CWD Outreach Service

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. Lessons were learnt to continually identify and embed good practice.

There was an accident and incident log in place, which demonstrated leaders acted appropriately following incidents. Staff learnt from these to reduce the risk of recurrence. For example, leaders gave an example of a practical step they had taken following an incident involving a lanyard. Lessons learnt were discussed with staff in supervisions and team meetings. Leaders also told us they shared any learning with wider teams.

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.

Leaders explained how they worked with children and their families to transition into adult placements when needed. They did this alongside social workers and any other relevant professionals. Leaders explained how they shared their risk assessments with adult placements so that care was joined up.

One leader told us how they had continued to support a child after they moved to a different home. This enabled the child to have continuity of care. Leaders undertook risk assessments when a child was transitioning to another service, due to there being higher levels of risks during transitions.

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.

All incidents were recorded and responded to appropriately, including referring to safeguarding and CQC where needed. Staff had been trained to an appropriate level of safeguarding and understood how to protect children from abuse. Staff told us they discussed safeguarding in supervisions with their line manager in line with best practice. There was a safeguarding children policy which outlined how to safeguard young people from abuse.

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.

Risks to young people had been assessed and mitigations were recorded. Relatives fell staff managed identified risks well. Comments included, “Staff understand the risks regarding our [family member’s] care, for example, they always check the whereabouts of [emergency medication].”

Staff said they had enough information in children’s care plans to mitigate risks. For example, staff told us, “Yes [risks are] all detailed in their care plans and we are trained and given opportunities to shadow if needed.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Staff had assessed environmental risks children faced, including risks relating to fire safety. Where required, children had detailed moving and handling plans in place to enable staff to support people safely with equipment and mobility aids. Leaders had also assessed the risks relating to staff working alone, and mitigations were outlined in the provider’s lone working policy. Leaders worked with occupational therapists to ensure equipment was in good working order.

The provider did not always make sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. However, they worked together well to provide safe care that met people’s individual needs.

Staff had been recruited safely and received a range of training relevant to young people’s needs. Staff felt well supported. Comments included, “Where a child has more specialist needs, additional guidance and training are provided to ensure we can support them safely and effectively” and “My supervisor and I meet regularly for supervision but also at least bi-monthly for a general catch up and to check on my health and wellbeing.”

Children were supported by a longstanding staff team which supported continuity of care.

However, some relatives told us, at times, visits were cancelled at the last minute. Leaders were aware of this concern and were actively addressing this. Leaders told us when care visits were missed, these were carried over.

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. There was a policy in place which outlined procedures for staff. Staff had been trained in infection, prevention and control [IPC]. We did not receive any concerns regarding IPC during our assessment and relatives said staff wore personal protective equipment [PPE] where appropriate.

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Staff had been trained in medicine administration, and their competencies were checked by leaders. Staff also completed specialist training. Staff knew how to respond in the event of a medicines error. There was a detailed medicines policy in place which outlined procedures for staff. Relatives felt staff managed their family member’s medicines safely. Children received their medicines as prescribed.