Larwood

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

People were protected from the risk of harm and abuse. People were supported to understand and manage risk. Care plans were clear and provided sufficient guidance to staff to keep people safe. There were sufficient and appropriately trained staff in place to support people. People received their medicines in a safe and timely manner.

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.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

Staff understood their responsibilities to keep people safe. One staff member said, "I would always raise any concerns and speak up if I had a problem."

Staff had undertaken safeguarding training and knew how to identify and report any concerns. One staff member told us, "If I have any concern of abuse, I will escalate this to the manager and if nothing is done about it, I will escalate to CQC." Leaders notified the local authority and CQC of any safeguarding concerns where required. The provider's safeguarding policy and processes were in line with relevant legislation. This promoted people being safeguarded from the risk of abuse and having their rights upheld.

People using the service and their relatives told us they felt safe. A relative told us, "My [relative] has lived there for 10 years. It is fantastic, he is so well looked after."

Relatives told us they were involved in making decisions about their relative's care and support. Care plans were clear and provided sufficient guidance to staff to keep people safe. There were sufficient and appropriately trained staff in place to support people.

Risks to people had been assessed and risk assessments had been put in place to help mitigate risks as far as possible. These risks included areas such as supporting people with mobility equipment or with personal care. Relatives told us staff knew how to support their family member with known risks. There were systems in place for staff to report concerns, incidents, and accidents. This promoted the provider having oversight and being able to manage risks. Each person had a personal emergency evacuation plan in place. This is used to document how people can be evacuated safely when they may have difficulty responding to a fire alarm or exiting a building unaided in the event of an emergency. The registered manager assessed the risks within the environment, including building, equipment, and fire safety. There were plans to be followed in the event of an emergency evacuation. There were regular checks and services of all equipment and the building. The management team completed regular audits and action plans were put in place if any risks were identified.

Staff knew the risks to people well and told us they were kept up to date if there had been any changes to risk assessments. Staff completed health and safety, including fire safety checks of the environment to help ensure risks were mitigated as far as possible.

We observed positive interactions between staff and people who used the service.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

Staff told us they were happy working at the service and there was a low staff turnover. They told us there was always enough staff on duty and sickness and holidays were always covered. One member of staff had worked at the service for 26 years and told us they enjyoyed working there and felt part of a team. Another member of staff had been working at the service for 30 years and this had been marked with a celebration. Staff told us about the training they had as part of their job roles and were knowledgeable about the topics they were trained in, for example fire training, autism training and oral health.

The service had a dedicated staff team consisting of enough staff who knew people well. Staff had received relevant training to keep people safe. The registered manager had processes in place to ensure all staff received an induction and staff we spoke with told us they had an induction which included training in Autism and Leaning Disabilities. Staff were safely recruited, and the provider had completed the relevant employment checks prior to them starting work. Minor improvements were needed to staff recruitment files. For example, some references received had not been verified. Following the site visit, the registered manager took immediate action to make the necessary improvements. Staff were subject to Disclosure and Barings checks. (DBS) checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. However, following a DBS check, there was no risk assessment put in place for a member of staff who required one. Following this inspection, the registered manager put a risk assessment in place

There were enough staff at the service to support people. We observed positive interactions between staff and people who used the service. For example we saw staff playing games with people and having meaningful conversations.

A relative told us, "Each time I visit, the staff are interacting with people." Staff were subject to Disclosure and Barring checks. These provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. However, following a DBS check, there was no risk assessment put in place for a member of staff who required one. Following this inspection, the registered manager put a risk assessment in place.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

The registered manager told us, "Staff did not support people with medicines until they had completed the required training, and medicine competency assessments were completed." Medicine competency assessments were seen on staff files.

People had care plans and risk assessments in place which detailed what medicines they were prescribed and how they liked to be supported. Protocols were in place for medicines which were given as and when needed, such as pain relief medicines. This provided staff with information about the dosage and reasons for administering. Senior staff completed daily audits and the registered manager completed a monthly medicines audit. There was a robust system in place to identify any shortfalls and to ensure people received their medicines safely.

People were given their medicines safely and as prescribed, and it was recorded on their medicine administration record (MAR). We carried out checks of boxed medicines held in the medicine cupboard in the main office and the amount in the boxes reconciled with the total amount recorded on the Medication Administration Records.