The Goddards

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 good. At this assessment the rating has changed to requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed or potential harm.

This service scored 59 (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 did not always have a proactive and positive culture of safety. Appropriate actions to concerns about safety were not always completed, investigated or reported. Lessons were not always learnt to continually identify and embed good practice. Accident and incident reports were not always investigated or followed up where required. This meant the provider was unable to identify lessons learnt and prevent reoccurrence. There was no evidence of sharing learning from incidents with the staff team. People were happy living at the service and felt the manager and staff we supportive to their needs and preferences.

The provider 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 support by staff who understood people's health needs and knew how to access additional support if this was needed. Hospital passports were available for people attending appointments. These contained relevant information other services may need to know to support them effectively.



People were supported to manage their health conditions and staff ensured regular reviews with specialists. A healthcare professional told us, "The staff are very responsive to information and advice given to support people appropriately."

The provider did not always ensure people were safeguarded from harm, potential harm or abuse. The provider did not share concerns quickly and appropriately with the appropriate organisations or partner agencies.



People were not always protected from harm, potential harm or abuse. Where staff reported concerns to the management team regarding people's welfare, the registered manager did not always follow processes in place to ensure internal and external policies were followed.



People told us they felt safe at the service. One person told us, "I feel safe. I love it here; all the staff are excellent they are superstars." Another person told us, "I am very independent and they make me feel safe to go and do what I want to do."

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. However, systems in place to document risks were not always completed.



People received care and support from staff who knew their needs and preferences. However, care plans and risk assessments were not always reflective of the care and support people received. Risk assessments were not always reviewed in a timely manner to ensure staff had up to date information about people. The management were aware that work was needed to ensure care plans and risk assessments were reflective of people's needs.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.



Systems and processes were in place to monitor the care environment and make improvements where needed. There were some areas of the environment that required refurbishment. This had been identified by the provider. Safety checks of equipment was regularly carried out and people had personal emergency evacuations plans in place.

The provider made sure there were enough qualified, skilled and experienced staff. However, they did not always make sure staff received effective support.

Staff were happy within their work and felt supported by the management team. The registered manager worked alongside staff to ensure people's needs were met. This had impacted on the oversight and management of the service, which we have reported on in the well led section of this report.



Staff supervision was not always completed in a timely manner. However, staff felt confident to speak with the management team if they needed to. One staff member told us, "The registered manager is great, they are always available and if I had any concerns, they would support me fully."

Staff had not completed epilepsy training, despite having people within the service with this health condition. The registered manager addressed this following our feedback and provided evidence to show staff had completed the relevant training.

Whilst people and staff told us that allocated one to one support hours were provided, there was no system to record or evidence this. So, we could not be fully assured that people always received their one-to-one support where this was allocated.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.



Staff had received training in the prevention and control of healthcare related infections and always had access to the personal protective equipment they needed. We observed that all areas of the home were clean and hygienic. The provider had policies and procedures in place to ensure people were protected from the risk of infection.

The service did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened.



People were given their medicines safely and in a timely manner. This was recorded on their medicines administration record (MAR) and medicines were stored safely and securely. There were processes in place to ensure the safe and effective use of medicines. However, records to support the safe management of medicines were not always in place or completed appropriately. For example, body maps to show where creams were to be applied and stock balances of medicines. The registered manager was aware of this and implemented new systems to support the improvements needed during the assessment.