Sarnes Court

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

The service supported people to be safe from abuse and neglect. People’s care and risk management plans were person-centred, proportionate and staff reviewed these with people regularly. There was a proportionate approach to assessing risks to people’s safety and well-being. There were safe medicines management processes in place. Staff supported people with their medicines in a way that promoted their independence and helped them to achieve good health outcomes. The registered manager encouraged openness and transparency to report and learn from incidents and concerns. The provider ensured there were sufficient numbers of staff to support people safely. The provider used appropriate recruitment procedures to employ suitable staff. Staff completed induction and assorted training so they could support people effectively.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The registered manager encouraged a culture of safety and learning at the service. People were supported to be independent while maintaining their safety. People were encouraged to discuss and learning safety issues in an open manner, such as during one-to-one meetings with a keyworker and during monthly ‘Resident Meetings’. Learning from incidents and people’s experiences had informed ‘communal rules’ at the service, which people had developed and agreed to continue fostering and mutual respect in the shared accommodation setting. Staff also used one-to-one meetings with people to reflect on and learn from any incidents or concerns they had experienced.

Staff understood how to report incidents including using the providers digital recording systems for this. The registered manager encouraged people and staff to report issues and they felt supported to do so. The registered manager used regular team meetings to discuss health and safety issues and learning from incidents or complaints, both from this and the provider’s other services. For example, ensuring appropriate recording of actions taken when raising issues to other providers. This aimed to help the service to embed good practices based on this learning. Meeting records showed this took place. The registered manager was aware of their Duty of Candour responsibilities to be supportive, open and transparent with people and relatives and to apologise when things went wrong.

The provider had appropriate Complaints and Duty of Candour procedures in place for handling and learning from incidents and complaints. Incidents and complaints were reported and investigated appropriately. The registered manager checked that staff used meetings with people to discuss any relevant incidents with the person and identify learning from these. The provider’s systems for monitoring the quality of people’s care and support promoted continuous improvement at the service. For example, reporting processes required the registered manager to identify lessons learned from each incident and to inform the staff team of this. This enabled them to identify any incident patterns and trends and take remedial action to address them. The provider’s quarterly quality assurance auditing checked that the registered manager was doing this. The provider was signed up to national alerting systems so as to be informed of critical public health and safety information. The registered manager was aware of this and this information was cascaded to the registered manager for action when required.

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.

The provider’s processes promoted people living in safety, free from abuse, neglect and avoidable harm. This included procedures for handling people’s money for group activities. The registered manager reported safeguarding concerns to the local authority and CQC. They worked in collaboration with partners to keep people safe.

The service supported people to be safe from abuse and neglect. The service supported people to understand safeguarding issues, what being safe means to them and how to raise concerns. People were supported appropriately when they did so. This was done during one-to-one discussions with people, with care and risk management plan reviews and in workshops staff arranged for people. For example, the service had held workshops to promote people’s understanding of safeguarding issues and having safe relationships.

People appeared to be comfortable at the service. They spoke about and interact with staff and the registered manager in a relaxed manner.

The staff and registered manager had completed training on how to recognise and report abuse. They had a good understanding of safeguarding and how to take appropriate action in response to concerns, including reporting concerns to statutory agencies. The registered manager led on developing a culture of staff being open to people when they wanted to speak so as to give people the confidence to raise issues. A member of staff told us, “We make ourselves available.”

The registered manager and provider used a system of regular checks and audits to ensure that people’s care and risk management plans were reviewed regularly and updated when required. They also completed medicines support, money handling and infection prevention and control checks so as to keep people safe.

There was a balanced approach to assessing risks to people’s safety and well-being. People’s care and risk management plans were person-centred, proportionate and staff reviewed these with people regularly. People were informed about and involved in managing risks to themselves and in taking decisions about how to keep safe.

We noted some people’s plans were not always clear on some aspects of their care, such as how the person managed their healthcare needs. We discussed this with the registered manager and they addressed this promptly. Staff understood the assessed risks to people’s safety and well-being and staff described how they discussed risks with people. The service provided people with information and advice about the daily living decisions they made. For example, staff held a workshop on healthier eating to encourage people to make informed decisions about this. Staff provided easy read information about healthy eating as well.

Staff and the registered manager were around for people to talk with when they wanted. A person told us they got on well with staff.

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

There were sufficient numbers of staff to support people safely. There was a small team of staff and the registered manager was recruiting at the time of our assessment. The provider used appropriate recruitment processes to employ suitable staff. Staff completed induction and assorted training, including training on working with autistic people or people with a learning disability. Staff told us they valued the training opportunities and it helped them to be competent in their roles. Staff received regular supervision and felt supported by the registered manager and the provider. They could get advice when they needed to. They said the registered manager encouraged them to raise issues and concerns.

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.

There were appropriate arrangements in place for the administration, recording and storing of medicines safely. This included regular temperature checks of a fridge used to store medicine at a safe temperature. The registered manager audited these arrangements regularly and the provider also checked medicines support was in place and audited. This included ensuring staff completed medicines support training and competency assessments as required. The provider had appropriate medicines support policy and procedures. These advocated the principle that each person had the right to manage and administer their own medicines. The procedures were informed by guidance from the National Institute for Health and Care Excellence (NICE). The provider was signed up to national alerting systems so as to be informed of any adverse incidents relating to prescribed medicines and medicine devices. This information was cascaded to the registered manager for action when required.

People managed their own prescribed medicines and were involved in all decisions to do with this. Staff supported and respected people’s choices around managing their medicines, helping people and providing advice when required. People were involved in assessments and reviews about the level of support they needed to manage and take their medicines safely. This was clearly documented in their care and risk management plans. These included guidance for people on taking medicines prescribed for occasional use, such as pain relief. Staff completed assessments with people regarding their capacity to manage their medicines, in line with the Mental Capacity Act 2005. People signed consent agreements regarding the level of medicines support they wanted from staff. Staff helped people to discuss and review their medicines with prescribers such as their GP. Medicines were not used to inappropriately control people’s behaviour.

Members of staff completed training in medicines awareness and medicines support. The registered manager assessed their ability and understanding to provide this support safely before they were permitted to do so. This meant people were supported by competent staff. Staff used medicines administration records to note when they did support a person with their medicines, such as help to apply a prescribed cream. These records were completed appropriately and showed where staff were to apply this and recorded when they did so on a daily basis. The registered manager used regular team meetings to reinforce staff aware of safe medicines support practice and the provider’s medicines support procedures. Meeting records confirmed this took place.