Venus Healthcare

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

Staff followed peoples risk assessments and PBS plans most of the time however, we were concerned about a few incidents involving people using the service because staff had failed to take appropriate action outlined in a person’s risk management/PBS plan. These failures had placed people at risk of harm and represents a breach of Regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can find more details of our concerns in the evidence category findings below. People had person centred risk management plans in place which should have provided staff with all the information they needed to keep people safe however, some staff did not always follow this guidance. People were protected from abuse. The service was adequately staffed whose suitability and fitness to work in an adult social care setting had been thoroughly assessed. People lived in an environment which was kept clean. The provider had a positive culture of learning lessons when things went wrong. People received continuity of care when they moved between different services because the provider operated safe pathways and transition systems. Medicines systems were well-organised, and people received their prescribed medicines as and when they should.

This service scored 72 (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 shared occurrences of any incidents and accidents, safeguarding concerns, and near misses with the relevant partner agencies.

Managers told us all incidents and accidents, safeguarding concerns, and near misses were logged and reviewed to determine potential causes and to identify any actions we need to take to reduce the likelihood of similar incidents reoccurring. Staff confirmed information about any lessons learnt was always shared and discussed with them during regular individual and group meetings, and daily shift handovers. Managers encouraged an open and transparent culture about safety at the service where people receiving a service, their representatives and staff could raise concerns without fear about what might happen.

The provider learnt lessons when things went wrong. They had policies and procedures that included how to achieve continuous improvement. Managers continually reviewed all incidents and accidents, safeguarding concerns, complaints and near misses to determine potential causes and identify any actions they needed to take to reduce the likelihood of reoccurrence and learn lessons. This information was shared and discussed with staff during team meetings and handovers.

External health and social care professionals told us the provider was open and honest with them. One external health care professional said, “The first time I visited my clients at this service I had a lot of negative feedback however, the provider responded positively to this and quickly addressed my concerns.”

Managers told us people's dependency needs were assessed before anyone was offered a place with them and these assessments were used to help staff develop a person’s individualised care plan. It was also the providers staffing policy that a person’s dedicated staff team they had been assigned would always move with the individual they supported if they transferred within the service. This meant the person continued to receive continuity of care from the same group of staff who would be familiar with their needs, wishes and daily routines.

People’s relatives and external health and social care professionals told us they were all invited to participate in the pre-admission assessment process.

External health and social care professionals told us they were all invited to participate in the pre-admission assessment process. Most external health and social care professionals told us the provider collaborated with them to establish and maintain safe systems of care.

The provider had systems in place to assess people's dependency needs which they used to develop person centred care plans for each individual they supported. It was the providers’ policy for each person they supported to have their own dedicated staff team who would remain with that person even if they transferred and moved to new accommodation overseen by this provider.

Managers supported staff to safeguard people from abuse. Staff understood how to recognise abuse and neglect, protect people from its different forms and to report any concerns to their line managers. A member of staff told us, “I’ve had up to date safeguarding training and I know I must tell the managers straight away if I ever witness any of the people we support being abused. Another added, “I know some staff got in a lot of trouble for not dealing at all well with a safeguarding incident involving a service user. I'm therefore pretty confident the managers take these sorts of incidents extremely seriously and will take the necessary steps to stop them happening again.”

The provider's safeguarding policy and processes were in line with relevant legislation. The registered manager worked well with external agencies and acted in a timely way to make sure people were safeguarded and protected from further risk. People and those important to them engaged in this process and informed about what action the provider had taken to keep people safe. Training records showed staff had received refresher training in safeguarding adults.

We observed how people using the service interacted with staff and they looked at ease and comfortable in staffs presence.

We received mixed feedback about how the provider kept people using the service safe. A relative was concerned staff were not always able to keep their family member safe. They told us, “The safety of my [family member] living in their flat is concerning as they were able to leave the property unsupervised on several occasions.” We discussed this safety concern with the registered manager at the time of our inspection who acknowledged some staff had failed to always keep the people they supported safe. They told us lessons had now been learnt and appropriate action was being taken to minimise the risk of similar safeguarding incidents reoccurring. The comments described above notwithstanding, one person using the service and most external health and social care professional’s we contacted told us they or their clients felt safe using this supported living service. One person using the service said, “Yes, I do like living here because the staff know how to look after me.” An external health care professional added, “The provider has many safeguards in place to keep our clients safe.”

The registered manager acknowledged that although risk management and PBS plans were in place to guide staff, these were no longer as up to date as they should be as a result of one person’s needs significantly changing. Some staff had also failed to always follow peoples existing risk management/PBS plans. The provider responded immediately after the inspection and confirmed risk management and PBS plans had been reviewed and updated to include new actions for staff to follow in order to minimise the risk of similar safeguarding incident’s reoccurring in the wider community. The provider responded immediately after the inspection and confirmed risk management and PBS plans had been reviewed and updated to include new actions for staff to follow in order to minimise the risk of similar safeguarding incident’s reoccurring in the wider community. This formed part of this individual’s new PBS crisis plan which was coproduced by the provider and the commissioning authority. Staff received most of the relevant training they needed to keep people using the service safe. Staff told us they regularly refreshed their PBS training, which was personalised to meet the specific needs of people using the service. For example, a member of staff said, “We regular receive person centred PBS training from our PBS director, so we know exactly how to prevent or safely deescalate incident’s when people we support become distressed.” Another added, “I’ve recently refreshed my PBS training in relation to the person I regularly support, so I know I must back away immediately and giving [name of service user] time and space is the best way to manage his behaviour when he becomes distressed.”

We observed managers and staff follow risk management plans and use positive behavioural support techniques appropriately on two separate occasions during our site visit. On both occasions staff safely deescalated potentially harmful incidents involving people using the service. Manager and staff remained professional throughout these incidents and immediately gave the individuals involved enough time, space and reassurance to deescalate these potentially harmful situations.

People were not always supported to stay safe because the risks they might face were not always properly assessed and managed. People had risk management and personalised PBS plans in place to guide staff, but staff had not always correctly followed them. In addition, some existing risk management/PBS plans were no longer relevant as the result of one person’s needs significantly changing recently. The provider responded immediately after the inspection. They confirmed risk management and PBS plans had been reviewed and updated for one person whose needs had changed, with input from their PBS director. The plans included new actions for staff to follow in order to minimise risk of similar incidents of distressed behaviour reoccurring in the wider community.

We received mixed feedback from relatives and external health and social care professional’s about how staff assessed, prevented and/or managed risks people using the service might face. Most external care professionals told us staff kept people safe by following their risk management/PBS plans however, some relatives and local authority social professionals said this was not always the case. Mixed feedback we received included, “The staff are aware of the positive interventions that are required to keep each of my clients safe and how to prevent and manage the identified risks they might face” and “The staff do not always follow my [family members] risk management plans and I'm not sure they know how to meet their complex mental health care needs”.

We saw the premises were kept free of obstacles and hazards which enabled people to move safely around their flats.

A person told us their self-contained flat was a safe and clean place to live. They remarked, “My flat is good and the staff help me keep it clean.”

There are effective arrangements to monitor the safety and upkeep of the premises. Regular checks were completed to help ensure the safety of the self-contained flats physical environment and fire safety equipment. There were a number of environment checks and audits in place which helped to ensure people were able to live in a safe place. This included electrical safety, evidence of remedial works, fire books, and evidence of gas safety. Health and safety checks were completed by staff at each individual supported living service. The provider completed fire risk assessments for individual supported living services which meant they had oversight into any safety issues in relation to the risk of fire. Fire emergency evacuation plans were in place for each supported living service.

Managers were able to assure us that there were effective governance arrangements to monitor the safety and upkeep of the premises and equipment. We discussed the safety of the environment people lived in following several incidents involving individual’s accessing the wider community in a distressed state putting themselves and others at potential risk of harm. The registered manager agreed to put additional restrictions in place with immediate affect including, keeping an external door leading from the building where one person’s self-contained flat was located locked when it was not in use and installing a gate to secure the exit and entrance to the services communal space, limiting access to the wider community and the main road just outside.

There were enough suitably skilled and experienced staff to support people. We observed staff were visibly present throughout our inspection and deployed in sufficient numbers in people’s flats, which care plans and the daily staff duty rota stated they needed. For example, we observed two staff supporting one person each in both the self-contained flats we visited during our site visit. Staff were vigilant when people were moving around and undertaking activities in their flat to ensure people remained safe.

Staff received regular and relevant training to support them in their role. Staff told us about the training they had as part of their job roles and were knowledgeable about the topics they were trained in. A member of staff said, “The training I’ve received since working for this organisation has been very good, from the comprehensive induction to the on-going refresher training we’re all expected too continually complete.” These positive comments notwithstanding the registered manager acknowledged staff training required further improvement following several significant incident’s where a person using the service had been placed at unnecessary risk of harm. We discussed this staff training and competency issue with the registered manager at the time of our inspection who told us staff had now all received physical restraint training in addition to their PBS training. Managers told us that staffing levels were determined according to the commissioned contracts in place. They gave examples where people with two or three to one support were provided this. It was positively noted the provider had increased staffing levels one person now received in the evenings following the occurrence of several incident’s involving this individual at that particular time. Managers told us that each supported living home was staffed by a team leader, a deputy team leader and the whole service was supported by a dedicated [PBS] director and consultant.

Staff were visibly present throughout this inspection and matched the duty rota for the day. We observed care staff providing people with the appropriate levels of care and support they needed. Staff were quick to respond when people required assistance or became distressed. The registered manager confirmed they used the providers dependency tool to calculate the number of staff that needed to be on duty at any one time in order to meet people’s needs. These staffing levels were regularly reviewed to ensure there were always enough staff to meet people’s needs. It was positively noted staffing levels had been immediately increased from two to three staff in the evening for one person following the occurrence of several incidents involving this individual. To ensure people received continuity of care from staff who were familiar with their individual needs, preferences and daily routines each person was assigned their own dedicated staff team who always supported them. The provider submitted rotas which showed that staff were suitably deployed in sufficient to meet people's needs. Staffing levels in each supported living service matched that day’s staff duty rota. There was a system for out of hours support from an call manager in place in case of emergencies. Recruitment procedures were robust which helped to ensure only staff that were checked as being safe to work with people were employed. Managers carried out checks on staff that applied to work at the service. This included checks with the Disclosure and Barring Service (DBS) who provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. Training records that were submitted by the provider showed staff received training in topics that were relevant to their role and helped them to meet the needs of people using the service.

We received mixed feedback from relatives and external health and social care professional about staffs competency to continue meeting the needs of people using the service. Most external care professional were confident staff had the necessary knowledge and skills to keep people safe. However, all the relatives and professional’s representing one local authority told us the training staff received needed improvement. An external care professionals said, “My client is always adequately supported by the same group of staff who are familiar with their needs.” A relative added, “The qualifications and training of the staff members are a point of concern. It is evident that not all staff members have the necessary skills and training to effectively manage my [family members] complex needs, resulting in them being involved in an increasing number of dangerous incidents.” People reported receiving care from enough staff. One person told us there were enough staff to support and keep them safe. They said, “There's always lots of staff here in my flat to look after me.” An external health care professional added, “There has always been two staff supporting my client whenever I’ve visited, which is the appropriate level of support it’s been agreed they require to stay safe.”

We saw staff and visitors were not required to wear PPE, which reflected the governments risk-based approach to wearing PPE in an adult social care settings.

People told us staff used personal protective equipment [PPE] effectively and safely.

There was an infection prevention and control policy in place. Records showed staff had received training in areas relevant in the area of infection prevention and control.

Staff told us they had access to PPE and had received training in infection prevention and control.

Medicines systems were well-organised. Medicines were safely administered, appropriately stored, disposed of, and regularly audited by the managers and staff. People’s medicines were safely stored in lockable cabinets securely fixed to walls in people’s own self-contained flats. We found no recording errors or omissions on the medicines records we looked at during this inspection. People’s care plans included detailed guidance for staff about their prescribed medicines and how they needed and preferred them to be administered. This included protocols for people prescribed ‘as required’ medicines, which helped guide staff to manage these medicines safely. In accordance with STOMP/STAMP and recognised best medicine’s practice for people with learning disabilities we found more positive non-chemical alternative approaches were being used by the provider to help manage behaviours that were expresses of distress instead of ‘as required’ behavioural modification medicines.

We observed staff manage peoples prescribed medicines in a safe way which indicated they we clear about their roles and responsibilities in relation to the safe management of medicines. Staff showed us where they kept peoples prescribed medicines which were securely stored in locked cabinets in people self-contained flats.

Staff were clear about their responsibilities in relation to the safe management of medicines. Staff received safe management of medicines training and their competency to continue doing so safely was routinely assessed by their line manager.

People received their medicines as they were prescribed. A person told us staff supported them to take their prescribed medicines as and when they should. They said, “Staff give me my medicines.” An external care professional added, “Yes, my client receives their prescribed medicines on time and staff keep their medicines records up to date.”