Your Life (Stratford-upon-Avon)

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.

Staff recorded and reported any accidents and incidents. The provider had systems to monitor and review accident and incident reports to ensure actions had been taken to keep people safe and to improve the quality and safety of the service.

Staff described a ‘no blame’ culture where mistakes were seen as opportunities for improvement. One staff member told us, “It is good to discuss events because they can have a big impact on people. We then try and re-evaluate to see if it can be done better or safer and what changes we can make. I do feel I can always own up and there will be efforts to help you work through it, whether it be retraining or advice to prevent that mistake happening in the future." A senior member of staff explained, “You have got to own any mistakes but that is how you learn and know how to do it correctly. Everyone who works here, if they make mistakes, come straight to the office and tell us about it." The provider’s care performance manager told us where a need was identified, staff received further support to improve their practice.

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.

Information about people’s medication and wishes for future care could be shared with other healthcare professionals in an emergency. One person had recently had a fall that had resulted in a hospital admission. The person told us a member of the management team had stayed with them to support their transition into the care of the paramedics. When people had been admitted to hospital, the registered manager liaised with social workers and family members to ensure a safe pathway back to their home.

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 confident with the staff providing their care and support. When we asked 1 person if they felt safe with staff they responded, "Definitely, it is just the way they go about the job." Another person told us they felt safe because, “Staff are very positive and very helpful in every way."

All staff had completed safeguarding training to make sure they knew how to recognise signs of abuse. Staff told us they would report any suspicions or concerns to the management team and escalate it further if they felt appropriate action had not been taken. The registered manager understood their responsibility to report any safeguarding concerns to the local authority and to us, CQC.

The registered manager was aware of schemes they could utilise to safeguard people whilst respecting their independence. For example, the Herbert Protocol, which is a preventative, national, police-led scheme for recording vital information about vulnerable people who may go missing.

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.

Assessments were carried out to identify any risks to people’s health and wellbeing. Care plans informed staff of the actions they needed to take to mitigate identified risks and promote people’s safety. Where people needed equipment to maintain their safety, this was identified and risk assessed. However, 1 person had pressure relieving equipment to mitigate their risk of skin damage that was not recorded in their care plan. Whilst risks were mitigated as the person was independently mobile, the registered manager took immediate action to ensure the care plan was reviewed and updated.

People were involved in developing risk management strategies. One person told us that following a fall, there had been a discussion about how the risk of future falls could be managed.

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

Any environmental risks within people’s homes were identified during the assessment process. Information was included in people’s care plans about any actions staff should take to keep people safe. Where equipment was required to support people, there was guidance informing staff how they should check the equipment to ensure it was safe to use.

The registered manager supported people to keep their environment safe. For example, the fire prevention team had given a fire safety talk at the service.

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.

People were positive about the care and support they received. They told us staff arrived when they expected them and provided all the support set out in their care plans. One person told us, “They are pretty good. It is not very often they are late. They will stay as long as you want them to stay."

Staff worked flexible working hours which helped ensure there were enough staff available to cover each shift. One staff member told us, "We have had moments with staffing due to illness, but we do pull together really well as a team: taking extra shifts or staying a bit later." Staff told us the scheduling of calls gave them enough time to provide the support people needed.

Staff knowledge and learning was monitored through supervision meetings with their manager and observations of their practice. Staff said this provided an opportunity for them to discuss personal development and any training requirements.

The provider had processes to ensure all safe recruitment checks had been completed prior to staff starting with the service. Recruitment checks included staff identity checks, references and Disclosure and Barring Service (DBS) checks. DBS checks provide information including details about convictions and cautions held on the Police National Computer. This helps providers make safe recruitment decisions.

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.

Staff received training in infection control and food hygiene. Staff told us they always had sufficient personal protective equipment to use during personal care. If any infection control risks were identified, control measures were introduced to mitigate the risks of it spreading. The provider kept people up to date with national or local guidance to reduce infection risks.

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.

Care plans contained information about the medicines people took, and the support they needed from staff. When staff administered people’s medicines, this was recorded on a medicines administration record. When people were prescribed medicines on an ‘as required’ basis there were guidelines in place informing staff when these should be administered. This included the gaps required between doses and the maximum dosage within 24 hours. Staff received training in safe administration of medicines and had regular competency checks to ensure they continued to follow best practice. Medicines records were audited regularly to ensure they were completed accurately and any discrepancies identified in a timely way.