Fiveways

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 told us they felt safe living at the service. We found people continued to receive a good standard of care and support. People were supported to take positive risks and learn from incidents, to make changes and reduce risks. There were enough staff to support people safely. Staff had been recruited safely, received training and supervision to have the skills to meet people’s needs. People received their medicines as prescribed. Staff understood their role to protect people from abuse and discrimination.

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.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us staff accompanied them when they went out to make sure they were safe. This had been agreed because people were not physically able to go out by themselves or had been assessed as at risk to themselves or others. People told us that if they did go out by themselves, they knew staff followed them or went to look for them to ensure their safety. Relatives said they trusted staff to keep their family member safe. One relative told us, “He is very happy at Fiveways. He will let you know if he is not happy about anything. He is safe”. One person told us they would speak with the registered manager if they were worried or scared at the service. They also told us they had not been scared of any staff. They were confident if they had any concerns the registered manager would keep them safe. They told us they felt happy and safe at the service.

Staff had completed whistleblowing and safeguarding training and knew how to raise any concerns they had. They told us they were confident the registered manager and deputy manager would act on any information they shared. The registered manager understood their role in reporting safeguarding concerns and working with other agencies to keep people safe.

We observed people sitting in the company of staff and chatting with staff. People were familiar with staff which helped them to relax and feel safe. During our assessment visit maintenance work was being carried out on the fire system. Regular tests and fire drills took place to ensure staff were alerted if there was a fire and knew how to evacuate people safely. Each person had an individual plan about any support or equipment they needed to exit their home in the event of a fire.

The provider had a safeguarding process in place. Staff’s knowledge of safeguarding was checked during the recruitment process and at on going supervision meetings. The registered manager had trained other staff including the deputy manager to follow the safeguarding process, including notifying the local authority safeguarding team. This was so concerns could be raised promptly in their absence.

People were encouraged to pursue their interests, maintain relationships and be a part of their community through positive risk taking. People told us about all the activities they took part in at their home and also outside of their home. People were informed about any potential risks in their daily lives and how to keep themselves safe. For example, people told us that potentially dangerous objects such as scissors or a cigarette lighters were safely kept in the safe. They said that if they wanted to use items they asked staff for them and then knew to hand them back to staff for safe keeping. People also told us that staff popped in to see them when they spend time alone in their rooms to ensure their well-being. One person told us they went out every day with staff. They told us they were happy with this arrangement and knew staff went with them to keep them safe. One person explained to us how they cleaned their bedroom. They told us they asked the staff for the cleaning products and staff supervised their use. They completed other tasks such as changing their bedding without support. They told us they also wash up but did not want to cook meals, when they wanted staff supported them to bake cakes.

Staff knew what may cause people to become anxious or upset and supported them to avoid these things, such as crowded places or the unknown. Some people liked to spend time on their own when they were upset. They had agreed with staff that staff could check on them and the frequency of the checks to allow the people to calm in their own time. Some people lived with epilepsy. Staff described people’s seizures to us and explained what action they took to keep people safe. This reflected the guidance in people’s care plans. The registered manager told us staff had completed additional training in relation to epilepsy to support them to identify each type of seizure and be aware of potential triggers such as dehydration or constipation.

We observed staff supporting people to manage and mitigate risks for them and so help keep them safe. Some people required staff support or equipment to move around their home. We saw these people being appropriately supported by staff according to their needs. Staff offered their hand to guide one person and for another person staff were at hand to check they negotiated a step safely with their walking aid.

People had been involved in planning how risks were managed. This included how to support people when they were anxious or upset. Risk assessments were reviewed every 3 months to check they remained relevant. If people’s needs changed risk assessments were reviewed immediately and revised if necessary. There were assessments of potential risks to people in their daily lives. These included continence, nutrition, mobility, mental health. Specific guidance about what to do if someone had an epileptic seizure for example how it usually presented, what to do such as give the person a white board and pen so they could communicate as were not able to communicate verbally, after what length of time to call emergency services. Positive behavioural support plans had been developed for people with anxieties. These plans set out preventative and reactive strategies for staff to follow to help ensure people receive an enhanced quality of life.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

People were mostly complimentary about staff the staff team. Some people were happy with any member of the staff team supporting them and other people said they had particular staff whom they preferred. They said this was because some staff were particularly good at making them feel calm and less anxious. Relatives were very positive about the staff team. They said staff had the right skills to care for people. One relative told us, “Staff are very capable of coping with my family member’s needs”. Relatives said there were enough staff available and that the staff team were good at keeping them informed about their loved one’s care. Another relative told us, “The staff are lovely people. If there is a problem, we try and sort it out. It is very helpful talking to the staff”. Social care professionals said there was a core staff team who had worked at the service for many years which helped to ensure consistent care. A social care professional told us, “I have only had a positive experience working with the manager and her staff team.” We asked people if staff had the skills to support them. One person told us, “Staff know what they are doing”. One person told us they could usually go out with staff when they wanted. They told us, “Sometimes at weekends I can’t go out because of staffing. I’m not overly fussed if I have something to do”.

Staff told us they felt supported when they joined the team and had time to get to know people. They told us they completed a detailed induction which included shadowing experienced staff and spending time with people. Staff told us they had completed training to support them in their role. One staff member told us training in communicating with people with a learning disability or autistic people had been particularly helpful. Staff worked long shifts and told us they felt tired on occasions. They told us the registered manager encouraged staff to take regular breaks, especially if they were stressed, there was a room so staff could take time away from work. Staff wellbeing, including if they were feeling tired was discussed at regular supervision meetings and arrangements could be made for staff who wished to work shorter shifts. The registered manager described how staff worked with different people throughout the day so people and staff got a break from each other. The registered manager also supported people at times to give staff a break.

We saw there were enough staff, including one-to-one support, for people to take part in activities in their home and to go out. During our visit we observed staff taking people out on planned activities and appointments. Staff were responsive to people, did not rush them and spent time relaxing in their company.

Effective processes were in operation to recruit staff. Checks on staff’s character, as well as their skills and experience had been completed. New staff completed a robust induction to ensure they knew people and the service well. They also completed the Care Certificate, an agreed set of standards that define the knowledge, skills and behaviours expected of specific job roles in the health and social care sectors. It is made up of the 15 minimum standards that should form part of a robust induction programme. Staff had completed training in topics including learning disability and autism, managing distressed behaviour and epilepsy. They met regularly with a member of the management team to discuss their practice, any concerns they had and their development needs. Staff’s goals were agreed and reviewed at annual appraisals and showed staff had developed in their roles. Processes were in place to make sure there were enough staff working at the service to support people. This included making sure people received the one to one hours purchased by commissioners to support people to out and about and take part in household tasks and hobbies at home.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us staff looked after their medicines for them. They said staff gave them their medicines at the times they were needed. People said staff supported them at doctors appointments when discussing and reviewing their medicines. People told us they received their medicines regularly and in the way they preferred. One person told us staff administered their medicines at breakfast time and in the evening. They knew when to expect the medicines and what each medicine was for.

Staff administering medication felt confident and told us they had the skills and support they needed. They knew how people wished to take their medicines and supported them in the ways they preferred.

Effective processes were in operation to order, store, administer, record and dispose of medication. Medication care plans were in place and informed staff how people preferred to take their medication. Effective processes were in operation to ensure people continued to take their medicine as prescribed when they were aware from the service, for example, when on holiday with friends or family. People's medicines were reviewed regularly to make sure people still required the medicines and removed medicines which were no longer required. This was in line with STOMP (Stopping over medication for people with learning disability or autism) guidance. Risk relating to the potential abuse of medicines had been assessed and people had agreed with staff how the risks would be managed. Medicines were regularly audited to identify any errors, which had been promptly identified and action had been taken to address them. For example, when a daily total for one medicine had been recorded incorrectly, this was identified and the correct total recorded.