May Morning

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• 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 safe living at the service. Staff understood how to recognise and report any safeguarding concerns. The registered manager and provider responded to concerns appropriately. Risks to people were assessed and when incidents occurred new assessments made, and measures implemented to reduce the risk of repeated incidents. There were enough staff to support people. Staff had the right skills and received training to support people with their specific needs.

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.

People told us they felt safe, relatives said they felt confident safeguarding concerns would be reported. People had fed back within surveys they felt safe. Staff spoke with kindness and care to people. People were relaxed in the home and staff responded respectfully to their needs. Staff listened to any concerns raised by people and their relatives in relation to their safely. People received personalised support and staff knew people very well. They had positive behaviour support plans in place which were person-centred and in line with Right Support, Right Care, Right Culture.

Staff told us, “We need to carry on being aware of safeguarding, reporting any issues, listening and supporting the clients in a positive way”. Staff understood their responsibilities around safeguarding. Other staff said, “If there is any issues I contact the manager straight away, CQC, or police and make sure the person is safe” and “I have no safeguarding concerns, I know what I need to do, if there was safeguarding issues I would raise this with the manager”. We did not observe any safeguarding concerns.

People were protected from the risk of abuse, the provider had appropriate safeguarding policy and process in place. Staff received training in safeguarding and the registered manager reviewed any incidents so appropriate referrals were made to the local authority. Safeguarding was an agenda item which staff discussed during team meetings. The provider kept an oversight of incidents so action could be taken to reduce repeated incidents and to identify any patterns. Safeguarding was considered with people alongside their mental capacity to help them understand the processes around safeguarding to help them remain safe. People can only be deprived of their liberty when this is in their best interests and legally authorised under the Mental Capacity Act (MCA). In care homes this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). Some people living at the service were deprived of their liberty in order to support them to remain safe. Where this was the case we found the appropriate legal authorisations were in place.

We observed positive interactions which supported positive risk taking. For example, a person was making themselves a hot drink with the support of staff. We observed staff being present for people if any support was required. There was a calm and friendly atmosphere.

Robust processes were in place to ensure people were provided with safe support. People had detailed care plans and risk assessments which staff referred to so they could support needs effectively. Guidance included areas such as behaviour management, health needs, emergency situations, risks which were specific to the person and other areas such as how to support people manage their medicines. When new risks were identified people were assessed and guidance implement to reduce the risk of further incidents occurring. For example, there had been an incident which was not usual for a person. The incident was immediately reviewed, and measures were implemented to prevent repeated incidents. The registered manager spoke to staff about the lessons learned from the incident to ensure they understood what preventative measures they should take in the future.

Staff knew people well and could describe how they supported people to manage risks. Some people were at risk at times when they were distressed, staff understood how to support them effectively at these times and were responsive to preventing incidents from happening when possible.

Relatives told us they were able to raise any concerns and people were supported to be safe without unnecessary restrictions being placed on them. Relatives told us, “Communication is good, the staff have brought (person) on a lot by spending time listening to him. Communication is great at this home” and “I feel she’s well looked after. The staff all seem to genuinely care”. People told us they were supported to take positive risks. Some people said they were encouraged to go out on their own, to increase their self-esteem and confidence.

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

There were enough staff to support people with their needs and people who were allocated 1-1 hours received them. The 1-1 hours were allocated in people’s daily planners. This helped organise the staff team and they could plan with people their daily activities. Training records demonstrated staff had received the required training to support people effectively. Staff were trained in areas such as positive behaviour support, mental health awareness and mental capacity. Staff had undertaken training on learning disability and autism. This training aimed to equip them to meet the needs of people using the service. Staff competencies were checked through observations by appropriate staff. Competency assessments were made on practical elements of care such as medicines as well as observations around how staff interacted with people in a respectful and dignified way. New staff and staff that progressed in their roles underwent induction training and were allocated a mentor to support them to develop well in their roles. Staff received regular supervision and appraisals. Staff were recruited safely. For example, Disclosure and Barring service (DBS) checks were undertaken. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

Staff fed back positively about the registered manager and said there was a better team spirit and culture since they had been in position. Staff said, “I see everyone pulls together in the same direction, for the benefit and happiness of the service users” and “I finally feel supported and able to progress, both in my learning and within my job role”. The registered manager involved staff in all aspects of the service and asked for their feedback about how the team were working together so improvements could be made. This created an open culture where staff felt comfortable and confident to raise concerns. Staff told us they felt there were enough staff to support people with their care needs. There were no staff vacancies and newer staff were being supported by more experienced members of the team. Staff said, “The new guys are doing amazing, they all seem very driven” and “‘There is enough staff, we have got a good staff team, the morale is so much better, we have good training, if we feel like we need training the registered manager will put us on it”.

Relatives told us there were enough staff to support their loved one and meet their needs. Relatives said, “(Person) seems to get along with staff and he really enjoys helping them”, “(Person) doesn’t have additional funds for 1-1 so the home does very well with the package they have” and “There always seems to be plenty of staff with people”. Relatives fed back positively about staff competence and said they felt training must be good because staff were confident in their roles.

We observed there was enough staff to support people with their individual needs and preferences. People were free to go out when they wished and there was enough staff available to facilitate this. Staff had time to engage with people in a meaningful way.

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.

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