P.S We Care Ltd

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

Safe

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

This is the first assessment for this registered service. This key question has been rated Good.

This meant people were safe and protected from avoidable harm.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People and relatives, we spoke with confirmed they were able to raise concerns with staff, and they acted on any concerns to make improvements to the care provided. One relative told us, “Any issues I have raised have been dealt with immediately on the same day, they are very good.”

Staff we spoke with were assured that any concerns they raised on behalf of people, or their relatives were dealt with by the provider. Staff stated they were able to approach the provider and the management team if they had any staffing concerns or suggested improvements, which were always acted on.

Records of incidents and accidents were kept by the provider, which contained the circumstances and action taken to mitigate the risk of further occurrences. The provider completed monthly audits where incidents/accidents were analysed to ensure the appropriate action had been taken and any trends could be identified and acted upon.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People and their relatives told us staff raised concerns with health and social care professionals when required to provide advice or guidance for staff to follow. One relative said, “They [staff] let me know if there are any concerns, and they have called the GP. I don’t have to ask they just do it out of concern.” Staff confirmed they sought and followed advice from external professionals to ensure they were providing support that met people’s changing needs.

People’s care records contained details of advice received from health and social care professionals, and care records were updated to ensure staff had up to date information to follow when providing care.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People and their relatives told us they felt safe with the staff who provided care. One person said, “I do feel safe because the staff are all very good and they know what they are doing, and they do it well.” A relative told us, “It’s 100% safe, I have access to the App to see what calls have been carried out and the care provided.”

Staff had a good understanding of their actions and responsibilities to safeguard people from harm. Staff understood how to recognise suspected abuse and the processes in place to report concerns to keep people safe from harm. One staff member said, “I have had safeguarding training, and I would report any concerns straight away to my manager to make sure the person is protected.”

The provider had clear systems and processes in place to ensure people were safeguarded from the risk of harm, which were followed in practice by all staff. The provider had made referrals to the Safeguarding Authority when required to keep people safe.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People's risks were managed and mitigated to keep them safe. People and relatives told us how staff involved them when managing risks to people’s health and wellbeing. One relative said, “The carers know what I can do for myself, which isn’t much now, but they promote my independence as much as they can because it has always been important to me. It's really hard when you need to rely on other people.”

Staff understood people’s individual risks and explained how they supported people to remain safe, which enabled people to do the things that mattered to them. One staff member said, “All the care plans and risk assessments are on the Care App. I always have time to read them as it’s important I know people’s risks and how they like to be supported. I support the same people regularly, which has helped me to have a really good understanding of their risks.”

Risk assessments and care plans had been completed with people and their relatives, which ensured people’s support was provided in a person centred and holistic way. Staff confirmed the records provided sufficient information and guidance to follow to support people safely in line with their needs and preferences.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Environment risk assessments of people’s homes had been completed before staff provided support to people. This ensured identified risks associated with the environment were mitigated to maintain people’s and staff’s safety.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

People and relatives told us there were enough staff to provide support at the time they preferred in a calm and unrushed manner. People confirmed they had a consistent staff group providing their care. One person said, “The care is never rushed as they [staff] are so well organised. I have the same staff every day and they have a system of who supports with different things after they have both helped me into the chair.”

Staff confirmed they were given enough time to support people in an unrushed way and there was a system in place to ensure people continued to receive a service when staffing levels had changed. One staff member said, “There are no issues with staffing, we work like a family, and everyone pulls together to cover the care needed.”

Staff recruitment records showed the provider had undertaken required checks to ensure staff were safe to provide support to people. Staff told us they had an induction before they started to provide care including training to carry out their role, which was tailored to people’s individual needs and conditions. Competency checks were carried out to ensure staff understood the training received. One staff member said, “Even though I have worked in care for a while, I understood the training better than when I completed training with other companies.”

Staff told us they felt supported in their role and received supervisions to ensure any issues or areas of development were discussed. One staff member said, “I feel very supported, I can ask if I am unsure about anything. I am encouraged to develop my skills during supervisions and appraisals.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People and relatives told us staff used aprons and gloves when they provided support. One person said, “They [Staff] always wear gloves when they are helping me.”

Staff explained how they followed infection control guidance and ensured personal protective equipment (PPE) was used when they supported people such as gloves and aprons. Staff confirmed there was always enough PPE available for them to use. One staff member said, “PPE is always used, we get through so many gloves because we do it properly.” This meant people were protected from the spread of infection.

The provider ensured staff understood how to reduce the risk of cross contamination through training and discussions in team meetings and supervisions.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

People were supported with their medicines and creams as prescribed. People and relatives confirmed staff understood how and when they needed their medicines and creams. One person said, “The staff put cream on my legs as they get dry. They [staff] do it just how I like it and know what they are doing.” A relative said, “They [staff] help my relative with medicines and creams, if staff are asked by the GP to support with a cream that’s not prescribed, they request a prescription and make sure the correct records are in place.”

Although people were happy with the way their medicines were managed, we found some improvements were needed. PRN protocols were not always in place to provide staff with specific guidance on how to recognise when people required these medicines. PRN is medication required for people as and when needed. Staff had not always recorded the dosage of PRN medication administered and 1 person’s pain patch had not been rotated in line with the guidelines to reduce the risk of irritation to their skin. We fed this back to the provider who acted on the feedback immediately.

Medicine Administration Records (MARs) were used to record when staff had supported people with their medicines and topical creams. The MARs contained guidance for staff to follow for prescribed medicines. Staff knew people well and were able to explain how they supported people with their medicines and topical creams.

Staff told us they were trained in the administration of medicines, and competency assessments were carried out by the In-house trainer to ensure medicines were administered safely in practice. One staff member said, “I have received training in safe medicine administration, it is good training, and I know how to support people with their medicines safely. The MARs contain information to make sure I know what medicine people need.”