Smitham Downs Road

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 requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

The provider was no longer in breach of regulation relating to safe care and treatment.

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

Staff understood the systems in place to record and report any safety concerns that occurred. We saw these were investigated to ensure appropriate action was taken to support the person involved and implement learning.

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.

Staff obtained information from the person, their family, and health and social care professionals involved in their care to support with transitions. This gave staff clear information about how to support the person and enabled a smooth and safe transition to the service.

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.

Staff were aware of their responsibilities to safeguard people from avoidable harm. They completed safeguarding adults training and were aware of how to report and record any concerns identified. A safeguarding adults’ policy was in place and regularly reviewed. The management team worked with the local authority safeguarding team to learn from and implement recommendations following any concerns raised.

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 regularly reviewed risks to people’s safety. Clear risk assessments and management plans were in place instructing staff how to keep themselves and people safe at the service. People’s risk management plans included communication profiles that informed staff how people communicated so staff were able to give them prompt support, this included how people expressed if they were in pain.

People had positive behaviour support plans in place which instructed staff about how to support people safely. Some staff requested specific behavioural support training tailored to the individuals living at the service. The management team told us this was already being arranged to upskill their staff and give them more confidence when supporting people at the service and in the community.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

At the time of our assessment, we identified a number of concerns regarding the safety and suitability of the environment, including sharp knives not being securely locked away. Immediate action was taken to address this risk. We saw the environment needed updating to address damage to walls and update bathrooms. A full refurbishment plan was in place and on the day of our site visit the home was being repainted. All of the bathrooms at the service were due to be updated and damages repaired. A maintenance log was in place and staff reported that requests were promptly addressed.

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.

Safe recruitment practices were in place to ensure suitable staff were employed. There were some vacancies at the service and recruitment was in place to fill these vacancies. Staffing levels were based on people’s needs and the number of 1:1 support they required to keep them and others safe. Staff felt at times staffing levels were difficult when supporting people in the community. The manager was working with people’s funding authorities to review their 1:1 support funding and the additional behaviour support training being delivered to staff would provide them with more skills and confidence to support people in the community.

Staff completed regular training to ensure they had the knowledge and skills to do their role. Staff told us they felt well supported in their role. Staff had not received supervision sessions as regularly as planned due to changes in the management team, however, we saw that supervision sessions were scheduled for all staff now a permanent manager was in post.

The provider did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading or share concerns with appropriate agencies promptly.

The home was clean and tidy when we visited. However, we saw the mops and buckets for cleaning were not stored appropriately and there was a risk of cross contamination. The manager had already informed the team of the importance of ensuring mops and buckets were stored appropriately and would reiterate this message to staff.

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.

Improvements had been made, and safe medicines management processes were now in place. We saw medicines were stored securely. Medicine administration records were maintained of all medicines given and there were daily stock checks to ensure people received their medicines as prescribed. Information was available to staff about how and when to administer ‘when required’ medicines.

The management team were working with people’s GP to review prescribing practices and where possible reduce the prescribing of psychotropic medicines in line with STOMP. STOMP isa national NHS England program to Stop The Over-medication of People with a learning disability, autism, or both, with psychotropic medicines.