Azalea House

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

As part of this assessment, we looked at 4 quality statements for the key question of safe. These were ‘safeguarding, involving people to manage risks, safe and effective staffing and safe environments.’ People were protected from avoidable harm and abuse with an emphasis on openness, transparency and learning lessons when things went wrong. People were fully involved in developing different approaches to keeping safe. This enabled them to take positive risks, to maximise control over their lives. Staff were recruited safely, and people were supported by a consistent staff team that knew them very well. The home environment supported people’s well-being. It was pleasantly decorated and well maintained. There were several communal areas where people could choose to spend time if they wished to.

This service scored 81 (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 had developed very positive and trusting relationships with staff which made them feel safe. One person told us, "I feel very safe here. This is the safest I have felt in any care facility. I feel safe because the staff respect me.” A relative told us, “[Family member] is very safe. I know where they are, that staff are looking out for them, and we all work together to keep [family member] safe.” People were empowered to keep themselves safe. Easy read guides around safeguarding and bullying were given to people. If a person did not have a mobile phone, they were provided with a basic phone so they could make calls to the service or the police if they were in a situation that made them feel unsafe. When someone had not returned home, the staff team would go and look for them and staff not on duty would also volunteer to look for a missing person. The staff would report a ‘concern of welfare' to the police when someone had not returned home and worked with the police to find them, on occasions the police would go to known locations and ensure the persons wellbeing.

Staff demonstrated they were highly skilled at recognising when people felt unsafe and were confident when challenging and reporting unsafe practice. They knew from people's body language and actions if a person felt unsafe or were worried about something. One staff member informed us, “We are a small home and most of the staff have worked here for a long time, so we know the residents very well. We get to know signs to look for if something is not right so then we can try and support them in any way we can. I would not hesitate to report anything I thought was wrong." Staff were proactive and continually looked at how they could improve people's safety. Staff confirmed they had completed training in recognising and reporting abuse and all staff we spoke with were able to tell us where safeguarding policies and information was held. The registered manager said, “We work jointly with the people who live here, as they all have capacity and a right of choice and freedom of life without restriction. We support them to stay safe while still being able to choose their preferred lifestyle."

Staff interactions with people were respectful and inclusive. For example, we saw that 1 person liked a staff member to stay with them while they watched a film. Another person using the service told us, “That’s because it makes [person] feel safe when there is someone there with them.” We saw that staff sat with them throughout the morning chatting and reassuring them.

Staff training records confirmed that all staff had completed safeguarding training for vulnerable adults and children. The registered manager had implemented 12 tips for ‘Back to Basic’ knowledge about keeping people safe and this included questions about safeguarding. There were safeguarding policies that were accessible to staff and the registered manager maintained a safeguarding matrix, so they had good managerial oversight of any safeguarding concerns. There were risk management plans in place if anyone failed to return home outside of joint agreements and there was robust guidance for staff to follow if this happened. There was information displayed around the office with contacts of who to call if staff had any safeguarding concerns. Records showed the provider reported safeguarding incidents as required to the relevant agencies and used these to learn lessons when things went wrong.

Staff had a 'can-do' attitude and supported people with their chosen lifestyles to stay safe. People were enabled to take positive risks so they could have control over their lives. For example, 1 person had been supported to collect their own medication from the supplying clinic despite the risk of misusing their medication. The impact of this had been significant to the person as they had gained independence, had gained the confidence to access the community, had gained knowledge and control about their own medication and were able to take responsibility for their own medicines. If there were areas of people’s lives where risks were too high, the staff team were very proactive and able to think outside the box to offer a solution. For example, a person had been supported to gain employment, but this had posed a high level of risk to them which in turn would set them up to fail. The person was offered a voluntary job at the service which was fully supported by the staff team. The person proudly showed us the areas they took care of. A relative told us “The staff have time for [family member] and have given them a purpose which means the risks are reduced.”

Staff told us they were able to keep people as safe as possible, whilst also promoting their independence and mental wellbeing. One member of staff told us, "We are always risk assessing because things can change quickly here and we need to act and support people as soon as we can. The risk assessments are a useful tool, and they help give us guidance but we risk assess every day.” Staff supported people to take positive risks to improve their quality of life and increase their independence to its maximum. For example, the registered manager told us about a person who had been supported to manage their own finances using a debit card. Staff had enabled the person to take ID to the bank and introduce themselves to the staff, so that if the cash machine kept their card they could confidently go into the bank and manage the situation. The registered manager said, “At one time it could have led to significant negative distress if they couldn’t get their money, but now they have learned the thought process to manage the situation and risk.” Overall, this had a positive impact on the person as its empowered them to take responsibility and manage situations reasonably whilst feeling in control.

Staff interactions were courteous, respectful and patient. Where people were disregarding the rules of the home for example, smoking in the premises, we observed that staff reminded them politely about the risks of smoking in the house and that this was not permitted to which the person responded to quietly and without distress.

Risk assessments fully addressed people's diverse needs. For example, people's specific needs around their mental health needs, addiction, self-care needs and chosen lifestyles. They were completed in a way that allowed people as much freedom as possible and promoted independence. People were involved in managing their risks if they wished to.

Each person had their own bedroom and 1 person wanted to show us their room which they were very proud of. Their room was personalised to reflect their interests and hobbies. They said, “I have lived here for many years, and I have always been in this room. It’s my home and I like my room. I feel safe here.” A relative commented, “The home is lovely. It’s always clean and bright and [family member] is proud of their room.” People were encouraged to be involved in the maintenance of the home and the registered manager confirmed that a person completed fire checks with staff on a weekly basis.

The registered manager told us that both houses were fitted with sounder alarms at the front door so staff knew who was on the premises at all times. The provider was very discreet about the service and did not highlight Azalea House with large signs outside. Staff completed checks of the houses throughout the day and night to observe and monitor any risks. The registered manager informed us that the police regularly monitored the surrounding area of Azalea House, especially if the service contacted the police with any concerns.

There were 2 houses situated next to each other. Both houses shared facilities which included the garden and communal areas. People living in both homes also moved freely from each location and staff also supported each other. We saw that the communal gardens had been adapted to provide a quiet area where people could sit and reflect. There was also an area where people could grow vegetables and plants. One person had 2 pet rabbits in the garden which they proudly showed us. Communal areas in both houses were bright, spacious, well maintained and nicely decorated. In both dining areas we saw a ‘wall of praise’ which showcased people’s achievements with certificates and photographs.

The registered manager had excellent oversight of the service and regular assessments of the premises, both internal and external were completed and any repairs or risks identified were dealt with promptly. There were service certificates in place to ensure all equipment was in good working order.

There were sufficient qualified, skilled and experienced staff to fully support people and meet their needs. One person told us, “The staff are the best. I don’t feel they are here for the money but because they genuinely care.” A relative said, “There are always plenty of staff. I have never known them to be short of staff. They are welcoming and they know [family member] so well. We are all like 1 big family.” People told us they had regular staff to provide their support which was important to them. One person said, "We do have the same staff, and we all know each other well. We are friends. They know how to support me.”

Staff expressed satisfaction regarding staffing levels. One staff member told us, "Yes we have enough staff to help people when they have to go out to appointments or want to do something different like go shopping.” Another staff member commented, “There are enough staff. We are not under pressure at all. We don’t use agency and staff cover shifts which is much better for the residents.” The registered manager told us, “We use staff's experiences, training and specific skill set to match people and staff where they are compatible.”

We observed there were sufficient staff to meet people’s needs when they required staff company or support. Interactions with staff were respectful and there was a lot of banter and laughing.

People were involved in the staff interview process if they wished to be. Applicants visited the service and engaged with people living there. Staff then asked people for their views and opinions about the applicant and whether they would like them to be recruited. A robust assessment of people’s needs was completed before a support package was agreed. This meant the provider was able to assess how much support a person needed and how many staff were required to provide that support safely. Staff rotas showed that sufficient numbers of staff were consistently deployed to fully meet people’s needs.

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.

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