Isabella’s Home Ltd

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.

This is the first assessment for this registered service.

This key question has been rated Good: This meant people were safe and protected from avoidable harm.

This service scored 69 (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.

The provider monitored and analysed incidents and accidents which occurred at the service to see if there were any trends or themes. Where areas for learning were identified the provider assigned actions to named staff members to ensure they were accountable and actions were implemented with the aim of improving the service provided. Staff we spoke with told us they were encouraged to raise concerns and reported that changes were communicated to them through various communication systems.

Where learning was identified, this was shared within the organisation so improvements could be made across all services within the company.

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.

Processes were in place to ensure people’s needs were assessed before they started using the service. During the transition to and from the service, the provider would utilise a phased transition into and out of the service to allow people to familiarise themselves with the service and its staff.

Staff told us they were aware of people’s assessed needs and used this information the ensure they met people’s needs.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that.

People told us they felt safe being supported by staff.

Systems were in place to ensure safeguarding concerns were identified, documented and investigated, where needed. Staff had received safeguarding training, and they told us they knew how to and would report concerns should they have any.. One staff member told us they had raised a safeguarding concern which was investigated by the provider and appropriate actions were taken as a result.

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 had care plans and risk assessments that were reflective of their current needs. These plans considered the needs of people and were kept up to date through regular reviews. This included how people were supported to mobilise, their preferred routines and risk factors such as dietary needs and the monitoring of ongoing health conditions. These were reviewed regularly or when changes had occurred.

Staff we spoke with were familiar with people’s needs and demonstrated a good awareness of people’s risks and how to support them.

The provider detected and controlled potential risks in the care environment. They utilised technology in order to support the delivery of safe care.

People had environmental risk assessments in place. These risk assessments detailed a range of potential risks staff might need to be aware of and mitigate in people’s homes. Staff were aware of potential risks in people’s homes and supported and followed guidance to ensure people remained safe.

The provider did not always make sure there were enough qualified, skilled and experienced staff.

Staff told us and records confirmed staff had received training; however, at the time of the assessment, some staff had not renewed their autism and learning disabilities training. The provider confirmed they had requested additional training in this area, which was to be delivered by an external training provider.

People and their relatives shared mixed feedback regarding the care people received. One person told us they felt there were not enough staff on duty at any one time for them to access the community. However, another relative told us, “At first there were not enough hours to meet [person’s] needs, but after discussing it with the manager there is someone available all the time.”

We saw there were enough staff available to support people in-line with their assessed needs, and additional staff were provided should people need to attend appointments or be required to support people outside of staff’s routine scheduled working times. Where the provider had identified additional needs and additional support may benefit people, they made requests for additional funding which they could use to provide the additional support.

Staff told us they felt there were enough staff to meet the needs of people they supported, and the service completed relevant pre-employment recruitment checks before they started working with people to ensure they were safe to do so.

The provider assessed and managed the risk of infection and had a pol.

We observed staff using Personal Protective Equipment (PPE) correctly, where required. Staff had received infection prevention and control training. There were processes in place including daily cleaning checks to reduce risks of cross infection and staff followed these systems in line with the providers IPC policy.

The provider did not always identify risks associated with the safe storage of medicines.

Systems in place to ensure medicines were used safely to meet people’s needs, capacities and preferences were not effective.

We identified concerns with medicines management. Systems for monitoring the temperatures of medicines cabinets where medicines were stored inside were not always completed correctly. Medicine storage temperature checks were taking place; however, these were not sufficient to ensure temperatures always remained within safe temperatures. This meant we could not be assured medicines were stored safely, increasing the risk of medicines deterioration which could cause harm to people when administered.

In addition, concerns were identified regarding the documentation of medicines administration and their associated records. For example, records showed people had been given more ‘as required’ (PRN) medicines than they were prescribed to take according to care records. We found gaps in ‘Electronic Medication Administration Record (EMAR)’. Where medicines had been documented as having been administered in people’s daily care records, these were always recorded on the people’s EMARs.

When raising this with the provider they confirmed this was a documentation error and medicines were being administered correctly. The provider confirm they would update the medicines records to ensure medicines records were correct.