Choices for Living Well (Killelea)

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 72 (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. Performance reports were completed, which analysed all areas across the service, including accidents, incidents and untoward events. Learning was routinely shared amongst staff and positive action taken to reduce to the likelihood recurrence in the future. Comments from staff and leaders included, “We operate a ‘no blame’ culture across the service which supports staff to speak up when errors are made” and “Sometimes we don’t always get things right first time, but I believe its how we respond and learn that is equally important.”

The service 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 the community and hospital settings, with the management and flow of people between these settings being safe and well managed at every stage.

The provider worked with people and with health and social care 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 and their relatives said the service was safe. Comments included, “The staff are very good, they are very friendly; I feel I am being looked after well here and feel very safe.” “They [staff] have given me my confidence back and I feel very safe and well looked after here.” “I know [Relative] is safe here. I have no complaints whatsoever only good things to say. The carers are all brilliant.”

At the time of this assessment no one who used the service was subjected to any lawful restrictions. In the event of any such restrictions needing to be put in place to keep people safe, staff fully understood their roles and responsibilities in this area.

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. Staff assessed risks to people’s safety and wellbeing. People’s risk assessments and support plans were regularly reviewed and updated. Staff understood about the risks for each person. The provider made sure staff were trained to support people in a safe way. For example, when supporting them to move, using equipment and with eating and drinking. The MDT regularly reviewed people’s care to make sure this reflected best practice guidance for mitigating risks. Medical oversight and clinical risks were well managed within the service, including the response to conditions likely to deteriorate.

The provider detected and controlled potential risks in the care environment. They made sure equipment and facilities supported the delivery of safe care. These included risks associated with fire, gas and electrical safety. Relevant checks were completed by competent people and records and certification were properly maintained and in order. We learnt that WIFI connectivity had been an ongoing issue throughout the building for a while. We spoke with the provider about this, and we were assured this was due to be upgraded.

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.

The registered manager and wider leadership team kept staffing and resources under constant review to meet the needs of people. Most people who used the service felt there was enough staff on duty. Comments included, “I am bed bound so when I ring the buzzer their response is ok, sometimes you have to wait a little, but I know they are busy.” “I have a buzzer round my neck and they come quite quickly to assist”, and “I can’t complain, I’m not left waiting for help.”

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Staff had access to personal protective equipment (PPE) at the point of care. Relevant training had been delivered and associated policies and procedures were in place.

The provider had not always made sure that medicines were managed safely. This primarily related to recording keeping and consistent practice amongst staff.

Although people generally received their medicines as prescribed, practice related to documentation needed improvement. We noted errors in transcription, with medicine names not always accurately recorded on medicine charts. All staff responsible for administering medicines had received training and competency assessments. However, the provider had not clearly demonstrated how responsibility for competency checks was delegated, nor how they were assured that staff were competent to assess each other’s ability to administer medicines safely. The ambient temperature throughout the home felt excessively high. There was no documented evidence of routine temperature monitoring to confirm that medicines were stored in compliance with the required temperature parameters.

Despite the issues highlighted above, we found no evidence people had come to harm. We spoke at length with the registered manager and other senior leaders and remedial action was taken without delay. Furthermore, we were assured that in line with the provider’s approach to continuous learning and improvement, leaders were working with staff to embed consistent good practice across the service.