Tushmore Lane

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

People were protected from the risk of harm and abuse. Staff understood their responsibilities under safeguarding with respect to identifying potential abuse, escalation and the reporting of concerns. People were involved with managing their care, including risks to their health and support. People were supported by enough staff who received appropriate training to meet thier needs.

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.

People were kept safe from avoidable harm because staff knew them well and understood how to protect them from abuse. Relatives told us that they felt that staff understood thier loved ones needs well and felt they were protected from forms of abuse. One relative said, "We are very happy the care staff there are very good."

Effective systems were in place to manage safeguarding risks. The provider had escalated incidents to relevant local authorities and CQC when needed. Systems in place to review behaviours that challenge to protect individuals and others that may be affected. When there were incidents of challenging behaviour, the service had sought the input of its internal positive behaviour team to review and provide additional guidance. Training records showed that staff compliance in safeguarding training was at 100%. Training also completed by staff in identifying financial abuse as all those at the service were identified as being at risk and was also supported by training in Positive Behaviour awareness and sexuality and relationships. Provider has internal PBS in place which reviews incidents that occur within the service to determine if PBS support plans and support requires adjusting.

The manager and staff were clear on their safeguarding responsibilities. Statutory notifications had been submitted to CQC and LA alerted to any potential safeguarding incidents. The registered manager had recently left the service, but people and the staff were being supported by a peripatetic manager who was aware of safeguarding processes. Staff were knowledgeable about safeguarding processes and when to escalate incidents. One staff member said, “Incidents are managed within Positive Behaviour Support (PBS) and we know peoples triggers.”

Risk assessments were detailed, person centred and provided detailed guidance for staff to manage these. For example, people were active in the community with activities and there was a balanced and proportionate assessment of the risks associated with those. This allowed them to participate as much as possible. Risks associated with people’s health were managed well. For example, some people required ongoing support and monitoring with Epilepsy. There was appropriate guidance and systems in place for staff to monitor any seizure activity and what staff needed to do in response to any seizures. Risks to managing people’s anxieties were monitored well. Staff received training in providing postive support, were knowledgeable about what triggered peoples anxieties and recorded any incidents appropriately. For example, a trigger for one person incident was identified as being the change of staff on shift. One to one support was provided following the incident with the manager to manage anxieties and work with the person to manage this risk. Systems were in place to involve people in managing any risks in their daily lives. Risks were discussed in monthly key worker meetings with people. For example, key worker discussions for one person involved retraction and support with personal care tasks for which the person needed ongoing support to avoid neglect.

People lived safely and free from unwarranted restrictions because the service assessed, monitored and managed safety well. People were involved in the managing of risk and were supported by staff to take positive risks. This supported people to undertake daily activities and interests of their choice. One relative said, "Yes, I believe they support this (risk mangement) well."

The manager was new to the service but had gained knowledge of the people the service supported. Management ensured that risks to people were regularly reviewed, and guidance updated if needed. Staff were knowledgeable about risks to the people they supported. For example, many people required support to manage their epilepsy. Staff spoke confidently and accurately on the support people needed to manage their medication, environmental risks etc, as well as what actions to take in the event of seizure activity for that person.

Staff were observed supporting people in activties when one to one support was needed. Staff undertook this confidently and safely.

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

The manager and area director were clear on the induction and training process and had clear oversight of staff’s progress and development. Staff spoke positively about the induction and ongoing training they received to equip them for their role. One staff member said, “Managers are supportive and give time for us to complete training.” One staff member said about their induction, “I started by reading support plans and shadowing staff for this site.”

People were supported by enough, trained staff to meet their needs and keep them safe. People were observed being comfortable and confident approaching and engaging with staff. One relative said of staff’s approach to their loved one, “They know him well and very capable of looking after him. When (person) first went to the home, staff had a bit to do, and I was a learning curve. They did that straight away. They dealt with it very well and kept us informed.” Another relative said, "I was there the other week and there was plenty of staff there. They are fairly self-sufficient there anyway."

We observed there were enough staff and they were engaging with people in a safe and positive manner.

Staff were consistently recruited through an effective recruitment process that ensured they were safe to work with people. Appropriate checks had been completed prior to staff starting work which included checks through the Disclosure and Barring Service (DBS). DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. New staff were expected to complete the care certificate. The care certificate is a set of standards for health and social care professionals, which gives everyone the confidence that workers have the same introductory skills, knowledge and behaviours to provide compassionate, safe and high-quality care and support. Training had been identified according to the needs of the people living at Tushmore Lane. These included positive behaviour support, learning disability, Autism, safeguarding, Mental Capacity Act (MCA), medication and moving and handling. Staffing levels were reviewed to ensure that people were supported by enough staff. The provider calculated these based on people’s assessed and funded one to one support.

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.