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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

We assessed 5 quality statements in the safe key question and found areas of good practice. The scores for these areas have been combined with scores based on the rating from the last inspection, which was good. We identified some concerns with medicine management, but the registered manager took prompt action to address the concerns. People and their relatives told us they were safe. One person told us, “Yes I am safe here.” Our observations told us that staff knew people well. People’s relatives told us that the staff were kind and caring, for example one person said, “Yes, [Person] is cared for and staff are so helpful, and I am happy with the care”. Another person told us “I am happy here; the staff are kind and helpful”. There was enough staff deployed to meet people’s needs. Staff were recruited and inducted safely. Staff understood their duty to protect people from abuse and knew how and when to report any concerns. Risks to people had been assessed and there were appropriate measures in place to safeguard people from the risk of harm.

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 felt incidents and accidents were dealt with in a safe way. One relative told us, “Staff know [person] well and they know how to provide care and staff have the training required".

Staff had the necessary skills and training to manage when incidents occurred. One staff member told us how they supported someone when an accident occurred. The registered manager told us, “When an accidents occur, we discuss them in the team meeting, we would do a deep dive and discuss how we can learn from this”.

There was a clear process in place to monitor incidents, accidents and near misses. This ensured all accidents or incidents were individually reviewed and prompt action could be taken where required. Incidents and accidents were analysed monthly and discussed with staff as a way to learn and improve practice.

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 were protected from the risk of abuse. People told us they felt safe at the home. A family member told us “[Person] is safe living there”.

Staff were knowledgeable about supporting people from the risk of abuse. Staff were able to describe clearly the signs of abuse and understood their duty of care to report concerns. One member of staff told us, “If I see a bruise or I have a concern, I would speak to the person and the registered manager”. The registered manager told us, “I am confident that staff have the training and know the systems to report safeguarding concerns.”

There was a safeguarding policy and procedure in place and staff were aware of these. The staff and registered manager had worked with the local safeguarding teams to investigate and respond to allegations of abuse. Staff had received training in the Mental Capacity Act (MCA) and Deprivation of Liberty safeguards. They understood the importance of not placing unnecessary restrictions on people.

People who used the service were protected from the risk of avoidable harm, peoples safety and well-being had been assessed an appropriate mitigation was in place to protect people from the risk of harm. There was risk assessments in place to ensure people were able to be as independent as possible and could enjoy activities they liked doing.

Staff were aware of risks when supporting people, for example, they spoke about the need to support people who were at risk of falls and who may need extra support with their nutritional needs. Staff were able to discuss in detail people’s care plans and knew specific guidance to provide care safely. The registered manager told us, “All information is recorded in our care plans and we robustly monitor this and we can seek support if required”.

We observed people were supported to remain safe in the home. People were actively encouraged to prepare meals and drinks. If a risk was identified, we observed staff working with people to encourage them to participate whilst keeping them safe.

There were regular audits of environmental risks completed such as fire checks and relevant health and safety checks. Fire alarm tests and fire drills were undertaken regularly to help ensure that staff would know what to do in the event of an emergency. People had personal evacuation plans (PEEPS) in place and they were up to date.

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

People and their relatives told us there was enough staff to care for them safely. One relative told us, “There is enough staff and I have no problems. They are all really good here and I am happy. I know [Person] is safe and staff care.” Another relative told us, “Yes there is enough staff”.

Throughout our visit, we observed there were staff available to meet people's needs in a timely manner.

The provider had systems in place to make sure people had access to sufficient staff to meet their needs. Staffing levels were determined by individual needs and the activities they wished to take part in. The provider carried out checks on the suitability of staff before they started working at the service. These included checks on their identity, eligibility to work in the United Kingdom, references from previous employers and Disclosure and Barring Service (DBS) checks. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

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.

People were not always supported to receive their medicines as prescribed. People told us they received their medicines safely however we identified that medicines were not always prescribed safely. People receiving medicines were offered encouragement and support and clear explanation was provided to the person receiving their medicine.

Staff told us they had the necessary training to administer medicines safely. Staff undertook training to understand how to safely manage medicines. There was a system for assessing staff competencies and skills in handling medicines.

The provider had policies and procedures for safely managing medicines however we found some staff did not always follow these, for example There were no protocols to give guidance for staff on when to administer PRN medicines, which are medicines taken as and when required. Medicines were not always counted before or after administration or at shift handover. There were weekly medicines audits which identified errors with medicines however there was no robust process in place to ensure staff received the necessary training when issues were identified. We brought this to the attention of the registered manager on the day of our visit and they took prompt action to address the issues found.