St Anne's Community Services - York DCA

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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 kept safe from the risk of abuse or harm. Staff had received safeguarding training and knew what to do if they had any concerns. Risks to people were discussed with people where possible and relatives. People’s support plans had been reviewed, risks identified, and plans implemented to manage those risks. The environment was safe, and health and safety checks were up to date. The service was clean and tidy. Recruitment procedures were safe, and staff had received training to enable them to safely support people. Medicines were administered safely.

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.

Relatives told us they had noticed improvements following the previous inspection. One relative told us, “There is a lot better communication, [staff] are engaging with us more, it is more homely, and they are trying to do more in the garden.” Another relative told us, “We have noticed significant changes since the new deputy manager has been in place and now together with a new manager.” Improvements had been made to the safety of the service and the management of risks, and people were now supported in a safe environment. However, whilst some improvement had been made since the previous inspection, other areas still required improvement to demonstrate a good learning culture at the service. For example, improvements around people’s activities, social stimulation, sensory stimulation, aims, goals, and supporting independence.

Staff told us there had been improvements since the last inspection. Leaders told us about action plans in place and were motivated regarding the continuous improvement of the service. Although feedback about learning and improvement was positive, there was a new management team in place and this team needed time to embed a learning culture in the service.

Following the previous inspection, partners had involvement with the service to support improvements. Feedback from professionals confirmed that progress was slow and hindered by multiple changes in management.

Processes were in place to support a learning culture, but these had not yet been embedded and further learning and improvements were required. Monthly staff meetings took place where learning could be shared. A new system of audits had been introduced by the new deputy manager and an organisation improvement plan was in place.

People were referred to other healthcare professionals where appropriate. People had accessed the dietician and the Speech and Language Therapy team. Appointments had also been scheduled with the Learning Disability team and Occupational Therapy team.

Staff supported people to attend appointments, and staff incorporated professionals’ advice into people’s care plans.

No concerns were raised from partners about the service supporting people to access other appropriate professionals.

Hospital passports were in place to support people to safely transition to other services.

People were kept safe from the risk of abuse or harm. Relatives told us, “[The service] is definitely safe and I have never had a reason to worry about safeguarding or anything like that” and, “[Person] appears happy and contented with staff.”

Staff had received training in safeguarding and knew what to do if they had any concerns. Staff confirmed they would go straight to management who would act on concerns. One staff member told us, “If anything happened that I wasn’t happy with, I would whistle-blow to CQC.”

People were appropriately supported. No safeguarding concerns were observed.

A safeguarding policy was in place and potential safeguarding concerns were investigated appropriately. Safeguarding concerns were reported, actions were taken, and lessons learnt.

Risks to people were discussed with people where possible. Relatives were involved in risk management. Feedback from relatives included, “I have been involved in [person’s] plans which have been completed lately and the staff have clearly been involved in doing these together with management and us as parents”.

Positive Behaviour Support plans had been implemented and staff were knowledgeable about how to support people who may be communicating through behaviours which may challenge others. Staff told us they felt confident in supporting people to stay safe and were able to manage behavioural risks to people.

People were supported to keep themselves safe in a way which was as least restrictive as possible. Staff explained to people why they were supporting them in such a way, so as to keep them safe.

People’s support plans had been reviewed, with input from relatives and staff members. Risks to people had been identified, and plans were in place to manage these risks. Information about people’s medical conditions was in place. Procedures were in place to help protect staff, including lone worker policies and risk assessments.

People were supported in an environment which was safe. Relatives told us that staff had been decorating the house and making it more homely. Plans to create a sensory garden and a sensory wall in the dining area had not started when we visited the house. These were implemented during the course of the assessment, after our visit.

Staff told us about the steps they had taken to make the property more homely. Leaders told us about the process for the safe storage of medicines and cleaning products.

The environment was safe. Medicines and cleaning chemicals were stored securely. Radiator covers had been installed. There was new furniture in the lounge and the doors were secure.

Health and safety and maintenance checks were up to date. The fire risk assessment was up to date and recommendations had been completed. Fire drills were behind schedule, but verbal competency checks had been completed and a plan for drills was in place.

People were supported by competent staff who understood how to safely support people. Relatives told us there was the option for them to be involved in recruitment. One relative told us, “The manager has offered for me to be involved in interviews for new staff.” Relatives spoke positively about the new manager and deputy manager. They also told us people had been allocated an experienced senior as a key worker and this was working well.

Staff told us they had received a good amount of training, particularly in recent months, and this included face to face training. One staff member told us, “Training was poor, it is much better now. Massive improvement on the training side” and “We have a good staff team now. Staff who are really interested in the job, the service has been made a much more pleasant place to work and a much better place for people to live.”

Staffing was in line with funded hours and there were enough staff to safely support people.

Staff were recruited safely, and appropriate pre-employment checks were in place. Staff training compliance was good, and staff completed an appropriate range of training. The provider had applied for funding for additional 2:1 staff hours to enable staff to support people with more activities outside the property.

People were supported in a clean and tidy environment.

Staff confirmed there were cleaning schedules in place and staff had access to appropriate cleaning products.

The service was clean, tidy and well maintained.

Cleaning schedules were in place and infection control audits were completed. There was a laundry protocol and risk assessment in place. There was an up to date infection control policy in place.

People received their medicines at the right times and in the way prescribed. No concerns were raised by people or relatives in relation to support with medicines.

Staff had received competency checks regarding the administration of medicines. Leaders told us these competency assessments would be repeated every six months. Staff were aware of the principles of ‘Stopping over medication of people with a learning disability and autistic people’ (STOMP) which is a project in England created to stop the overuse of certain medicines.

We saw medicines being administered in a safe and kind way. Medicines were stored safely, and stock levels were appropriate.

The provider’s medicine policy had been reviewed and updated and contained a comprehensive description of how medicines should be managed safely. The policy followed national guidance. However, some of the information contained in the policy was not applicable to this particular service and there were no written standard operating procedures specific to this service.