Carrick

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 supported by a stable staff team that had a good knowledge of their needs. Training was regularly updated and competency checks completed. When incidents occurred, staff had an opportunity to debrief and learn from the experience. Risks were well managed including risks associated with medicines. Staff knew how to raise safeguarding concerns. Relatives had no concerns about people’s safety. When new people moved into the service the registered manager completed a needs assessment based on the information available. There had been no opportunity for people to be involved or consulted in the process.

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.

One person used an electronic communication device. Some staff had received training in how to use this effectively and were planning to cascade the learning to the rest of the staff team.

There was an open culture at the service. Staff felt comfortable raising concerns and were confident they would be listened to. Staff told us they had opportunities to develop their skills and reflect on practice. One commented; “If you have any ideas [registered manager] is very proactive and encouraging.”

There were systems to support learning from incidents. Following incidents staff had an opportunity to reflect on what had happened and consider what might be done differently. However, we found these debrief sessions were not always completed in a timely manner.

Systems to minimise the risk of people’s needs impacting negatively on each other had not been well established. One person had only been living at Carrick for a few months. Prior to moving in they had not visited the service or met with any of the people already living there.

The registered manager told us that, due to circumstances, it had not been possible for the newest resident to visit the service prior to moving in. They had gathered information from relatives about the person’s needs as part of the assessment process. However, this had not provided any insight into people’s compatibility. One member of staff commented; “My opinion is that it is the age difference (between the service users) they cannot manage the noise. [Name] cannot sit when [Name] is there.”

We did not receive any feedback from external agencies about the transition process. A relative said they had no concerns about the decision. They told us they had been involved in planning and had visited Carrick before their family member moved in. They said, “The move went well, they were 100% welcoming. It felt like it was planned well.”

The organisations Positive Behaviour Support team had completed paper based matching exercises to assess if people would be compatible and concluded they would. Initially the person had settled well. However, at the time of our visit the person’s needs and behaviours were starting to impact negatively on others. Following our visit the registered manager told us about plans to improve the situation for everyone living at Carrick. The provider said they did not believe including people in the process would have impacted on the decision. However, this gap in the process meant all possible actions to assess people’s compatibility and mitigate the potential risk had not been taken.

People were more comfortable and at ease in the service than at our previous inspection. Although there were sometimes incidents which impacted on people the atmosphere was generally more relaxed.

Staff had completed safeguarding training and told us they would not hesitate to raise a concern directly to the registered manager. They were confident any concerns would be addressed. One commented; “People are safe, yes. The staff are encouraging them to do things. We always ensure the environment is safe and give care according to their needs.”

We observed people were at ease with staff and appeared confident in their company. Staff checked on people regularly to make sure they were safe and comfortable.

The registered manager reported safeguarding concerns to the relevant agencies when necessary. There was information displayed in the service which provided guidance on how to raise safeguarding concerns outside of the organisation. There were systems to protect people from the risk of financial abuse.

Staff supported people to manage risks and there was a culture of positive risk taking. Relatives said they believed their family members were safe at Carrick. One commented, “[Name] relies on you 100% to keep them safe, I have never thought [Name] wasn't safe.”

Staff told us they were confident supporting people at all times. When new risks were identified risk assessments were updated and any necessary changes made to support plans, for example following a change in a person’s behaviour, arrangements were made to provide increased support when they were travelling.

People spent their time moving around the premises freely and with no unnecessary restrictions. Staff were aware of where people were and were available for support when needed.

One person’s behaviours had changed in recent weeks and they sometimes became distressed which had led to them acting in a way which could put themselves, or others, at risk. Staff told us they knew how to support the person safely and care plans and risk assessments had been updated to reflect these changes.

Improvements had been made to people’s bedrooms which were personalised and decorated to reflect their interests.

The registered manager was alert to risks in the premises. New flooring was being fitted during the assessment visit. They noticed the height of the carpet cover strip was a potential trip hazard and were making arrangements to address the issue.

Further improvements had been made to the environment, internally and externally. There remained some areas for improvement. For example, a shelter in the back garden and a bathroom both required attention. Following our visit the registered manager told us about planned improvements to these areas.

Safety checks were completed of utilities and equipment within the service. This included internal checks and checks carried out by external professionals. Any identified areas for improvement had been addressed.

Everyone had support from one member of staff throughout the day. The service was fully staffed and some of the staff had worked at the service for a long time so people were able to get to know staff and form positive relationships.

One person sometimes acted in a way which could put themselves, or others, at risk. Staff told us they felt more staff were needed at these times to keep everyone safe. The registered manager said they had applied for additional funding to support this.

There were enough staff to meet people’s needs. People were supported to go out during the day. When in the service staff encouraged people to be occupied and spent time with them.

Safe recruitment practices were followed. Staff received regular supervisions and training to help ensure they were able to support people in line with their needs. An external professional told us; “[Staff] were very knowledgeable and caring.”

People were encouraged to follow safe hygiene practices.

Staff told us they had cleaning schedules to follow.

All areas of the home were clean and tidy. We observed staff encouraging and supporting people to participate in and take responsibility for cleaning and other domestic tasks.

Cleaning schedules were in place and these were monitored weekly by managers.

People’s medicines were stored safely in their bedrooms. They received annual health checks which included medicine reviews.

Staff were able to describe the process to follow if there was a medication error. Staff were trained in medicine administration and had their competency checked.

The service had recently begun using an electronic Medicine Administration Record system. Staff told us the system worked well. Protocols were in place for medicines to be given ‘when required.’ This helped ensure a consistent approach. Staff had not recorded information on the effectiveness of these medicines in line with best practice. The registered manager assured us this would be addressed with the staff team.