ABI Homes - Dyers Mews

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• 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

We looked at 7 quality statements in the safe section. People received care that was planned, safe and met their needs. Risks were well managed and communicated with staff who knew people very well. The provider promoted a learning culture.

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.

Feedback from people and their relatives did not indicate any concerns in relation to being able to raise complaints and concerns if they needed to. People and relatives knew who the manager was and felt able to approach them. One relative told us, “If I have any concerns I raise them with the manager, and they get it sorted.”

Staff told us they would have a debriefing session after any incidents and had the opportunity to discuss during their team meetings and supervisions.

The provider regularly reviewed any accidents and incidents in the service to identify any lessons to be learned. For example, the positive behaviour support team carried out reviews of incident and accidents and produced a detailed report with recommendations to improve and reduce any future incidents. Following the analysis of incidents, the provider arranged further advanced training to reduce the risk of injury for one person in the service.

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 and their relatives told us they felt safe. Relatives’ told us, “I know [relative] is happy in a safe place and very well cared for” and, “If I have any concerns I raise them with the manager, and they get sorted.”

Staff were aware of their responsibilities in relation to safeguarding. Staff were able to give examples of reportable safeguarding concerns and told us they would be confident to raise them with their manager. The Registered Manager was aware of their legal responsibilities about safeguarding and was able to demonstrate examples of where they had followed safeguarding processes.

We observed a relaxed environment where people were free to come and go within the service. During our inspection many people were out participating in their chosen activities.

People were protected from the risk of harm and abuse. The provider had clear guidance in place for staff and reported any concerns to the local authority as required.

People and their relatives told us they felt safe in the service and were able to do things they wanted to do.

Staff told us they thought people were safe. Staff said they had access to the care plans and risk assessments and could actively contribute to their development when things changed.

We observed people actively involved in their day. People had freedom to come and go as they pleased with support from staff.

Risks to the health and safety of people using the service were assessed and regularly reviewed. Risk assessments were in place, for example, in relation to peoples’ emotional well-being, risks when going out and in relation to their health. The provider also completed risk assessments for general areas of the service, for example, fire risk assessments and water safety checks.

We did not receive any direct feedback about the environment; however, we noted peoples’ rooms were personalised and people were involved in decisions about the décor in the service.

The registered manager was receptive to our findings in relation to the environment. Staff did not further comment on the environment.

We observed some areas of the service were tired and in need of refurbishment. For example, we noted the banister for the stairs was loose and could present a risk should this become further damaged. We also noted some areas of damage to the environment which would impact the ability to clean, we have reported on this in the IPC area of this report.

The provider had a service improvement plan which had identified some areas due for refurbishment, however this had not identified all of the areas observed during the inspection, following our visit the provider took immediate action to address our findings. Health and safety checks were completed as appropriate, for example, electrical testing, fire alarm servicing.

Relatives were highly complementary about the staff in the service. Relatives told us, “The staff are second to none and if there was an award they should certainly receive it”, “Staff are amazing, and [relative] has a great life” and “The staff are well trained and there are plenty of them. I have never had an issue with them. They are great.”

Staff told us there were enough staff to support people. Staff told us they received a clear induction and ongoing training to support them in their role.

We observed there were enough staff on duty during the inspection. Staff took their time with people and engaged with them positively.

Staff were recruited safely. We reviewed 3 staff files. The provider had robust recruitment processes in place which included obtaining relevant references and ensuring staff had the required criminal records checks in place. Staff received training appropriate to their role to support staff knowledge and understanding.

We did not receive any direct feedback about infection prevention and control from people or their relatives.

Staff received training in infection prevention and control. Staff told us they had access to personal protective equipment as needed.

We identified some areas of the service were damaged, this meant not all surfaces could be disinfected effectively. However, we noted the service was overall clean and did not have any malodours. We saw colour coded cleaning items, for example mops and buckets, were used for specific tasks to reduce the risk of cross infection.

The provider had processes in place to manage infection prevention and control in the service, this included clear policies and guideline. However, quality assurance processes had not always identified environmental factors that could impact the control of infection, we have reported on this further in the environments and governance quality statements in this report.

Relatives told us they were regularly involved in any health checks or medical appointments and their outcomes.

Staff told us they received training for administration of medicines and had received further specialist training where this was required.

Overall medicines were administered correctly, however we found records in relation to medicines to be given “when required” were not always detailed. For example, medicine to support a person with distressed behaviours was administered with the reason given as, “Agitation”, we were told the medicine was given at this time, prior to extended travel to help with the person’s anxiety. This discrepancy meant the provider would not always be able to robustly review the use of anti-psychotic medicine in the service and track trends.