ELSI (SW) LTD

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

We reviewed all 8 of the quality statements in this key question.

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.

People told us about learning following incidents. For example, 1 person told us about a piece of equipment they had started using to help keep them safe. This had been introduced in response to incidents of falls. People felt able to raise any concerns about safety with staff and management.

There were regular opportunities for staff and management to discuss any learning from incidents and accidents. Staff told us they had forms to fill in following any incident which prompted them to think about how they could avoid a reoccurrence.

Healthcare professionals we spoke with told us they had observed a learning culture at the service. They told us during their reviews of records staff demonstrated awareness of risks and effective management to support people safely.

All incidents were recorded on the provider’s system and reviewed by management. Any lessons learned were identified and actions taken to prevent reoccurrence. Learning was discussed during staff supervisions, staff meetings or handover processes.

People spoke positively about their experience of moving into the service. They told us they had been given the opportunity to visit for short periods of time and overnight stays before moving in.

The registered manager told us about supporting people to visit the service and meet other people prior to deciding to move in. Staff told us that a recent process of the provider taking over management of a service had been a positive experience for them.

Healthcare professionals told us when they visited the service people felt their views and ideas were listened to and acted upon. We were told staff had worked well in making sure records were transferred effectively and safety from paper to an electronic records system.

People’s records demonstrated their needs were assessed before they started using the service. Assessments included details of the range of health and social care services the person used and arrangements to ensure the support was maintained.

People told us they felt safe at the service being supported by staff they knew very well. Relatives also felt safe systems of working kept people safe from harm.

Staff understood their role in keeping people safe. Staff knew how to report any safeguarding concerns. The registered manager told us they were confident staff had the training needed for safeguarding and there were opportunities in meetings and supervisions to discuss concerns.

We observed people being supported safely.

The service had systems to make sure safeguarding incidents were recorded and reported to the local authority in a timely way. The registered manager kept records of incidents with outcomes to make sure all the required actions had been completed. The provider had a safeguarding policy which all staff had access to. Safeguarding training was provided to staff regularly and staff had opportunities to discuss safeguarding at meetings and during supervision.

People told us they felt able to take risks and have the support they needed from staff when appropriate.

Staff knew how to access risk assessments and they were aware of risks to people’s safety. Staff told us how they used pictorial information to help people understand about risks. Staff also said they would involve relevant healthcare professionals where appropriate. For example, staff had worked with occupational therapists to review equipment for people to help them be safe in the home.

We observed staff supporting people safely and making sure people had what they needed to go out into the community.

People had risk assessments and risk management plans, which set out the support they needed to stay safe. The plans had been regularly reviewed with people to ensure the measures in place were up to date.

People told us they felt their environment was safe and they had any equipment they needed.

Staff were responsible for carrying out health and safety checks in the service. They told us any defects were reported to the landlord and repaired promptly.

We found the environment was well maintained.

There were systems to check people’s accommodation and action was taken to repair any defects identified. Checks included gas safety systems, water systems, fire equipment and electrical systems.

People and relatives told us there were enough staff available to support people. People were having their commissioned 1-1 hours consistently.

Staff told us there were enough staff to provide a safe service. Staff felt they had the training they needed for their work. Staff told us training was very effective and helped them develop skills and knowledge.

During our observations we saw there were enough staff to meet people’s needs safely.

Required pre-employment checks had been completed for staff before starting work. This included a check with the Disclosure and Barring Service (DBS). New staff received an induction, which included training and shadowing experienced staff. Records demonstrated staff had regular supervision sessions.

People and relatives were satisfied with the cleanliness and hygiene at the service. People told us they enjoyed completing light domestic tasks which included keeping their own rooms clean. This activity was part of people's weekly routine which was important for their wellbeing.

Staff told us they had any personal protective equipment they needed and had received training on infection prevention and control. Staff told us they also had been provided training on food hygiene which helped them support people with their meals.

People’s homes were kept clean and free from odours.

The provider had an infection prevention and control policy, which was regularly reviewed and updated to reflect current guidance. The management team completed checks to ensure staff were putting the procedures and their training into practice.

People told us they were happy with the support they had from staff to manage their medicines.

Staff told us they received medicines training and they were confident providing medicines support to people. Staff said they also had been assessed for competence in administering medicines. Staff we spoke with knew how to report any medicines incidents and where to go for further advice.

People told us and we observed they had the support they needed with their medicines. We also observed medicines were being stored safely.

Policies and procedures were available to help staff support people with their medicines. People’s support needs for medicines administration were assessed and recorded. Records demonstrated people received their medicines as prescribed. There were protocols to support staff with any medicines prescribed ‘as required’. Staff were trained and assessed as competent to administer medicines.