St Edmunds

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 understood their responsibilities to record and report accidents and incidents. Accidents and incidents were monitored and investigated appropriately.Lessons learnt were shared with staff to prevent them from happening again.

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 were skilled at identifying when people’s health deteriorated and raised concerns about people’s health quickly. They worked with all agencies involved in people’s care for the best outcomes. A health professional who was involved with discharges to the service said, “I find the service responsive and cooperative”.

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 told us they felt safe. Staff had completed safeguarding training. They knew how to protect people from harm and abuse and how to raise concerns.

The provider had safeguarding policies and procedures in place. Records showed safeguarding concerns were recorded in detail and reported promptly to the relevant external agencies. People and their representatives were involved in this process.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. When people receive care and treatment in their own homes, an application must be made to the Court of Protection for them to authorise people to be deprived of their liberty. We checked whether the service was working within the principles of the Mental Capacity Act 2005 (MCA) and how they managed DoLS within the service.

At the time of the assessment, no one using the service had a court of protection authorised to deprive them of their liberty.

The service did not always have enough detail recorded in people’s risk assessments. However, 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.

A staff member said, “There are times where information is either not fully up to date or does not entirely reflect the person’s current needs and medical history. At times, this can mean that additional communication or clarification is needed to ensure risks are managed safely and before we are able to undertake care.”

People were involved in their assessment of risk. Staff were given relevant training to help them keep people safe. This included any training regarding equipment used to support people, such as hoists to help people move and transfer safely. Staff assessed people’s needs at each visit. Visit records showed staff identified risks and understood how to manage them. Where staff identified additional support or equipment was needed to reduce risk, this was actioned.

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

Environmental risks were assessed within people’s homes prior to care being delivered. Lone working risk assessments were carried out to protect staff from the risk of harm.

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.

People told us they were happy with the staff who visited them. Comments included, “The OT is coming in to show the carer how to use the hoist. Carers know how to use it. They’re well trained and know how to look after me” and “They’re very professional.”

Staff told us they had completed a wide range of training and felt confident in their role. Comments included, “I had 4 weeks to shadow another support worker and 2 weeks of the Trust induction and then the HCA clinical induction and the extra training like Oliver McGowan (The Oliver McGowan Mandatory training on Learning Disability and Autism). The induction was very thorough, and I met with my line manager either weekly or 2-weekly reviews and I knew she was on the end of the phone or via Teams if needed anyway.”

The service had a safe staff recruitment system in place. Supervisions and spot checks were carried out to ensure staff were competent in their role.

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.

People told us staff wore personal protective equipment (PPE) such as gloves and aprons. One person said, “My home is left clean, tidy and safe.” Staff told us they had completed infection control training. The provider had a policy for infection control. PPE was always available to staff. The provider had undertaken spot checks on staff working in people’s homes to ensure staff were wearing the correct PPE.

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.

People told us they were happy with the support they received with their medicines. Staff told us they had completed medicines training. The provider had a medicines management policy in place. Information relating to people’s medicines was contained in their care plans, and staff completed MAR sheets (medication administration records). There were protocols in place for medicines prescribed ‘PRN or as required’. Records showed staff had worked with pharmacists and GPs to ensure people received their medicines as prescribed.We found where one person had regained independence in taking their medicines, their care plan had not been updated to reflect this. The service took immediate action to resolve this.