The examples below provide insight into how other Good or Outstanding rated services are succeeding in this area of inspection.
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Exceptionally high standard inclusive environment
The service had been recently refurbished to an exceptionally high standard, following significant investment by the provider. We saw this had created an environment which was a safe, welcoming and inclusive place for people to live. The management team had consulted with people and external partners prior to making these improvements, to ensure they were fully involved, and peoples’ needs could be met. One relative told us, “The refurbishment has made it really homely.” Another relative said, “I would absolutely recommend Hall Park. It was the first home we looked at. The refurbishment has made it homely and comfy. I have no issues at all.”
The maintenance team were passionate about maintaining and improving a high-quality environment for people. One member of the maintenance team told us, “The provider has significantly invested in the home, which is brilliant. I dislike some of the waste this created, the throwaway society we are in. So, I have a store of items, which I like to re purpose and reuse where I can. It is so important that people are respected and supported as individuals. I love my job. I love seeing all of the residents here every day.”
We saw the maintenance team had ensured people were fully protected from the risks of fire, legionella and harm from unsafe equipment. The service held regular fire evacuation drills and alarm tests. Signage for fire escape routes was clear and exit routes were clear and well lit. Personal emergency evacuation plans for people were reflective of their needs, regularly reviewed and updated when a person’s needs had changed.
Read more about this service .
Care provider: Hall Park Care 天美mv
Date published: March 2025
Exceptionally clean, safe smart environment
The provider was fully aware of all potential risks in the care environment and controlled them well. They made sure equipment, facilities and technology supported the delivery of safe care.
We found the service to be exceptionally clean and well maintained. The provider had many systems in place to ensure the environment was regularly checked for any hazards, this included daily walkarounds and audits. We found all health and safety compliance certificates were in place and up to date. Emergency evacuation drills were regularly carried out with all staff and people had personal emergency evacuations in place to support the safe evacuation of people from the building in an emergency. We found the environment to be spacious and had many areas for people spend time. Objects of interest, activities, books and games were seen throughout the service. Technology was found throughout the service to support people, for example information was electronically displayed to show people and visitors which staff were on shift, what the menu options for the day were and the activities that were planned.
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Care provider: Goldwell Manor Care 天美mv
Date published: January 2025
Environmental risk assessments and support
The provider detected and controlled potential risks in the care environment. They made sure equipment and technology supported the delivery of safe care. The provider completed environmental risk assessments of people’s homes to help ensure there was a safe environment for staff to deliver care. Where risks had been identified, the provider worked with people and partner organisations to help improve safety. For example, where domestic fire risks were identified, staff signposted people to the local fire and rescue service to seek advice around improving safety. The provider used technology to support the safe and effective delivery of care. This included the use of electronic systems to monitor care tasks and medicines administration. This helped the registered manager maintain remote oversight of the care carried out by staff.
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Care provider: Tru Caring
Date published: January 2025
Safety adaptations and environmental diligence
Processes had been improved to ensure regular checks on the safety and suitability of the environment. Any areas identified as requiring improvement were addressed in a timely manner.
The provider had made the environment safer for people. Restrictors were now fitted to windows in people’s rooms, to reduce the risk of people falling from height. Fire doors had been alarmed to warn staff if people had exited through these on to the external fire escape. The fire escape route had been made safer with non-grip material to reduce the risk of people slipping and falling. A barrier had been installed to reduce the risk of people accessing the flat roof when using the fire escape. The rest of the environment was clean, tidy and free from slip or trip hazards.
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Care provider: Eversfield House
Date published: February 2024
Building a safe environment
The service promoted safety through the layout of the building and equipment. For example, corridors were wide, light sensors were place in all corridors and bathrooms, assisted baths and shower rooms were purpose built and readily available throughout allowing easy access and promoting safety for people using them.
People had en-suite facilities, gel mattresses and profiling beds. This promoted comfort, reduced pressure area risks, promoted cleanliness, mobility and safety for people. The home was exceptionally clean and well maintained.
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Care provider: Hepworth House
Date published: November 2022
Designing an outside space informed by research and best practice
The provider ensured that outside space had been designed using research that identified best practice on the positive impact of nature on older people's well-being.
People had level access to the grounds, bi-fold doors enabled people in the lounge to feel they were outside. Cameras had been placed in the grounds so that people could have streamed onto their TV's images of visiting foxes and badgers, as well as baby blue tits being fed in their nest.
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Care provider: Burwood Nursing 天美mv
Date published: September 2022
A theatre and live streaming of theatre and films
A fully equipped theatre had been created and was filled with memorabilia significant to the people living at Burwood. This had included original seats from a local theatre which people had memories of attending.
At the time of the CQC inspection a video system was being installed so that productions could be streamed into the rooms of people unable to attend a show and to families so that they could enjoy the event live and talk together about it. A large cinema screen enabled people with visual impairments to enjoy their favourite films.
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Care provider: Burwood Nursing 天美mv
Date published: September 2022
Safety checks providing an intensive interaction opportunity for resident and staff
This learning disability service expands the champion role to the people they support in helping manage the safety of the premises.
One resident with a particular interest in the running of the service was appointed as a champion to support other staff. The resident (with autism, learning disability, severely impaired communication and complex behaviour) accompanies the maintenance person or other staff when conducting fire alarm/equipment testing. He helps to record when checks are being made.
The resident enjoys completing these important duties and ensuring that the checks are undertaken. It also provides him with meaningful occupation, stimulation, and most importantly ‘intensive interaction’. The resident and staff are engaging in purposeful activities and building their relationships.
It’s a very simple concept and one which probably occurs millions of times every day, yet people still refer to ‘intensive interaction’ and many still struggle with the concept and its implementation.
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Care provider: Beckside Lodge - Horizon Care Services Ltd
Date published: July 2021
Dechoker and defibrillator equipment
The service had a very proactive approach to managing risk. Some people were at risk of choking and to mitigate this risk, specialist 'Dechoker' suction equipment had been purchased. This meant if a person started to choke, their airway could be cleared quickly. Staff had been trained to use the devices and told us that having the equipment available had increased their confidence to manage a choking emergency.
The service also became part of a national life saving initiative called ''. The equipment located at the service was accessible to the ambulance service and the local community.
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Care provider: The Royal Star & Garter 天美mvs - Solihull
Date published: March 2020
Ensuring people are safe in their own homes
People were assured their home was a safe place to live. The registered managers and staff worked with the housing association to seek out best practice and technologies such as floodlighting, CCTV and discreet motion sensors which could be used to drive improvement. This provided further reassurance for everyone using the service.
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Care provider: Creative Support - Doncaster Personalised Services
Date published: February 2020
A range of options in an outstanding service
The attention to detail to ensure people were comfortable and led active and fulfilling lives was exceptional. For example, the environment was of the highest standard and the layout of the internal and external environment was thoughtfully developed, making it stimulating and engaging for people. People enjoyed sitting looking out at beautiful views of open countryside and had binoculars to support them.
People had access to safe, secure and well-maintained gardens that incorporated raised flower beds with integrated resting places. The gardens afforded changing views and varying points of interest as people moved around the external spaces.
Each bedroom had its own private balcony or patio area. There was good use of signage to support orientation and help people to find their way around their home. The environment was bright, spacious and stimulating.
Memorabilia-themed areas encouraged positive interaction and supported the creation of a relaxed and welcoming environment.
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Care provider: The Byars Nursing 天美mv
Date published: August 2019
Accessible safe guides
The service had developed innovative new ways to ensure people knew what safe care should look like. 'Safe guides' were produced with people, in a way that was meaningful to them as individuals. Some had safe guides in picture form, whilst others were in video form, where staff used British sign language (BSL) and people's own signs to explain who to talk to if they were worried or concerned, what to expect and what not to expect. These were then uploaded to their tablets or provided in DVD form for people to watch.
The safe guides are reviewed by the person monthly, or whenever someone wants to view it on their tablet. The service tests the people they support after they watch it to make sure they understood, and the person signs back answers to the questions.
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Care provider: SENSE - 89 Hastings Avenue
Date published: April 2019
Connecting with fire safety specialists
The registered manager made links with the local fire service following the commission of a fire report to minimise the risk of fire. Fire marshal training was provided to all staff and fire safety was made a standing item on meeting agendas at the supported living accommodations.
In addition, the service forged links with the local fire prevention officer and arranged for a visit to a fire station to meet fire officers and talk about fire safety, for those people who wished to. In addition, a group of people receiving support visited 'Hazard House' (a mock house belonging to the fire service that purposely contains domestic fire hazards) to show them potential hazards and minimise risk.
People were provided with a range of accessible information about how to keep themselves safe, including details of fire escape routes in their supported living accommodation. The information used pictures and diagrams to show people safe exits.
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Care provider: Community Support Service (D.D.H. Services Ltd)
Date published: March 2019
Encouraging independence whilst keeping people safe
The service was committed to helping people be actively involved in managing their own risks. For example, one person being supported was involved in an incident that impacted on their safety in the local community. The person felt very strongly that they wished to continue going out on their own. The service worked closely with the police and the person receiving support to explore ways of reducing risk whilst continuing to enjoy a social activity that was important to them.
The service supported another person to build up evidence for concerned family members to show they could be more independent. The person successfully moved into their own flat. The service shared with the CQC inspector a written statement made by the person to show they were fully involved in considering risks and now led a full life.
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Care provider: Community Support Service (D.D.H. Services Ltd)
Date published: March 2019
Tailoring the environment to meet different dementia related needs
The home had been decorated in a homely and thoughtful way, and although it wasn’t purpose-built with some smaller areas, the design and layout was developed to promote independence for people living with dementia and ensure a homely, non-institutionalised feel.
People were helped discreetly to be independent. For example, one toilet had the person's name on the door so they could find it easily near their room. This had reduced their issues with continence and self-neglect.
There were three lounges which people, staff and relatives could access at any time. Staff were always visible and people were able to move around the areas as they wished. Loosely, the lounges were tailored to different stages of advancing dementia, enabling quieter areas, free and safe access to the garden and varying stimulus that people could touch and use themselves or with staff. The front lounge had a traditional homely feel, very similar to most elderly people's lounge at home. Most people who choose to sit in this room enjoyed watching television or reading without too much distraction.
The middle lounge for people living with middle-stage dementia was where most of the activities/stimulation occurred. There was storage for all sorts of soft pets and dolls and activities, used to help reduce people's stress levels or when people found their mind orientating to a much clearer time in their past. The television wasn’t often on in this room, as most people who chose this room were no longer able to follow the television for any length of time.
Specialist chairs with built-in pressure relief cushions, tilt options and wheels were used appropriately to reduce the level of transfers with hoists to reduce stress levels. There was also easily accessible weighing equipment that could be used with hoists and wheelchairs to reduce any anxiety for people.
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Care provider: Wisteria House Dementia Care Ltd
Date published: January 2019
Training staff to be capable and confident to use specialist equipment
When complex moving and handling equipment was discussed for a person needing care and support, the provider was pro-active in contacting the supplier and organising staff training to ensure they were familiar with the equipment and aware of the benefits.
Care provider: Anonymous
Date published: April 2018
Keeping safe packs
The service used a ‘keeping safe’ pack, which provided people with information about what keeping safe means in pictorial format that was easy to read, sign and write.
It included individual rights, personal safety, types of abuse, bullying and how to raise concerns, including talking to the police and tips for using public transport. The pack also included a ‘safe place’ card so each person could carry their details and emergency contacts. Staff took their emergency contact details with them when they went out, either in their phone or on a card.
Care provider: Anonymous
Date published: April 2018
Protecting people from wear and tear at home
When a homecare agency identified risks from wires, frayed carpets and excess furniture, they used this learning to develop guidance to help staff minimise this risk.
This approach helped staff to protect the people they cared for by taking the appropriate action. For example, an electrician was called to make the wiring safe, and furniture moved to make the area safe.
Care provider: Anonymous
Date published: April 2018