Levitt Mill

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 assessed all quality statements for this key question. Our rating for this question remains Good. People felt safe living at Levitt Mill. People and their relatives made positive comments about the staff team. Staff understood their responsibilities to raise any concerns about people’s care and were confident to raise concerns with the management team should they need to. Staff understood people’s risks and helped people to manage them effectively, without overly restricting their freedom. The service worked with people to plan for when they experienced any periods of distress using a positive behaviour support (PBS) approach. People received their medicines safely and as prescribed and there were systems in place to monitor the safety and cleanliness of the home. There were enough suitably recruited and trained staff to support people to enjoy full and rewarding lives. People were supported to move safely into the service, having been assessed before admission. The provider was working in line with the Mental Capacity Act. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguarding (DoLS).

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 they were safe and relatives told us they felt confident in the support people received from staff. Incidents and complaints were managed well. Relatives said there was a culture of openness.

Staff were aware of how to respond to accidents and incidents which included how to record and report incidents. One staff member said, “I’m confident to report things if I need to, and I know they’ll be dealt with properly.”

The provider had policies in place which were accessible to staff. The registered manager, general manager and wider management team analysed incidents, accidents and concerns thoroughly. This helped to identify themes and patterns, and any lessons to be learned. Action was taken to address shortfalls and changes were made in people’s care and support, how the service was run, or training needs for staff.

People told us staff helped them when they needed to see a healthcare professional, such as the doctor and dentist. There was evidence of involvement from other health care professionals in people’s care records and staff made referrals to make sure health needs were met.

Staff spoke positively about consistency of approach, teamwork and communication in the team and the benefit of for the people they supported.

Feedback from partner professionals showed the service worked well in partnership to assess and address people’s individual needs. One partner professional told us, “I have an individual placed there who I have been supporting. I have found Levitt Mill to be open, honest and transparent, they always keep me up to date regarding the individual, they notify me of any incidents or concerns. They will also contact me for advice.”

The service undertook thorough assessment of people’s needs before people moved into Levitt Mill. This was so the service would be aware of, and equipped to meet people’s needs and helped to make sure people experienced a safe transition into the service. Staff referred people to other services, such as community mental health teams, speech and language therapy and social services for additional help when needed. Staff communicated well with other professionals to help people to experience smooth transitions when using healthcare and other social care services.

People told us they felt safe with the staff and relatives felt their family members were safe. People were supported to understand abuse and how to report it, and information on how to do so was provided in accessible formats.

Staff received training on safeguarding and understood their responsibilities to keep people safe. Staff were confident that any issues raised with the new management team would be fully investigated to make sure people were protected.

We saw warm and respectful interaction between people and staff. Staff offered people choices and asked for consent before providing care and support. The atmosphere across the service was friendly, calm and relaxed.

The provider had policies about safeguarding and whistleblowing to provide guidance for staff. Safeguarding concerns were recorded appropriately and reviewed to make sure the relevant professionals were notified. Lessons learned were shared in the staff team and used to improve the service. Some people would be at risk if they did not have continuous supervision. Where this was the case, the provider had applied for Deprivation of Liberty Safeguards (DoLS) to make sure people who could not consent to their care arrangements were protected, where those arrangements deprived them of their liberty. This was monitored by the registered manager and reflected in people’s care records.

People and their relatives were involved in the assessment of people’s needs and the management of their risks where appropriate. Relatives told us risks were well managed without restricting people’s freedom more than was necessary.

Staff were trained in the use of restrictive interventions and were aware of the need to use the least restrictive option. Staff said people’s risk assessments and care plans were reviewed on a regular basis and when there were changes in people’s needs. Staff told us they were kept up to date with changes in people's care from written records, staff handovers and team meetings.

Staff were vigilant when people were moving around or undertaking activities, and made sure people remained safe. When people communicated their needs, emotions, or distress, we saw staff managed this in a positive way that protected people’s rights and dignity.

People had person-centred care plans and risk assessments in place that included ways to avoid or minimise the need for restricting people’s freedom. This helped to make sure staff knew how to provide care that mitigated known risks.

People and relatives spoke positively about the environment provided at Levitt Mill. People were safely supported in the service. The provider made sure any potential risks were assessed and managed, including checks of equipment, where necessary.

Staff were aware of safety and told us they received a range of training to support them to keep people safe. Staff supported people to do the things they wanted to do.

People were safely supported in the service. There were systems in place to monitor the safety and upkeep of the premises.

The provider made sure any potential risks were assessed and managed, including regular checks to make sure the environment and equipment was safe for people.

People indicated they liked the staff and there were enough staff to support them to do the things they liked doing, at Levitt Mill and out in the community. Relatives spoke positively about staffing levels. One relative added, "The staff are all lovely. They treat [my family member] like they’re part of their family.”

Staff felt they received good quality training and support to help them to deliver a high standard of care. Overall, staff told us there were safe staffing levels at the service. However, a staff member felt senior staff should not be expected to accompany people out in the community when they were in charge of managing a shift. We fed this back to the registered manager.

There were appropriate staffing levels in place to meet people’s needs and enable people to get out in the community. People did not have to wait for support from staff. Staff were seen to regularly check on people to make sure they were well and ask if they needed anything.

Safe recruitment processes were in place, so people were cared for by suitably qualified staff who had been assessed as safe to work with people using the service. Staff underwent an induction and shadowing period prior to commencing work. They had regular updates to their training to make sure they had the skills and knowledge to carry out their roles including specialist training to meet the individual needs of people using the service. Staff received the support they needed to deliver safe care. This included supervision, appraisal and support to develop.

People told us staff helped them to keep their homes clean. Some people proudly showed us how clean they kept their bedrooms. One person said, “I like my room to be nice.”

Staff told us they supported people to keep their houses clean, involving them in day to day upkeep of their home, where possible. Staff were aware of good practice on the use of personal protective equipment (PPE). The registered manager described how any maintenance had to be carefully planned around people’s needs to minimise disruption for people.

We noted no concerns with cleanliness and infection control during our visits. The houses were homely, and acceptably clean.

The provider had policies and procedures regarding infection prevention and control (IPC) and had effective systems in place to monitor standards. Personal protective equipment (PPE) such as gloves and aprons was accessible throughout the service.

People said they were happy with the support staff provided with their medicines and relatives we spoke with raised no concerns about the support people received.

Staff knew when and how to administer people’s medicines appropriately, safely and effectively. Staff said staff administering medicines received training and there was guidance in place about people’s ‘when required’ (PRN) medicines.

The provider understood and implemented the principles of STOMP (stopping over-medication of people with a learning disability, autism or both) and ensured people's medicines were reviewed by prescribers in line with these principles. Systems and processes were in place for the safe administration and storage of medicines. There was clear documentation and audit trails to show where all medicines were booked in and disposed of. Stock checks and audits were regularly carried out by senior members of the team and this was clearly recorded.