Gilburn

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

We reviewed all quality statements in the Safe domain. Since the last inspection improvement has been made to staffing levels. Staff reported there were enough of them to provide the support people needed, and the registered manager had responsibility for managing the rotas. Staff were knowledgeable regarding people’s needs and associated risks. Care plans and risk assessments were regularly reviewed and contained information on recognising deterioration, and how and when to seek support from relevant health and social care professionals. Environmental checks and infection prevention control systems were in place and effectively used. People were supported with medicines, however processes were not always effective in identifying errors and did not always provide information on best practice.

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.

The culture of the service focused upon keeping people safe. People were aware of safety plans and risk assessments in place to keep them safe.

Staff felt management responded to risks and investigated any concerns accordingly. Incidents were reported and investigated with relevant partner agencies.

Systems were in place to document and review accidents or incidents. The registered manager and leaders within the organisation analysed incidents to reduce the likelihood of them happening again. Learning was identified and shared.

People’s care needs were identified and recorded. Information was available to be shared between partner agencies as required.

Staff and leaders felt information sharing between health and social care professionals was effective.

Most partner agencies felt information sharing was effective, however some felt improvements to the quality and type of information shared by staff could be improved.

Policies were in place around people moving between services to ensure their care needs were known and shared appropriately.

People felt safe. We observed people being supported by staff who understood the level of support they required. A relative told us, “[Person] is definitely safe there.”

Staff understood safeguarding. Staff were able to discuss what safeguarding concerns were, and how they would respond to them. One staff member told us, “Safeguarding is when you prevent people from neglect or harm. I would report concerns to the manager to ensure people are safe.”

We observed people being supported by staff. The appropriate numbers of staff were in place to support people safely. People appeared comfortable with staff supporting them and interactions between them were positive.

Safeguarding processes were in place. We reviewed policies and processes which appeared effective to allow staff to identify, investigate and report any safeguarding incidents. Staff were appropriately trained and the registered manager maintained oversight of incidents to ensure concerns were acted upon promptly.

People were encouraged to be independent and try new activities. For example, people were assisted to cook to maintain their safety and reduce the risk of harm. Others had measures in place such as having sharp items locked away to reduce the risk of harm to themselves. People were aware of restrictions in place, and appropriate legal frameworks to support this practice was in place.

Positive risk taking was advocated. The registered manager and staff promoted people to make decisions and try activities using positive risk-taking strategies. Staff told us they had read positive behaviour support plans which helped them to understand how best to support people to manage risks safely.

We saw people being supported by staff who knew them well. We observed one person who was beginning to become anxious, and staff spoke to them in a way that calmed them effectively. This meant risks were reduced to the person and staff supporting them.

People had been involved in planning how risks were managed. Some people became upset or distressed, and we saw risk assessments were in place guiding staff on how to speak to people, and what activities could be used to de-escalate situations. Regular reviews of risk assessments were completed to ensure support required was sufficient to meet people’s care needs.

People and their relatives felt the environment was safe supported people’s needs. People had access to communal spaces, but also had their own flats if they preferred to spend time on their own.

The registered manager told us all staff had a shared responsibility to monitor the service and raise tickets for any environmental work to be attended to. Daily, weekly and monthly environmental audits were undertaken by staff. A staff member told us, “The environment works well for the people who live here.”

We observed communal areas and people’s flats to be safe, clean and tidy. Security measures were in place at the service such as electric gates at the main entrance which kept people safe.

We reviewed records which showed audits of the environment and premises took place. Safety checks were undertaken by third party providers (e.g. gas maintenance and fire safety), and any actions were completed in a timely manner.

People and relatives views varied on whether there were enough staff. Some relatives felt there were not enough staff at all times, while others felt there were not. One relative told us, “There’s not enough staff, certainly not enough drivers.” Improvements could be made to the number of staff who were able to drive the service’s vehicle. This would enable more people to access the local community and travel further distances more frequently.

Staff received training and support. We reviewed records which demonstrated staff accessed and completed training modules in a wide range of areas. This included Oliver McGowan training and additional Autism and Learning Disability modules. This meant people were supported by staff with appropriate levels of knowledge and understanding. Staff told us the quality of training was good, and they felt able to ask questions if they were unsure of anything.

There were enough staff. We observed there to be enough staff available to provide the care and support people needed. The environment was calm and people were engaged in activities that were meaningful to them by staff who were responsive to their changing needs.

Staff were recruited safely. We reviewed recruitment files of 3 staff and found appropriate pre-employment checks were in place. This meant people were supported by staff who had undergone relevant checks such as Disclosure and Barring Service (DBS) before they started working at the service. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

People were supported to keep their flats clean. One person had a pet and staff helped them to look after it and keep the area clean.

Staff told us they undertook cleaning and infection prevention and control (IPC) measures at the service if people were not able to independently clean the environment themselves.

We observed the service had cleaning equipment, hand hygiene facilities and access to personal protective equipment.

Policies and protocols around IPC were in place and followed. Staff had completed IPC training. Daily checks and audits were undertaken on a frequent basis to monitor cleanliness of the service and identify any areas that required improvement.

People (or those acting on their behalf) told us that they were supported by staff who understood their individual medicines needs and that their medicines needs were supported. People (or those acting on their behalf) told us they were supported to access appropriate monitoring relating to medicines e.g. blood tests, urine analysis, peak flow tests.

Staff had received medicines training and their competency to handle medicines had been assessed. Staff had dedicated time to manage medicines processes, such as ordering and receiving medicines. People were being given their medicines at the right time. People’s medicines were securely stored and at an acceptable temperature. They were disposed of safely when no longer required.

Records of controlled drugs (CDs) were not accurate and were not being made in line with legislation not the service’s policy. There was no process to report CD concerns to appropriate bodies (such as the NHS England CD accountable officer) in the case of any controlled drugs concerns. Care plans did not always contain up to date information about how to support people with their medicines, such as those for diabetes, asthma or epilepsy. The provider’s role in relation to people’s medicines was clearly defined and described in relevant policies, procedures, and training. Current and relevant professional guidance about the management of medicines was available, but not always followed. Medicines were given as prescribed and recorded. There were clear records of the administration of medicines and any allergies.