ongoing suitability for the role. Further improvements were planned, including introducing formal annual checks for all employees.

Staff received appropriate training relevant to people’s needs, including conditions, communication, and safety. Some refresher training was slightly overdue; however, the registered manager took immediate action to ensure the training was completed without delay and improved monitoring systems to ensure timely completion going forward.

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.

Safe infection control practices were followed. Staff were observed following good hygiene practices to support infection prevention and control.

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 were stored safely in a locked cabinet. Electronic records were used and included details of prescribed medicines, the individual’s name and photograph, and PRN medicines where applicable.

Staff demonstrated a good understanding of safe administration practices. One staff member explained that they follow the key principles of medication administration, “Right dose, person, time, route, and medication. We use an online chart, and it is important to check the count. If it is a new medication, it will flag up. We use observations to see if people are in pain, as sometimes they cannot communicate.”