South Hill

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 questiongood.At thisassessmentthe rating hasremainedgood.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. However, staff did not always investigate and report safety events appropriately.

A system was in place to report, record and monitor incidents and to help support people safely. Management discussed accidents/incidents with staff during meetings to help ensure staff were familiar with their responsibilities and what action to take in such an event. However, we were made aware that a recent incident had not been reported appropriately. We discussed this with the manager who advised that they had carried out an investigation into the delay notifying parties of the incident and a root cause analysis, identifying lessons to be learnt and a staff reflection exercise. The manager told us that staff had been reminded of their reporting responsibilities and that it was “shared responsibility that involves all staff.”

Records showed that the leadership team reviewed accidents and incident data to help identify trends and themes.

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.

Care plans included clear protocols for managing risks with relevant information. There were detailed communication and hospital passports in use to support hospital admissions. These processes supported safe transitions and reduced the risk of avoidable harm.

Staff accompanied people to their appointments, especially when they needed reassurance.

Handover systems were in place and information was shared amongst staff so that people continuously received care and support that met their individual needs.

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, avoid able harm and neglect.

Procedures were in place to help safeguard people from abuse and improper treatment. Staff were able to recognise signs and symptoms of abuse and received training to help ensure they were up to date with best practice guidance. Staff told us they felt confident raising concerns and were confident that management would respond promptly to any concerns.

A relative told us, “Overall, yes, I am confident that[my family member]is physically safe at South Hill. I naturally worry about[family member], but I have not had concerns regarding their physical safety.” Another relative said, “I trust the staff will help with anything[my family member]could need.”

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.

Risk assessments included clear guidance for staff on how to manage risks associated with people’s care and support. These were comprehensive and included details of existing controls and proposed actions to eliminate/reduce risk. Risk assessments covered risks such as personal care, health conditions, accessing the community and taking part in activities. Staff encouraged people to remain independent as far as possible whilst mitigating risks. 

Information about people's mobility and medical conditions that could impact on their ability to leave the premises in the event of an emergency were documented and included guidance on how staff should support them.

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 supported people to maintain a clean, tidy, and hazard-free home environment. We observed that some communal areas of the service were tired and in need of refurbishment. We discussed this with the manager who advised that they had raised these issues with the housing association and were monitoring this to help ensure actions were completed in a timely manner.

Staff carried out environmental safety checks, including routine inspections of fire safety equipment and fire drills, to help ensure both people and staff understood the procedures to following the event of a fire.

The provider made sure there were enough qualified,skilledand experienced staff.Systems were in place tohelpensure staff received training suitable for their role and that they have the required qualifications.

Staff confirmed that appropriate staffing levels were in place to safely meet people’s needs. People who were funded for 1 to 1 support and received this as planned, and we observed staff were consistently available when support was needed. Care and support were provided by a stable and regular workforce that people and relatives were familiar with.

Systems were in place to help ensure staff received training suitable for their role and that they had the required qualifications. This included additional training on learning disabilities, autism, and mental health needs. Staff were also supported to develop professionally through regular supervision, appraisals and opportunities to gain recognised qualifications. However, not all relatives were confident that all staff had the necessary skills to support autistic people. A relative said, “I have observed considerable differences between staff members. Some demonstrate a strong understanding of autism and communicate in a calm, respectful and supportive manner. Others appear less confident or less experienced in supporting autistic adults with complex needs.” We raised this with management who advised that they would look into these concerns.

The provider followed safe recruitment practices, including completing necessary pre-employment checks, to ensure staff were suitable for their roles.

The provider assessed and managed the risk of infection. Staff detected and controlled the risk of it spreading and were aware of the procedures to follow if any concerns had to be shared.

Staff followed infection control processes, including washing their hands, keeping people’s home’s clean and wearing personal protective equipment (PPE) where appropriate.

Staff had completed training about infection prevention and control. Staff said they had enough PPE.

The provider mostly made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

Medicines management systems were in place. We looked at a sample of Medicine Administration Records (MARs)and found that these were not always completed fully. For example, where medicines prescribed on a when required basis (PRN)were administered, the reasons fordoing so were not always consistently documented. Also, when medicines were refused by people, there was a lack of documented information about the circumstances of the medicines being declined. At the time of this assessment, the manager was already aware of some of these issues and had taken proactive steps to attempt to address them. The manager told us, “These findings have been used as a learning opportunity with the wider staff team, and ongoing monitoring through audits and spot checks will continue to ensure improvements are embedded into daily practice and sustained moving forward.”

People's medicine support needs were documented in their care plans. Staff received training to administer medicines to help ensure they had the appropriate knowledge and skills.

Medicines in supported living services should be stored in people's own flats in accordance with guidance. Medicines were stored in this way and people had a lockable cabinet in their flat where they stored their medicines.

The provider worked in line with STOMP, which is national best practice guidance on Stopping the Over-Medication of People with a learning disability and or autistic people. There were systems to make sure people’s distressed behaviour was not inappropriately controlled by medicines.