Mirabeau

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 requires improvement. At this assessment 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 provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Leaders analysed incidents where people became distressed to reduce reoccurrence. Staff were open and honest when things went wrong, and issues quickly addressed. A person’s relative told us, “There was an incident, one of the night staff fell asleep and [person] has seizures. I received a call at 7.30am in the morning to let me know! It could have been brushed over, but I was called immediately. There are several people there with epilepsy. The outcome is that they (Mirabeau) rotate the staff now, then someone else oversees all of them.”

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. A professional who worked with the service told us, “Records have been shared by the service that exhibits involvement of various relevant health professionals: GP, psychiatry, speech and language. I do feel [staff] support transitions safely and effectively.” People were also supported to safely move into their new home. A person’s relative told us, “The transition from [previous service] to Mirabeau was handled beautifully by Mirabeau.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. A professional told us, “I have seen the manager reporting safeguards correctly and even contacting the safeguard team to confirm if the situation required a safeguard. The manager ensures there is an open and honest culture within the home.” Staff were aware of potential indicators of abuse or neglect and knew what to do if they were concerned about a person.

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. When people became distressed, staff took steps to understand why a person was distressed and what support they needed to express their emotions. A staff member told us, “At times the guys [people] might become distressed. It’s down to us to reassure them they are safe, and working with them in a way they understand, as all the needs within the house are different.” There was a clear commitment to minimising the use of restrictive interventions, including specialist staff training in how to de-escalate anxiety. People who had conditions such as epilepsy, were supported effectively to protect them from the risk of avoidable harm.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People’s individual sensory needs had been considered. There were adaptations and reasonable adjustments made to enhance people’s quality of life. A staff member told us, “We have a person that has anxiety issues with their daily activities. We support [person] by giving [them] plans and support to make [them] feel safer. We also would make the environment quieter to allow [person] to not have environmental influences that might make them feel unsafe.” People had Personal Emergency Evacuation Plans (PEEPs) in place, however, these required some further detail. The provider acted on our feedback to enhance these plans straight away.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. We observed interactions between people and staff where people appeared to be comfortable and relaxed. A person’s relative told us, “There’s definitely enough staff, most of them (staff) have been there a long time, and they are so caring and understanding.” Staff received an induction, training and supervision to support them in the role. Staff were recruited safely, although we have recommended some minor improvements to records.

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. A staff member told us, “For infection prevention control (IPC) we use gloves and aprons and use antibacterial spray, different coloured mop buckets and for food preparation we use different coloured chopping boards and knives.” Staff received training in IPC and regular audits were completed to ensure a good standard. Some shared bathrooms required renovation to ensure they could be cleaned thoroughly. This was already planned by the provider as part of a scheme of rolling improvement works, showing investment in the service.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. We found medicine stocks to be correct and tallied with people’s medication administration records (MARs). There was a commitment at the service to STOMP, which is national best practice guidance on stopping the over-medication of people with a learning disability and or autistic people when distressed. We identified 1 tablet which needed a pharmacist authorisation to crush, and the provider acted straight away to address this, seeking the medicine in a dissolvable form.