Felix 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

Safeguarding systems, processes and practices were effective to help ensure people were protected from the risk of abuse and neglect. The service had a balanced and proportionate approach to risk that empowered people and respected the choices they made about their care. Safe recruitment practices helped ensure all staff, were suitably experienced, competent, and able to carry out their role. There were appropriate staffing levels and skill mix to make sure people received consistently safe, good quality care that was person centred. Staff received training that was relevant to their roles and responsibilities. They were supported by the registered manager and colleagues. This included supervision, support to personally develop, improve services, and where needed, professional revalidation.

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.

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.

Staff took every precaution to help keep people safe from unnecessary harm. They were kind and ensured people were happy and felt safe. They encouraged people to make choices to reduce risks and stay safe, whilst respecting people's rights to make their own decisions. The registered manager and deputy manager maintained a visible presence within the service to monitor interactions and make improvements where necessary. They told us about recent improvements they had made to processes to ensure concerns were always reported in a timely way.

People appeared to be happy, comfortable, and safe in their surroundings. They told us they felt safe, they would speak with staff if they were worried, and they always felt listened to. Comments included, “I can speak with any staff, they always pass it on to the manager” and “Staff are very friendly and easy to approach.” One person wrote in a recent survey, “I feel safe. I feel supported. If I'm not happy I tell a staff member. I get along with others in the home and we have group meetings.” We also saw evidence where a person was upset about how another person had spoken to them, staff supported this person to raise a concern to help ensure this did not happen again. Relatives spoke with us about the support they received, whether they felt their family member was safe and that they were listened to. Comments included, “I feel happy, I sleep at night. I feel that the keyworker and a few other staff are particularly good with my relative and very tuned in”, “I think the staff are supporting my relative to stay safe” and “I feel like we’re a team, we work together to help my relative.”

Staff understood what constituted abuse and the processes to follow to safeguard people in their care. Policies and procedures were available, and staff had attended safeguarding training updates to refresh their knowledge and understanding. The registered manager and staff recognised their responsibilities and duty of care to raise safeguarding concerns when they suspected an incident or event that may constitute abuse. They notified the relevant agencies including the local authority, CQC and the police. People’s capacity to make decisions was assessed. Assessments were discussed with relevant parties and outcomes recorded. The registered manager had submitted appropriate Deprivation of Liberty Safeguard applications for people. The manager followed these up and information was available in people’s individual care records. Staff understood the principles of the Mental Capacity Act and had received training to ensure they knew how to apply these in practice.

During our visit, we saw how staff supported people to reduce identified risks relating to food safety and preparation. This included a person being involved in cooking a roast dinner with a staff member and observational support whilst people were making their own hot beverages throughout the day.

Everyone who worked at the service knew and understood the risks to people well. Staff told us risk assessments contained up to date information to support people safely and effectively. Staff had a good level of understanding when identifying potential risks, managing actual risks, and keeping these under review. Staff understood their responsibilities for reporting accidents, incidents, or concerns. Staff had identified when certain behaviours from people could impact on their safety and, that of other people who lived in the service, staff, and visitors. Staff considered what triggers may exacerbate certain behaviours so these could be avoided wherever possible, for example loud noises, shouting, pain, and distress. Where this had not been possible, staff knew how to support people to de-escalate the situation. Staff had the knowledge and skills to protect people safely without being restrictive. This particularly related to supporting people with behaviours that they were unable to control at times.

People were supported to take risks balanced on their safety and their health care needs. People's capacity had been considered when such choices had been made and their right to take informed risks was respected. We saw good examples where extensive work, re-evaluation, monitoring, and support had enabled people to be as independent as possible, whilst respecting there may be a degree of risk. This included, promoting life skills, attending appointments, managing medicines and finances, and exploring services within the local community. The registered manager and staff provided examples of a positive, person-centred approach to the management of risk and this was reflected in individuals’ achievements.

Processes and systems such as handovers, care record reviews, ‘residents’ meetings and keyworker support helped ensure risks continued to be managed safely and were effective in enhancing people’s lives. In addition, the service worked alongside families, significant others and health and social care professionals to help provide a holistic approach to risk management. Written accident and incident documentation were comprehensive. There was evidence of learning from incidents and changes were implemented. Monthly audits helped staff identify trends to avoid further recurrences.

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

During our visit, people had made individual plans for the day ahead and staff responded promptly to people’s requests for support when required.

People we spoke with and evidence from surveys confirmed there were enough staff to support individuals. One person told us there were enough staff and commented, “They are a stable team, I know all the staff.” Relatives told us there had been use of agency staff, but this had improved and that weekends appeared well staffed when they visited. One staff member told us, “When we use agency, we do ask for feedback from the people we support”. People and relatives told us they felt staff were equipped with the skills to support people effectively. Comments included, “I think they do an incredibly difficult job, yes I think they are well trained” and “Yes, I think they all know what they are doing, they appear well trained. They know how to care for my relative properly”.

Systems and processes helped ensure training and supervisions were up to date and supported best practice. Recruitment was seen as an essential part of keeping people safe whilst ensuring they were cared and supported by staff of good character. Safe recruitment procedures were followed. Pre-employment checks had been completed and written references were validated. Disclosure and Barring Service (DBS) checks had been carried out for all staff. A DBS check allows employers to check whether the applicant has had any past convictions that may prevent them from working with vulnerable people.

Staff confirmed there were enough staff available to meet people’s needs. Levels would vary depending on people’s planned activities and in response to people’s changing needs. This included when people became unwell. The registered manager ensured there was a suitable skill mix and experience during each shift. The registered manager told us they were currently integrating new staff members into the team. The service used minimal and regular agency staff to ensure continuity of care. People were supported by staff who felt confident and competent to assist and care for people. The registered manager ensured staff were equipped with the necessary skills and knowledge to meet people’s physical and psychological needs. Staff confirmed the training they received was effective. Staff who had recently completed the provider’s induction told us the process prepared them to work in the service independently. The service had a small, steadfast group of staff. They felt supported by the provider, registered manager, and other colleagues. Additional support and supervision was provided on an individual basis. Supervision supported staff to discuss what was going well and where things could improve. They discussed individuals they cared for and any professional development and training they would like to explore. Comments from staff included, “The staff are great. Management are supportive, I have no issues. I love it here”, “My progression to team leader tells a story of how I have been supported” and “We are a really good team, and we do a good job.” Everyone attended staff meetings as an additional support, where they shared their knowledge, ideas, views, and experiences.

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.