Hayes

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. This is the first assessment for this newly registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm

This service scored 84 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider ensured there was a learning culture at the service. They had systems for investigating and responding to accidents, incidents, complaints and concerns. Records of concerns showed people using the service, their representatives and staff had been involved in investigating these. The provider had apologised when things went wrong and had taken action to address the issues and prevent reoccurrence. The provider had asked people for feedback and continued to monitor outcomes following concerns. They had discussed lessons learnt with staff. People and their relatives told us they were happy with the way the provider had responded when they contacted them. One person commented, “I do not have any complaints. They run the service well and consult with me.” A relative told us, “When I mentioned a minor concern, this was taken seriously, and I was pleased with the outcome." The registered manager explained, "We have a no blame culture. We want staff to be open, honest and learn from incidents. We need to be able to talk about these.” Staff explained there was good communication, and they were able to learn from the registered manager and each other.

The provider had systems to support people with safe transitions. Relatives and healthcare professionals explained how the registered manager had taken a lead in liaising with others to ensure 1 person was safe when they were admitted to hospital. The registered manager had met with the different professionals involved in the person’s care, including consultants and anaesthetists before the person had an operation. They had been an advocate for them and their family. They also had formal meetings to make sure the planned care was safe and suitable and developed risk assessments and care plans to be followed by hospital staff. They had arranged for staff to remain with the person at hospital to continue to provide their care interventions. This helped to ensure the person felt safe and always had familiar staff with them. This was particularly important because the person did not use words to communicate and relied on familiar staff for communication. The person’s relative told us how this had been vital for their wellbeing. They also told us how the registered manager had helped translate information to put them at ease and support them to understand what was happening in hospital.

The registered manager was a qualified nurse and used their knowledge and skills to liaise with different healthcare professionals about people’s complex healthcare needs. They had developed hospital passports which provided other professionals with important information about each person and how they should be cared for and supported.

The provider undertook thorough assessments of people’s needs. The registered manager explained when they had started caring for people, they had ensured they and the staff worked alongside previous care agencies to learn about the person and make sure they had a good handover of information. The registered manager continued to provide direct care to each person alongside their staff until they felt confident that they had identified and planned for all their needs. One relative confirmed the registered manager continued to be involved in care delivery when there were changes in the person’s need in order to fully assess these.

The provider had systems to help safeguard people from abuse. They shared information about their own procedures and those of the local authority safeguarding teams with staff, people using the service and relatives. People and their relatives told us they had information about what to do and who to contact if they were concerned about abuse. Information included ‘easy read’ guides And people told us they felt safe. Their comments included, “I feel very safe using this service” and “I am absolutely happy, and [relative] is kept safe. The staff are good at recognising any signs of distress or pain.” Staff told us they had undertaken training about abuse and safeguarding. They explained the processes they would follow if they had any concerns.

The provider had systems to make sure any support with people’s finances was appropriately managed. The staff kept records of shopping transactions and receipts. People were asked to confirm these were accurate and the registered manager audited these.

The provider had systems to help assess and plan for risks to people’s safety and wellbeing. These assessments considered people’s physical and mental wellbeing, accessing the community, eating, drinking and moving safely. There were clear plans for staff to follow to keep people safe. Assessments and plans were created with the person and their representatives. These were regularly reviewed and updated when needed. People told us they thought risks were well managed. Staff undertook a range of training to understand how to care for people safely. The registered manager carried out assessments of staff’s competencies and observed them providing care to make sure this was done safely.

People were supported to try new things, and the registered manager had carefully assessed the risks relating to these activities. For example, 1 person was supported to go swimming. The registered manager had worked with the staff, the person, their family member and others to consider the risks. They had then observed each swimming session to refine the assessment and make sure all factors had been taken into consideration, so the person would be cared for and supported safely.

The provider had produced additional guidance for staff and families to accompany risk assessments. These included information about skin integrity and how to prevent skin damage. They produced information in an easy-to-understand format.

The provider assessed people’s home environments to help make sure these were safe. They had assessed risks relating to fire safety, equipment and the layout of people’s homes. They supported people and their relatives to reduce risks and look at how to ensure people and staff were safe. The provider had created personal emergency evacuation plans which gave information about the support people needed in the event of an emergency evacuation. They had also produced guides for families and staff about how to help reduce ‘clutter’ whilst being sensitive to people’s feelings and to empower the person to make safe choices about their environments. They had also produced an information pack for families about general fire safety, and who to contact for a free home safety check.

The provider employed enough staff to meet people’s needs and keep them safe. The same familiar staff cared for people, and they developed positive relationships. People told us care workers arrived on time and stayed for the agreed length of time or longer. Their comments included, “I always have the same [care workers] and I have a good relationship with them. They always arrive on time” and

“The carers are very well trained, and they know what they are doing.”

The provider had systems for recruiting staff to make sure they were suitable and had the skills needed. They carried out interviews, checks on their suitability and provided a thorough induction. The agency provided nursing and personal care. Their recruitment processes included checking staff skills, qualifications and right to work in the United Kingdom.

The provider had systems to help prevent and control infection. People using the service and their relatives told us staff were good at keeping their homes clean and following infection prevention control measures. Their comments included, “They help me with the housework, and they do this to a very good standard”, “[Care worker] always wears a mask, [they] wash [their] hands, and [they] are very clean” and “[Care worker] is very clean and dresses nicely.”

Staff undertook training about infection prevention and control. They told us they understood about safe practices. They explained they had enough personal protective equipment (PPE). The registered manager carried out assessments to see how staff used PPE and observe their hand hygiene. They also carried out unannounced spot checks which included observations around cleanliness.

The provider ensured people received their medicines safely and on time. They had procedures for safely managing medicines and staff undertook training about this. The registered manager assessed staff competency and knowledge regarding medicines management. People using the service and relatives told us they were happy with this support. One person said, “They help with my medicines, and I am happy with that. They make sure I take them, and they do this well.” People’s medicines needs were assessed and planned for. There was information about the different medicines people were prescribed and any potential side effects. People’s capacity to manage their own medicines had been assessed. Staff kept records to show when medicines had been administered, and these were regularly checked and audited. The provider worked with people using the service, their families and other professionals to monitor whether they were prescribed the right medicines. This included working with others to follow the STOMP (stopping overmedication of people with a learning disability, autism or both) principles.