Prompts that may be used by CQC inspectors to explore this...
S2.1 What arrangements are there to manage risks appropriately, and to make sure that people are involved in decisions about any risks they may take?
S2.2 How do risk management policies and procedures minimise restrictions on people’s freedom, choice and control, in particular for people who lack mental capacity?
S2.3 Are people’s records accurate, complete, legible, up-to-date, securely stored and available to relevant staff so that they support people to stay safe?
S2.4 Are formal and informal methods used to share information with appropriate parties on risks to people’s care, treatment and support?
S2.5 Are there thorough, questioning and objective investigations into whistleblowing or staff concerns, safeguarding, and accidents or incidents? Are action plans developed, and are they monitored to make sure they are delivered?
S2.6 How is equipment, which is owned or used by the provider, managed to support people to stay safe? Relates to: All Services, How are the premises and safety of communal and personal spaces (such as bedrooms) and the living environment checked and managed to support people to stay safe? Relates to: Care homes?, How does the provider manage risks where they provide support in premises they are not responsible for? Relates to: All Services
S2.7 How do staff seek to understand, prevent and manage behaviour that the service finds challenging? How are individuals supported when their behaviour challenges? How well does this align with best practice?
Products that can help include...
Positive Behaviour Support
Positive Behaviour Support
If you are supporting people with challenging behaviour you need well trained and competent staff. The guide Positive behavioural support (PBS): a mini guide to arranging and paying for training to support with PHBs, covers: what to look for in PBS training for staffhow to find a suitable learning provider paying for training
Managing Risk (Good and outstanding care guide) Managing Risk (Good and outstanding care guide)
Recommendations and practical examples from services rated good and outstanding including;
- Follow legislation, human rights, provide freedom, etc.
- Avoid inconsistencies between assessments and plans, etc.
Supporting staff that regularly work alone Supporting staff that regularly work alone
A large proportion of frontline care staff work alone and it’s important that employers establish a healthy and safe working environment for lone workers. Our online guide provides information about what works well for employers that employ staff who regularly work alone. It’s based on learning and recommendations from research that Skills for Care did with adult social care employers that employ lone workers. It covers;
- What is lone working in adult social care
- Recruiting and retaining the right people for lone working
- Planning and managing the workload
- Supporting learning and development
- Meeting health and safety responsibilities
- Personal safety
- Supporting good mental health and wellbeing
- Communication and support
Delirium in adults (2014) (QS63)
Delirium in adults (2014) (QS63)
NICE quality standard on the prevention, diagnosis and management of delirium in adults in hospital or long-term care settings. It includes statements and measures on;
- assessing recent changes in behaviour
- interventions to prevent delirium
- the use of antipsychotic medication for people who are distressed
- providing information about delirium
The statements are specific and concise and focus on priorities for quality improvement.
In particular, please see statements 1 & 2.
Falls in older people (update 2017) (QS86) Falls in older people (update 2017) (QS86)
NICE quality standard on the prevention of falls and assessment after a fall in older people (aged 65 and over) who are living in the community or staying in hospital. It includes statements and measures on;
- identifying people at risk of falling
- risk assessment for older people at risk of falling
- strength and balance training
- home hazard assessment and interventions
The statements are specific and concise and focus on priorities for quality improvement. In particular, please see statements 1, 2 & 3.
Preventing excess winter deaths and illness associated with cold homes (2016) (QS117) Preventing excess winter deaths and illness associated with cold homes (2016) (QS117)
NICE quality standard on preventing health problems associated with cold homes. It focuses on people particularly vulnerable to the effects of the cold, such as people with cardiovascular or mental health conditions and older people. It includes statements and measures on;
- identifying people who are vulnerable to health problems associated with a cold home
- asking them about keeping warm at home
The statements are specific and concise and focus on priorities for quality improvement.
In particular, please see statements 1, 2, 3 & 4.
Recognising and preventing delirium: A quick guide for care home managers (2017) Recognising and preventing delirium: A quick guide for care home managers (2017)
This is a short and visually appealing guide for care home managers, containing key information from the relevant NICE guidance.
Violent and aggressive behaviours in people with mental health problems (2017) (QS154) Violent and aggressive behaviours in people with mental health problems (2017) (QS154)
NICE quality standard on short-term prevention and management of violent and physically threatening behaviour among adults, children and young people with a mental health problem. It includes statements and measures on;
- Identifying triggers and warning signs
- Prevening and managing violent and aggressive behaviour. In particular, please see statement 1.
Minimising the use of restraint (2015)
Minimising the use of restraint (2015)
Use these films to examine good practice in minimising the use of restraint in health and social care. What needs to be taken into account are:
- an individual's human rights
- putting people at the centre of decisions
At a glance 31: Enabling risk, ensuring safety: Self-directed support and personal budgets (2013) At a glance 31: Enabling risk, ensuring safety: Self-directed support and personal budgets (2013)
Use this briefing to find out emerging research and practice regarding risk taking and safety in the implementation of self-directed support and personal budgets.
QS163 Mental health of adults in contact with the criminal justice system (2018) QS163 Mental health of adults in contact with the criminal justice system (2018)
NICE quality standard on the recognition, assessment and management of mental health problems in adults (aged 18 and over) who are in contact with the criminal justice system. It includes statements and measures on:
• responding to mental health problems
• mental health assessment
• sharing mental health care plans
• risk management during transfers
The statements are specific and concise and focus on priorities for quality improvement. In particular, please see statement 3.
CG185 Bipolar disorder: assessment and management (2018) CG185 Bipolar disorder: assessment and management (2018)
This guideline covers recognising, assessing and treating bipolar disorder (formerly known as manic depression) in children, young people and adults. In particular see recomendations 1.4.1-1.4.3
CG90 Depression in adults: recognition and management (2018) CG90 Depression in adults: recognition and management (2018)
This guideline covers identifying and managing depression in adults aged 18 years and older, in primary and secondary care. In particular see recommendations 1.3.2.1-1.3.2.4 and 1.10.2.1-1.10.2.3
