97 Old Street

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 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.

We observed staff listening to people and responding to their concerns. Staff knew what incidents to report and how to report them.

The provider investigated incidents thoroughly and shared outcomes with people and relevant stakeholders. We saw evidence of change as a result of incidents which had occurred. The provider shared learning with staff through staff communication channels and team meetings.

The provider told us they received safety alerts from the government, local authority and CQC which informed them of upcoming risks. This included themes and trends to ensure the provider could take appropriate action to mitigate these risks.

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.

The provider had a robust admissions policy in place. The provider was able to explain the process which included assessing people to establish suitability and compatibility prior to moving in, visits for the person to the home, and ensuring any specialist equipment was available and staff had additional training.

People were consistently supported when they were distressed. There was a focus on planning for a good day and understanding what had caused people distress so positive changes could happen.

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 had access to easy read information, or staff who knew them well to help them raise concerns.

Staff knew how to protect people from abuse and who they would report any concerns to both internally and externally.

The service shared concerns appropriately by following the correct process and ensuring these were reported to the relevant agencies.

Where restrictive practices were in place Deprivation of Liberty Safeguards (DoLS) were in place to legally authorise, restrictions placed on people to keep them safe.

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 supported people to manage risks whilst maintaining their independence by promoting positive risk taking. For example, people were assessed for risks of falls, risk of choking and risks related to medical conditions. When risk had been identified staff acted to keep people safe such as using specialist equipment to monitor their health condition.

The provider shared with us an example of when a person had been supported to undertake a carefully risk managed move. They told us they worked with the person and made adaptions where needed to reduce the risk.

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

Health and safety and fire safety risk assessments were completed and checks made of equipment to ensure it was safe to use. Regular audits were undertaken to ensure the environment and equipment remained safe to use. Any concerns were reported to the management team or appropriate person for further action.

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.

Relatives told us there were enough staff and they felt staff knew their relatives well.

The provider had a training matrix in place which evidenced staff had completed statutory and mandatory training and competency assessments. This meant staff were able to meet people's individual needs. The provider ensured staff attended bespoke training relating to supporting people with a learning disability and autistic people. Where staff had not completed training, they were booked onto a session.

The provider had recruitment processes which were fair and ensured there was no disadvantage based on any specific protected characteristic. The provider followed safe recruitment practices.

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.

The provider had a robust up-to-date Infection Prevention and Control (IPC) policy in place and staff attended IPC training.

Relatives told us, the home was always clean and there were good hygiene procedures in place.

We reviewed cleaning schedules which were consistently completed. We observed the home was clean and staff followed good practice.

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.

There was a robust medicines policy in place. Staff received administration of medicines training, and their competency was checked to ensure they understood the requirements for the safe administration of medicines. Staff told us they felt well trained and confident to support people to receive their medicines safely. Staff supported and involved people to manage their medicines and followed best practice guidance for administering medicines. The staff team were proactive at reporting any changes to people’s medicines promptly.

The provider told us, during people’s annual health reviews, stopping over medication of people with a learning disability and/or autism (STOMP) plans were reviewed. They also shared with us examples of where recent medicines reductions had been made. This ensured people’s medicines were reviewed to ensure psychotropic medicines were not inappropriately prescribed or overused. This meant people were less likely to be at risk of medical restraint.