Low Laithes

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

People were safe and were protected by staff who understood their responsibilities and how to keep them safe. Staff told us they were supported by the new management team and felt confident to raise any concerns. People were protected from risks by very detailed, regularly updated risk assessments. Safe recruitment practices were followed. There were enough staff available to meet people's needs. Staff received comprehensive training to enable them to carry out their roles effectively.

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.

Relatives told us their family members were safe and that they felt confident in the support they received from staff. We received mixed comments as to whether any concerns would be appropriately responded to. One relative said, “Once I did yes, when the old manager was there, I spoke to [person], they looked into it thoroughly and I got a prompt response from [person]. It was about the number of people in [Name’s] team expanding and I wanted a small team. It was dealt with well; I was happy with the outcome.” Another said, “Because issues are being resolved now they will explain that they’ve listened and doing x,y or z, rather than if they’d apologise and saying they learnt by their mistakes. Overall impact for me it’s been quite stressful. I acknowledge they’ve been responding and acting to these things and making a difference to relative’s name.”

Staff were aware of how to respond to accidents and incidents which included how to record and report incidents. One staff member told us, “Always someone to report to and reporting system on the electronic system.”

The provider had policies in place which were readily accessible to staff. There were monitoring systems in place to ensure that lessons were learnt from incidents such as accidents and incidents, complaints, concerns, whistle-blowing, and investigations. The registered manager confirmed that all accidents and incidents are reviewed for lessons learned including reviewing with teams on each unit and at provider wide health and safety meetings.

We received mixed comments from some relatives about continuity of care where some felt it had been necessary for them to intervene on occasions to achieve the right level of support for their family member. However, it was recognised that recently improvements had been made and the new management team was more responsive. There was evidence of involvement from other health care professionals in people’s care records and staff made referrals to ensure health needs were met. We saw positive comments from relatives of joint working where people were supported to move on.

Staff were able to describe in detail how they supported people. They were positive about teamwork and communication and the benefit of this on consistency for the people they supported. One staff member said, “Perfect communication between the team. Excellent.”

We saw the provider had successfully worked with partners and had been involved in discussions with them about people's care needs, both for new and existing people who lived at Low Laithes. One professional commented, “Amazing that settled in so quickly after living with [parent] all [person’s] life. It’s as though [person] has always lived here.”

The provider had processes in place to monitor safe systems, pathways and transitions were maintained. This included a comprehensive needs assessment which was completed prior to support being provided with additional and ongoing input from the in-house team of therapists.

People were supported to understand abuse and how to report it, with information on how to do so provided in various formats. Relatives told us their family members were safe. One relative said, “Absolutely yes,” and another commented, “Yes, I do feel [person] is safe and I’m very hands on. "

Staff had received training on safeguarding and abuse and understood their responsibilities on how to keep people safe. All staff were confident that any issues raised with the new management team would be fully investigated to make sure people were protected. One staff commented, “I haven’t seen any safeguarding concerns. I would report it to [Registered Manager/Deputy Manager Names]. I would call other authorities.”

During our site visits we saw kind and respectful interactions between people and staff. Staff were seen to offer people choices and seek consent before supporting. The atmosphere across the service felt calm, relaxed and friendly.

The provider’s safeguarding policy gave clear guidance for staff about how to raise a safeguarding alert. Any safeguarding concerns were recorded appropriately and reviewed to ensure the relevant professionals were notified. Lessons learned were discussed in team meetings. A tracker was in place to monitor safeguarding concerns, and this was to be expanded to allow easier oversight of all actions taken and lessons learned.

People and their relatives told us they felt safe and were supported to understand and manage risks. People and their relatives were involved in the assessment of their needs and the management of their risks where it was appropriate to do so. One relative said, “Always has been a dynamic risk assessment, like a changing weather picture. We have regular dialogue and constantly hear of tweaks they are making.” However, one relative described how they felt they had needed to intervene in a number of areas of support for their relative but acknowledged that overall things were starting to improve.

Staff promoted people's safety and wellbeing. People’s care plans were regularly reviewed and in response to any change in needs. Staff were positive about the support they received with risk management from the on-site team of clinical staff. One member of staff commented, “We work hand in glove with the clinicians. We just ring them, and they will make a social story.”

When people communicated their needs, emotions, or distress, we saw staff manage this in a positive way that protected their rights and dignity. Staff were vigilant when people were moving around or undertaking activities and made sure people remained safe.

People's risks were assessed at regular intervals or as their needs changed. Care plans informed staff how to provide care that mitigated known risks and included ways to avoid or minimise the need for restricting people’s freedom. Staff were trained in the use of restrictive interventions and were aware of the need to use the least restrictive option. Staff were kept up to date with changes in people's care during handovers and team meetings and from information available on the electronic recording system.

People were safely supported in their own homes. The provider ensured any potential risks were assessed and reduced including checks of equipment, where these were necessary. Most relatives were positive about the environment at Low Laithes including the range of outdoor options. One relative commented, “Very safe environment, either in their apartment, or the garden or around Low Laithes. His environment is really well suited to [person’s] needs.” One relative was working with the provider to address specific concerns related to one person’s apartment.

The provider monitored and reduced any risks in relation to safe environments. Staff were aware of safety and had received a range of training to support them keep people safe. One staff told us, “All actions are taken to make sure people are safe and accountability at every level.”

People were supported to do the things they wanted to do, and staff helped them to do this safely. We saw staff supporting people safely around the home and out to activities in the community or to options onsite. Staff were patient and supported people at their own pace around the service. Where it was identified that people needed alterations to their environment to keep them safe this was done in the least obtrusive way possible. For example, where padding to walls was needed, this was discreet and matched to paintwork to maintain a homely feel to the environment people were living in.

There were systems in place to monitor the safety and upkeep of the premises. Regular checks were completed by the provider to ensure the environment and equipment was safe for people to use.

Overall relatives were positive about staff employed at Low Laithes. One relative told us, "[Person] has got a brilliant core team, really good.” However, some concerns were raised about the consistency of staff. One family member said, “Not a regular staff team. Some staff don’t know how he’s trying to communicate. He needs that structure of staff he knows.”

Staff said they were provided with the skills they needed to deliver a high standard of care and spoke extremely highly of the training and support they received. Staff told us there were safe staffing levels at the service. We saw evidence that recent recruitment drives had been successful with the number of available staff vacancies decreasing and agency staff no longer being utilised. One staff member told us, “Not having agency staff has made a difference.”

There were appropriate staffing levels in place. People did not have to wait for support from staff when they needed this. Staff were seen to regularly check in on people who chose to spend time in their rooms or in locations around the service to make sure people were well and ask if they needed anything.

Recruitment procedures were in place, so people were cared for by suitably qualified staff who had been assessed as safe to work with people. We saw evidence of a more stable staff team and agency staffing no longer being used following a successful recruitment campaign. Staff underwent an induction and shadowing period prior to commencing work. They had regular updates to their training to ensure they had the skills and knowledge to carry out their roles including specialist training to meet the individual needs of people using the service. Staff received the support they needed to deliver safe care. This included supervision, appraisal and support to develop. Some staff appraisals were overdue. However, a plan was in place to address this and for a more comprehensive tracker to be in place to monitor the support being provided to staff.

Feedback from people and relatives overall did not highlight any concerns about cleanliness and hygiene at the service or how staff minimised the risk of infection. One relative said, “Yes spotless. We visit and come to meetings and go to his flat, no issues.” Another said, “No concerns, they use gloves when they put cream on, and they offer them to me.”

Staff followed current practice when supporting people and used personal protective equipment (PPE) when required. The Facilities Manager described how the domestic and maintenance team worked with the care team around the needs of people living at Low Laithes. “We have a catch up meeting every week to discuss any jobs or maintenance. Access is the biggest issue. Work can be planned for weeks but if a person decides not to go off site we have to work round them.”

We noted no issues with cleanliness or infection control during our visits. The environment was well maintained, and people’s individual apartments were clean and tidy. PPE was accessible throughout the location. Staff were seen to follow current practice when supporting people and used personal protective equipment (PPE) when required.

The provider had policies and procedures in place regarding IPC (Infection Prevention and Control) and had systems in place to monitor practices. The home knew how to respond to risks and signs of infection and how to make sure infection outbreaks at the service would be effectively prevented or managed. There were arrangements in place to make sure the environment was cleaned by staff at regular intervals.

Positive Behaviour Support (PBS) plans were in place for residents and were person-centred. Staff had personal knowledge of residents and treated them with dignity and respect. Antecedent, Behaviour, Consequence (ABC) charts were used if needed to calm challenging behaviour. People’s ‘when required’ (PRN) medicines had procedures in place so staff knew when to administer these safely and effectively. Overall families had no concerns and were positive about support with medication. One family member said, “No because [person] had been on anti-psychotic and weaned off, has a good GP, keep it up. I’m involved with that, they do it right. I give them 100% for that.” One family member commented, “I think it would be useful to focus on health and medicine side effects it could lead to more positive outcomes.”

Staff told us they had recently switched pharmacy providers and this had a positive impact on the process of ordering and receiving medicines. Staff also informed us they were in the process of upgrading their system with new technology and training was in place for all staff to be able to use this in the upcoming months. There was clear documentation and audit trails to show where all medicines were booked in and disposed of. Stock checks and audits were regularly carried out by staff and this was shown clearly.

Systems and processes were in place for the safe administration and storage of medicines. There were clear processes in place for the use of emergency medicines, such as epilepsy rescue medicines. Staff were all trained on how and when to use these and there was a clear procedure to follow in such an event. We found that the temperature in one medicine cupboard in a resident’s flat was too high to be storing medicines. The staff acted upon this instantly and showed paperwork was in place to show what staff should do in future if such an event occurs again. The provider understood and implemented the principles of STOMP (stopping over-medication of people with a learning disability, autism or both) and ensured people's medicines were reviewed by prescribers in line with these principles.