Precious Homes North London

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 inspection we rated this key question requires improvement. At this inspection, 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 managed incidents affecting people’s safety well. Staff recognised incidents and reported them appropriately and managers investigated incidents and shared lessons learned. A staff member said, “When there are incidents, we have a staff meeting or an emergency meeting to discuss what happened.” Processes for investigating, analysing, and responding to accidents, incidents, complaints, and safeguarding alerts were in place, with systems for families, people and staff to raise concerns or share their views.

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. Relatives told us the service involved them and other health care professionals when their family member moved in. As a result, the transition went smoothly because they got to know them so things would be familiar to them. Staff and leaders demonstrated good knowledge of referring to external professionals when needed. There was an up-to-date referral, assessment, and commencement of service policy in place.

People were kept safe from avoidable harm because staff knew them well and understood how to protect them from abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. A staff member said, “I would alert managers to the safeguarding and also the local authority and Care Quality Commission.” A system for reporting, managing and recording safeguarding concerns was in place. The registered manager demonstrated how they learnt from incidents which affected people's safety and had implemented a process of thorough investigation, actions and outcomes and lesson learnt to prevent them from happening again. The registered manager shared concerns quickly and worked well with relevant local authorities to be open and transparent in any investigation.

People, including those unable to make decisions for themselves, had as much freedom, choice and control over their lives as possible because staff managed risks to minimise restrictions. Staff knew people's needs and the risks associated with their care and support. Information was recorded in people’s records and accessible to staff, including any reviews and changes to their care arrangements. People’s care plans identified areas where risks could be minimised such as mobility, eating and drinking, skin care, health, medication and the environment. People’s capacity to make decisions was also considered including any restrictions on their freedoms such as leaving the service. Appropriate professionals had been consulted to provide specialist advice and support, for example, the speech and language team, and the mental health team. This meant that people had communication profiles in place which enabled staff to support them individually and meet their communication needs.

People had their own individual flats that were well maintained, and the environment was safe. There was a system in place to ensure the environment and equipment was safe and well maintained. Checks of the environment and equipment were undertaken regularly and in line with the provider’s policy and legal requirements. Health and safety audits took place regularly and any areas for action were addressed. Staff understood and followed the service’s health and safety procedures.

The service had enough staff, including for one-to-one and two-to-one support for people to take part in activities and visits how and when they wanted. Staff were capable and professional and adapted their approach to individual people’s needs. We observed polite and warm interactions and communication between people and staff who worked at the service. Systems were in place to ensure there were suitably qualified, skilled and experienced staff. We saw rotas were planned and organised and accurately reflected staff on duty on the day of the assessment. There was an induction programme for new staff including face to face training, shadowing more experienced staff and competency checks. The provider had carried out background checks including criminal checks. This meant people could be confident that staff had been fully vetted prior to employment.

Staff were aware of their responsibilities to detect and control the risk of infection. They were knowledgeable about infection control procedures and had received training in how to manage cleanliness and report any issues of concern. There was a supply of personal protective equipment (PPE) in the service for staff to use. People were supported to clean their own flats, and the communal areas were cleaned by staff on a rota basis. There were systems in place to audit and monitor the cleanliness of the service and prevent the risk of infection.

People were supported to receive their medicines safely. Staff received medicines training, and their competency was checked regularly to ensure good practice was followed. Regular checks were also completed of the medicine's records, we reviewed these records, and found people had their medicines administered safely and in line with the prescribing instructions. The staff we spoke with reported they felt well supported by the provider’s policy and training. They were confident to administer people’s medicines.

Processes and policies were in place to ensure medicines were given in line with best practice guidance and appropriate arrangements were in place for the safe management, use and oversight of medicines.