Dean Road Extra Care Scheme

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

This is the first inspection of this newly registered service, and we therefore assessed all 8 quality statements associated with this key question. Based on the findings of this assessment, our rating for this key question is good. This meant people were safe and protected from avoidable harm. The provider had a positive culture of learning lessons when things went wrong. Care plans were based on pre-assessments conducted by the provider and various external health and social care professionals prior to people receiving a service. People were kept safe and were protected from avoidable harm, and staff understood how to safeguard people. Staff followed current best practice guidelines regarding the prevention and control of infection including, those associated with COVID-19.

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.

People told us the provider learnt lessons when things went wrong and acknowledged when they could and should have done better.

Managers and staff told us any incidents and accidents, safeguarding concerns or complaints involving the people they supported were always logged and analysed. These incidents were routinely reviewed to determine potential causes and to identify any actions they needed to take to reduce the likelihood of similar incidents reoccurring. Care staff confirmed information about any lessons learnt were always shared with them during individual supervision and group team meetings with their line managers and fellow co-workers. A member of staff told us, “We have lots of opportunities to reflect on how we work and what we might do better because we have regular supervision and team meetings, checks on our working practices when we visit people in their flats, and an annual appraisal of our overall work performance.” The office-based managers encouraged an open and transparent culture where people receiving a service, their representatives and staff could all raise concerns without fear.

The provider learnt lessons when things went wrong. The office-based managers continually reviewed incidents and accidents, safeguarding concerns, and complaints, to determine potential causes and identify any actions they needed to take to reduce the likelihood of reoccurrence and learn lessons so they could continually improve. This information was shared and discussed with staff during individual and group meetings.

People told us they were fully involved when they initially moved into the service.

Manages and staff conducted pre-admission assessments and received information about people’s support needs when they received referrals for new placements. This meant they were able to identify if they could support people in the best way. The registered manager confirmed these initial assessments were used to help staff develop person-centred care plans for everyone they supported.

Health and social care partners told us they worked in partnership with the provider which helped to ensure continuity of care, including when people move between different services.

Care and risk management plans were in place for everyone living at this extra care scheme. These plans were based on assessments conducted by the provider and various external health and social care professionals. The extra care scheme continued to have a well-established and stable staff team. This meant people received continuity of care and support from a group of staff who were familiar with their needs, wishes and daily routines.

People told us they felt safe living at this extra care scheme. A person said, “Not half! I really do feel safe here. I know I can call the staff anytime and they will come straight away to help me.” An external social care professional added, “The care team are proficient at recognising and raising any safeguarding concerns. These happen rarely due to the intensive input each customer receives, and any issues that do arise are resolved quickly.”

Staff were aware of safeguarding reporting procedures. They knew how to recognise and report abuse and were able to articulate how they would spot signs if people were at risk of abuse or harm. Staff received safeguarding adults training as part of their induction which staff confirmed was routinely refreshed. A member of staff told us, “We have safeguarding training every year, so we all know exactly what constitutes abuse and neglect and that we need to report it straight away to the managers or person in-charge if it ever happens.” The managers and staff understood their legal responsibility to immediately refer any safeguarding incidents or concerns to external agencies and bodies including, the relevant local authority, the CQC, and where necessary, the police.

Robust systems and processes were in place to protect people from the risk of abuse. The provider had clear safeguarding policies and procedures in place which were up to date, in line with relevant legislation and were accessible to all. Managers worked well with external agencies, such as local authorities, the police and the CQC, and acted in a timely way to ensure people were safeguarded and protected from further risk.

People told us staff knew how to manage risks they might face and to keep them safe. A relative said, “The staff know exactly how to look after my [family member] and keep her safe.”

Staff were aware of the risks people might face and the steps they needed to take to prevent or safely manage them. For example, staff were aware of the signs to look out for and the action they needed to take to minimise the risk of people with mobility needs from falling. Staff told us they always followed people’s risk prevention and management plans to enable individuals to take reasonable and acceptable risks. Staff said they were confident using the equipment in the extra care scheme, such as mobile hoists. A member of staff said, “We know a mobile hoist must never be operated by one member of staff alone, so we always make sure we double up on those calls where the customer will need to be transferred using a hoist.” Staff also told us they had clear guidelines available to help them deal with emergencies. In relation to fire safety, we saw personal emergency evacuation plans were in place to help staff evacuate people in an emergency.

Care Plans included details about possible risks that staff needed to be aware off and also details about how to manage the risk. These included areas such as communication, mobility/falls, personal care and self-neglect, continence and nutrition. Behavioural risk assessments were also in place which included guidance for staff to manage behaviours that could be seen as challenging including who may be affected, potential triggers, hazards, and how to support these behaviours.

People told us their self-contained flats were kept clean by the domestic staff and their home environment was safe.

Managers and staff told us people lived safely in their self-contained flats which had been suitably adopted to meet people’s individual needs and wishes.

There were effective arrangements to monitor the safety and maintenance of the premises, including peoples flats and the communal areas, which a Housing Association as the property's landlord is responsible for. They conducted regular maintenance checks to help ensure the safety of the extra care schemes physical environment and fire safety equipment. There was clear guidance available to staff to follow to help them deal with emergencies. For example, in relation to fire safety we saw personal emergency evacuation plans were in place to help staff evacuate people safely in an emergency. General risk assessments were regularly reviewed and updated including reference to equipment used to support people, such as mobile hoists. This equipment was regularly serviced and maintained.

People told us there were always enough, competent staff available in the extra care scheme to support them. A person said, “There’s always plenty of staff around whenever I need them. They come as quickly as they can whenever I call them for some assistance.”

Managers and staff told us there were enough people suitably deployed throughout the scheme to meet people’s needs and keep them safe. The registered manager said they regularly reviewed staffing levels at the extra care scheme to ensure there were always enough suitably experienced and trained staff on duty to meet people’s needs. A member of staff told us, “The scheme is well-staffed. We have at least 5 staff on duty during the day, sometimes more, and 2 carers on duty at night, which is enough to look after people here and keep them safe.” Staff received relevant training to support them in their roles. They were well supported by managers to learn and continuously improve their working practices. Staff told us about the training they had as part of their job roles and were knowledgeable about the topics they were trained in. A member of staff said, “We receive all the relevant training we need to help us meet people’s needs, which is constantly being refreshed.” Staff told us they felt supported by the managers and were able to discuss their job roles in their regular supervision, appraisal and team meetings they attended with their line managers and fellow co-workers. A member of staff said, “I feel well supported by all the managers.” Another member of staff added, “ We all work extremely well together and are a good team. We have lots of opportunities to discuss our work with everyone during regular supervision, team and appraisal meetings. The managers also carry out regular quality monitoring spot checks to assess our working practices during our call visits to people’s flats.”

The provider operated robust recruitment processes which helped to ensure staff were recruited safely. This included checks on right to work, identity and with the Disclosure and Barring Service (DBS) who provide information including details about convictions and cautions held on the Police National Computer. Training and supervision records showed staff had access to appropriate training and supervision opportunities. These records showed that training was current which meant staff stayed up to date with latest practice.

People told us staff wore appropriate personal protective equipment [PPE] when they supported them with any personal care. A person said, “They [staff] wear gloves and a facemask when they’re helping me with any of my personal care tasks.”

Managers and staff told us they had received up to date infection control and food hygiene training.

The provider followed current best practice guidelines regarding the prevention and control of infection including, those associated with COVID-19. The provider’s infection prevention and control policy were up to date. The provider supported visits to the care home in line with the government guidance in place at the time of the inspection. The provider continued to access COVID-19 testing for people living and working in the scheme when they showed signs and symptoms of COVID-19.

People told us staff supported them to take their prescribed medicines as and when they should.

Staff authorised to handle medicines in the extra care scheme told us they had received medicines training and their competency to continue managing medicines safely was routinely assessed by their line managers.

The provider operated effective medicines management systems. People’s support needs in relation to medicines were assessed. Where people required support from staff, medicine administration record (MAR) charts were in place. These were completed in real time by staff when they administered medicines and audited on a regular basis. This helped to ensure people received their medicines as prescribed.