SeeAbility - Bicester Support Service

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

Staff had received training in safeguarding and knew how to report any safeguarding concerns. We found not all concerns raised by staff had been documented within actions logs by the service in order to ensure there was a record of appropriate action taken to keep people safe. Risk assessments and management plans were in place and risks to people's safety and well-being were managed through a risk management process. People had comprehensive positive behaviour plans which guided staff on how to identify trigger and safely support people. Staff felt care plans could be updated more frequently following incidents and further training would be beneficial. People received care and support in line with their needs. During the assessment the service was fully staffed, however staff told us there were times where outings and activities were unable to take place due to staffing numbers. Staff felt they had adequate training around medicines, and regular checks of staff abilities were conducted. Not all people had adequate guidance in place for when required medicines. There was limited documentation around reasons why as required medicines was needed. The provider took action to ensure these protocols were in place following assessment.

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 had received training in safeguarding and were able to identify the common signs of abuse. Staff demonstrated they knew who to report any potential safeguarding to and where to escalate this if necessary. One member of staff said, “Safeguarding is about keeping people safe. You take it to the manager, if they don’t do anything then report to the Police or local authorities.” Although staff told us how they would keep people safe and who they would raise concerns to, not all staff felt they received a follow up about concerns they raised.

People engaged with staff in a relaxed manner, and they looked comfortable in their presence. There was a relaxed atmosphere which enabled staff to focus on people’s individual needs.

People had Deprivation Of Liberty assessments in place to safeguard people where required, and the provider had a detailed safeguarding policy and procedure for staff to follow. There were systems and processes in place to report and record safeguarding concerns. However, it wasn’t always clear what action was taken when staff raised concerns about restrictive practice. We were assured appropriate action was taken at the time of these concerns as the provider told us how they mitigated the risk to people using the service. These actions had not been reflected within monitoring documentation in order to demonstrate how the provider kept people safe. The provider told us they would ensure this documentation was in place following the assessment.

Staff supported the same people and knew them well. Staff felt care plans and risk assessments contained enough information about people they supported. Some staff felt they didn’t always have the time to read peoples care plans and guidance around people’s support needs could be improved.

We observed that risks to people were managed safely by staff.

People’s risk assessments included areas such as choking, accessing the community and person-centred positive behaviour plans which showed clear triggers and early warning signs for each individual. For example, one person at risk of choking had professional guidance which staff followed and ensured they were supervised during meals. Where people had been assessed as requiring a stipulated number of supporting staff, records seen indicated this was in place. Support plans specified how people wished to be supported and how staff ensured this was managed. People had detailed individual risk assessments which included safety and security, harm to self and others as well as general behaviours. There were also active, reactive, and proactive strategies in place which were followed by after event strategies. For example, one person expressing distress, staff utilised countdown strategies such as 5-minute, 2-minute, 30 second warnings to transition from activity to activity. The provider had procedures in place which gave them oversight of the recording and monitoring of the risks people faced in their lives. This included monitoring restrictive practice reduction plans which were audited regularly. The provider considered patterns and trends to minimize the risks to people and inform staff how to support people safely. Staff met with healthcare professionals on a regular basis to review people’s presenting risks and take action to ensure people were cared for appropriately.

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

Trends and themes within information identified there was enough staff to meet people’s needs, however there was high numbers of overtime hours and people’s social needs were not always met due to staffing numbers. This was something management had recognised and were in the process of training new starters. We received mixed feedback from staff about the training they received, some staff told us they felt they had enough training, other staff felt further training was required in order to work effectively as a team to support autistic people using the service.

On the day of assessment there were enough staff to safely support people and their needs. We observed people's care and support needs were being met in a timely way

Records of staff rotas showed planned staffing levels were met. The manager told us they only used agency staff to cover short notice absences. Recruitment records were in place. We found the provider documented that risk assessments had identified gaps in employment and had been reviewed, however there was no evidence of this. The provider took immediate action following inspection to ensure this information was in place. Training records evidenced staff were trained to carry out care in line within peoples needs, however the service had not undertaken Oliver McGowan training as they were unable to access this and had alternative training 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.

All staff we spoke to felt training around medicines was comprehensive. Staff knew the administration process for 'when required' medicines and were able to explain when people may need certain medicines, how to record this information and how to escalate concerns when needed.

Medicine administration records were viewed. Stock checks were carried out twice daily and medicines were signed appropriately by staff. However, not all people using the service had medicine protocols in place for 'when required' medicines. We found the outcome and reason for administering these medicines were not always recorded.

The provider carried out regular medication audits and took appropriate action where needed to ensure people received medicines in a safe way. However, systems and processes did not identify where guidance was not in place for some 'when required' medicines Following the assessment the provider put the appropriate guidance around medicines in place for those we found missing. Incidents around medicines and errors had been documented and adequate action was taken including further medicine training for staff involved.