Francis House

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

Care plans needed more guidance for staff about supporting people when they experienced emotional distress. Incident reports were not always completed by staff when required. The provider took immediate action to address these concerns. Care plans were person-centred and current. People were supported by enough staff who were appropriately trained and well-supported by leaders. People were protected from the risk of harm and abuse.

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.

The staff and the service manager had a good understanding of what safeguarding meant and when they should report concerns. They knew who they could contact externally to refer safeguarding concerns or seek advice. The service manager gave us examples of when they had made referrals to the safeguarding team for independent review. There was a good understanding of promoting people's rights, and all staff we spoke with were knowledgeable about the Mental Capacity Act.

The provider's safeguarding policy promoted people being protected from harm and abuse. Staff had completed safeguarding training. Information was on display and made available to people to whom they could report safeguarding concerns internally and externally.

People told us they felt safe and felt they could approach the manager with any concerns they had. A person told us, "They (staff) are kind and helpful. I can speak to the manager if I'm not happy; she's good."

Staff had good knowledge about risks to people and always had access to people's care plans; the staff we spoke with confirmed they had time to read and understand these. Accessible easy read information was also available to help people understand risks relating to areas such as relationships and staying safe in the community.

People were able to be involved in writing their care plans and risk assessments. However, when they did not want to be, this was documented, and staff instead captured people's views by including relevant conversations held in their care plans and risk assessments.

Staff involved people in managing their health needs whilst promoting their independence. For example, we observed that staff confirmed a person was ready to take their medicines where they needed these to be given to them, whilst they independently managed other prescribed medicines. Records also showed staff supported people to follow advice from external professionals such as dieticians and physiotherapists.

Incident and accident reports had not always been completed when people experienced emotional distress, and staff and managers did not always include information about what happened before an incident and any actions taken after. Care plans and risk assessments needed more information about how to support people when they experienced emotional distress. However, the provider assured us by responding swiftly to these concerns with an action plan and providing evidence of what they had done to improve these areas and manage future related risks. We found individual risks to people, such as health conditions and communication needs, were appropriately assessed and managed. The provider completed regular quality audits, which helped to identify actions needed to manage risks and make improvements. Safe and effective staffing

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 schedules showed enough staff were deployed. Records showed that staff had completed training relevant to their roles, including autism, fire safety and moving and positioning people. We reviewed staff files, which evidenced that staff were recruited safely, with the provider undertaking criminal records checks and obtaining references from previous employers.

We observed there were enough staff deployed. Furthermore, we observed good communication between staff when they left the service to support people with shopping or when the office was to be unmanned. This promoted people's and staff's safety.

Staff told us they felt the manager was approachable. Staff confirmed they received regular supervision and appraisal and felt supported by the service manager. The service manager understood safe recruitment practices and described actions they had taken to address staff performance issues.

A person gave us mixed feedback about staffing which included compliments and some concerns. During our assessment, we found no evidence of these concerns. However, we shared these concerns with the provider, the person's social worker and the safeguarding team for independent review.

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.