Pathways of Hope

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 Assessment Service Group since its registration. This key question has been rated 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. Staff understood their responsibility to report incidents and concerns. Staff documented accidents and incidents involving people and escalated concerns to the management team. Incidents and concerns were reviewed appropriately to identify any learning. One staff member said, “When concerns are escalated, they ensure we are kept informed throughout the process.”

The registered manager had oversight of recorded incidents to determine whether changes to people’s support needed to be made. Incidents were monitored, and actions were recorded. Risks were not overlooked, and care plans and risk assessments addressed any concerns over people’s mobility and health. Relevant referrals had been made to address any additional support people needed to stay safe.

A complaints process was in place, although the registered manager confirmed that there had been no formal complaints submitted. Carers received duty of candour training as part of their initial training. Staff had recognised when incidents had put people at potential risk of abuse and made the appropriate referrals and notifications.

There were systems in place to facilitate safe pathways and transfers for people. Assessments of need and risk assessments were completed during the initial assessment of care to ensure safe, effective support.

Care plans detailed people's health conditions and provided the guidance staff needed to seek additional professional health support and when to make appropriate referrals to partners. Referrals had been made to specialist services such as the mental health team.

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, within people’s care and support and when people moved between different services.

Effective systems were in place to manage safeguarding risks. The registered manager and staff were clear on their safeguarding responsibilities. Staff were knowledgeable about safeguarding processes and when to escalate incidents. Statutory notifications had been submitted to CQC, and the local authority were alerted to any potential safeguarding incidents. Systems were in place to review how people were supported when expressing their emotions and dealing with anxieties, to protect individuals and others that may be affected. Training records showed that staff compliance in safeguarding training was very high.

There were effective systems in place to involve people in managing risks.

Risk assessments were detailed, person centred and provided guidance for staff to manage risks. For example, people were active in the community with activities and there was a balanced and proportionate assessment of the risks associated with those. This allowed them to participate as much as possible.

Risks to managing people’s anxieties and mental health were assessed and monitored well. Detailed guidance for staff was in place to support individuals with social isolation, any decline in mental health, and support with medicines. These included triggers, protective factors and information for staff to anticipate any risks. Staff received training in supporting people with their mental health and were knowledgeable about what triggered people’s anxieties and recorded any incidents appropriately. Systems were in place to involve people in managing any risks in their daily lives. Risks were discussed in monthly key worker meetings with people.

Environmental risk assessments were completed to ensure that staff could undertake care and support safely within the supported living service. Risk assessments had been undertaken, with people’s input, on how to safely access and depart the service that included any agreed actions to maintain safety of the individual. These included specific arrangements around any difficulties with gaining access to the property.

Where people needed additional support to manage their own environments, there were detailed assessments and guidance in place for staff. For example, staff ensured that one person received positive reinforcement and support to clean and complete laundry to reduce health and hygiene risks.

There were enough trained staff in place to ensure people remained safe and meet their needs. People told us that staffing was generally consistent.

Staff were consistently recruited through an effective recruitment process that ensured they were safe to work with people. Appropriate checks had been completed prior to staff starting work which included checks through the Disclosure and Barring Service (DBS). DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

New staff completed an induction and probationary period. Staff completed shadowing shifts with established staff members prior to lone working. Training had been identified and provided to staff according to the needs of the people the service supported. These included training in areas such as Mental Health Awareness, Mental Health First Aid, ADHD, Mental Health and Dementia, Learning Disability, Autism Awareness, and Bipolar Awareness. When needed, additional specialist training was sourced to meet the needs of people they supported. One staff member said, “I apply my training to deliver person-centred care, ensuring that support is tailored to each client's individual needs. Since every client is unique, my approach is adapted accordingly.”

Systems and processes were in place to protect people and to prevent and control the risks of infection. Staff were trained in infection control and food safety awareness and there was an IPC policy and procedure in place. Staff demonstrated a good understanding of how to prevent the spread of infection.

When supporting people in their homes and providing personal care, staff used the appropriate personal protective equipment, such as face masks, disposable aprons and gloves. People spoke positively about staff practice and use of personal protective equipment (PPE).

Systems and processes were in place to ensure that people’s medicines were administered safely. Staff had received training in administration of medicines. People’s care plans contained guidance for staff on medicine administration or prompting. Each person had a medication care plan in place that assessed the level of support needed and what carers supported them with.

Where people struggled to manage their medicines safely and effectively, detailed risk assessments and staff guidance were in place to support and monitor administration.

Leaders had oversight of medicine administration and completed audits and analyses of any incidents. These determined why discrepancies occurred, what actions staff had made and what changes had been made to adjust practices and delivery.