Strathfield Gardens

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

Systems were in place to protect people from the risk of abuse. Staff had undertaken training about safeguarding adults and understood their responsibility for reporting allegations of abuse. Risk assessments set out how to protect people from harm and people were involved in developing these assessments. There were enough staff to meet people's needs and robust staff recruitment practices were in place.

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.

Relatives told us the service sought to protect people from the risk of harm. A relative said, “They are very good at recognising medical problems and monitoring them and doing something about it.” Another relative told us, “Yes, I do think [person] is safe. They are very excited to see the staff when they come to pick him up from my house and he always wants to go back.” The same relative added, “Yes, as I say, [person] wants to be there and they seem happy about being there."

The registered manager of the home told us that safeguarding was covered in a variety of ways. There is a ‘policy of the month’, where safeguarding is featured regularly amongst the organisations other policies in the staff meetings. We were told staff report any concerns to the registered manager, who was responsible for reporting to senior managers within the organisation as well as to other external agencies. In the absence of the manager, stand in cover is appointed and staff are required to report concerns directly to them. Staff were able to describe the different types of abuse to us and were clear about who within their organisation they can report to. Staff were also able to tell us the names of organisations who are external to their own who they could raise concerns with. All the staff we spoke with knew about the organisation’s whistleblowing policy and where to find the contact details for this if they had concerns. A staff member told us that they had worked in the home since August 2023. They told us that they had undertaken numerous training courses as part of their employment but had yet to be trained in safe hold techniques used by the staff team. We noted that there had been no allegations of abuse related to anyone living in the service since 2021.

We observed that there were some issues with the safety of the premises on the day of inspection. The COSHH cupboard was found to be unlocked and not all the fire doors closed automatically. COSHH stands for Control of Substances that are Hazardous to Health, and some products that are hazardous to health should be stored securely in a care home setting. We discussed these issues with the registered manager who took steps to address them issues during the course of the inspection.

The provider had various policies in place to provide guidance around safeguarding people from the risk of abuse. These included a whistleblowing policy and a safeguarding adults policy. The latter made clear the provider’s responsibility to report any allegations of abuse to the local authority ad Care Quality Commission. The registered manager told us there had not been any allegations of abuse within the past 12 months. Staff had undertaken training about safeguarding adults and understood their responsibility to report any allegations of abuse. The service held money on behalf of people. Records and receipts were kept of financial transactions. We checked three sets of monies, and in each case there was a small discrepancy [under £2] between the amount held and that recorded. Staff told us they checked the money every day but did not record they had checked it. The registered manager told us they would introduce a system to check and record monies at each shift handover, and that if there were any shortfalls in people’s monies these would be re-embursed. Where people had been deprived of their liberty to some degree, this was done in line with legislation, and people had Deprivation of Liberty Safeguard authorisations in place. Where there were conditions attached to these authorisations, we saw they had been met.

People and relatives told us they felt safe living at the service. A person replied ‘yes’ when asked if they felt safe. A relative said, “I do think it’s safe there, I have never had any issues with that. They take care of the residents really well."

Staff we spoke with were able to describe processes used to identify risk. They told us how from an initial assessment and an interim care plan, they were then able to identify risks within a 10 week assessment period before writing up a comprehensive risk assessment plan. Staff told us about the types of risk people took which balanced the need to keep them safe whilst learning to do new things. A member of staff told us, “We write down things using observation logs to describe what happens during the day or night, then we discuss it at team meetings.” Staff described working with others such as local authorities to gain information about risk associated with individuals prior to moving in. Staff talked about people’s right to take risks in order to grow as people.

The risk assessments we saw were in date and were detailed. They included information regarding all previous risks, describing what happened on each occasion and how it was managed with any necessary follow up action. We saw information, largely around behavioural incidents but also assessments covering a wide variety of areas tailored to the person’s individual needs. During our visit we reviewed positive behaviour support plans for the people we looked at. The plans contained detailed information including the three stages of emotions and what these look like as well as clear information about likes and dislikes. However, we noticed that one plan mentioned staff responding to ‘discernible triggers.’ We suggested that the triggers be listed in detail so any unfamiliar staff will be able to identify triggers as they arose. We saw health records and it was evident that people were supported to attend appointments to meet all of their health needs. Records detailed appointment information, who was seen and what the outcome was. However, further follow up information was needed in some cases to be able to see the final outcome for some health concerns.

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

People and relatives told us there were enough staff and that staff treated them well. One person said, “The staff that come in I like.” A relative told us, “They always seem fully staffed when I go.” Another relative said, “There always seems to be quite a lot of staff there. Staff working with all the residents."

All of the staff we spoke to told us that they felt there were enough staff. They told us how they were able to support people who may become distressed whilst having enough staff to support other people in order to reassure them. Staff told us about the things that people did in their local community. We were told that this required at least 1:1 support and for 2 people 2:1 support was required when going out. The Manager told us that there was a full staff team with no vacancies and in the previous month had used a small amount of agency cover, using a person who was familiar with the needs of the people in the home. The registered manager told us that in addition to the role of registered manager there were also 2 senior support workers who helped with the day to day running of the service.

Staffing levels were determined according to the needs of individuals so that people’s needs were met. We saw that the staffing levels on the day of inspection were in line with the staff rota and that there were enough staff to meet people’s needs. The service had effective systems to ensure suitable staff were recruited. Pre-employment checks were caried out on prospective staff. These included employment references, proof of identification and criminal records checks. This was in line with the provider’s policy on staff recruitment. Staff completed regular training and development courses to aid them in their roles. Training included understanding autism, dignity in action, equality and diversity and first aid.

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.