Laural House

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

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

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.

The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Processes were in place to ensure risks associated with closed cultures were identified and mitigated, and lessons were learnt to continually identify and embed good practice. The provider and registered manager were approachable and listened to concerns raised. Accidents, incidents, or safeguarding concerns were reviewed at weekly management meetings, with learning shared with the team. When asked about how learning was shared following, for example, a medication error or fall, a staff member told us learning was discussed at team meetings, handovers and through the homes communication file.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. People were consistently supported when they were distressed. Care plans were in place to support people to have a good day, and strategies were in place to prevent distress. Records of people’s care needs were kept so they could be shared with other professionals if needed. This included hospital passports which ensured relevant information was passed over if people were admitted to hospital. One professional told us, “In my dealings with the home they have made great efforts to offer continuity of care between services, for example [professional] (Mental health team, social services and care providers). Clients are always placed at the centre of any approach including transitions.”

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. Staff received safeguarding training and were able to tell us the actions they would take should they have concerns. There was a commitment to minimising the use of restrictive interventions. The registered manager gave us examples of how these had been reduced. Applications had been completed to authorise a person being deprived of their liberty.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. There were improvements since the last inspection. The service now ensured risks were identified, and were doing all that is reasonably practicable to mitigate risk. People had risk assessments in place, with areas covered including choking, community activities and fire evacuation. The service supported positive risk taking with the registered manager and staff providing examples of this. For example, 1 person has recently started accessing the community with less staff support which has had a positive impact and has opened up more opportunities for the person.

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. There had been improvements since the last inspection. There was a system in place to carry out environmental checks. We identified a potential risk in relation to the monitoring of fridge temperatures which had been highlighted by checks, but no action had been taken to reduce the risk. Action was taken before the end of the inspection. People personalised their rooms and were included in decisions relating to the interior decoration and design of their home.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. There were improvements since the last inspection. People were now supported by enough staff and receiving their commissioned hours. Staff were recruited safely, with people involved in this. Staff would visit people as part of the process, with interactions observed. Staff received effective support, supervision and development. They received training including how to support people with a learning disability and autistic people.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. All areas of the home were clean. Staff received training, had access to the personal protective equipment (PPE) they required and were observed to be wearing this throughout our visits.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened. There were improvements since the last inspection. The service now received their medication from staff who had their competency assessed annually. Medicines were stored securely and there where medicines were prescribed on an as required basis protocols in place. People’s medication was reviewed to ensure people's behaviour was not controlled by excessive and inappropriate use of medicines. The service understood and implemented the principles of STOMP (stopping over-medication of people with a learning disability, autism or both).