Key 2 Care Stoke

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

This is the first assessment for this service since registration with us. This key question has been rated Good. This meant people were safe and protected from avoidable harm.

This service scored 69 (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 the registered manager acted on their concerns to make improvements to care delivery. One relative said, “I have raised a few issues, I always feel listened to and action was taken to make improvements.”

Staff consistently told us incidents were investigated thoroughly, fairly and professionally. They described a positive learning culture where the focus was on understanding why incidents occurred, identifying improvements and preventing recurrence, rather than attributing blame. One staff member said, “I know incidents are investigated very thoroughly and fairly. The manager doesn’t look to point fingers; instead, they focus on why it happened and how we can prevent it from happening again. They [registered manager] look at whether the care plan needs updating, if the risk assessment was correct, or if we need extra training. It makes me feel safe to report things because I know it’s about keeping clients safe.”

Records of incidents and accidents were kept by the provider, which contained the circumstances and action taken to mitigate the risk of further occurrences. Staff felt confident reporting concerns and said learning was shared through debriefs, meetings and discussions to improve practice and people's safety. The registered manager completed monthly audits where incidents/accidents were analysed to ensure the appropriate action had been taken and trends were identified and acted upon to improve the service.

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 that staff were responsive to changes in health needs and acted promptly when concerns arose. Staff sought support from relevant health and social care professionals whenever necessary. One relative commented, “The carers will let us know if they think my relative is unwell and needs to see a doctor.”

Care records contained clear details of guidance and recommendations provided by health and social care professionals. These records were available for staff to access to ensure they were providing care in line with their assessed needs and recommendations from healthcare partners.

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 consistently told us they felt safe in the care of staff and were confident in the support they received. One person said, “I do feel safe when they [staff] are around.” A relative told us, “I do feel [my relative] is safe with them [staff], the carers are really good and [my relative] finds them so friendly.”

Staff demonstrated a good understanding of safeguarding responsibilities and described receiving regular safeguarding training and refreshers. They were able to explain how they recognised signs of abuse, neglect or harm and understood their responsibility to report concerns appropriately.

The provider had effective systems and processes in place to protect people from the risk of harm. The records showed the registered manager and staff consistently followed these procedures to ensure people remained safe and protected from abuse or avoidable harm.

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 understood the risks to people’s health and wellbeing. One person said, “I feel safe when they [staff] are around, who support me when I need it but allow me to be independent as much as I can be.”

Staff understood people’s individual risks and explained how they supported people to remain safe, whilst they promoted their independence. One staff member told us they focussed on people's strengths and encouraged them to remain involved in daily tasks and activities wherever possible before they provided support.

Staff, people and their relatives demonstrated a good understanding of individual risks and the support required to manage them safely. However, we identified some electronic records had not always been updated promptly to reflect changes in people’s needs. This was fed back to the registered manager, who responded immediately and took action to ensure records were updated accordingly.

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 and equipment was completed before staff provided support to people. This ensured identified risks associated with the environment and use of equipment were mitigated to maintain people’s safety.

The provider used an electronic recording system which enabled staff to access care plans, risk assessments and record the delivery of care and support. Systems were in place to ensure records were accessible to staff when required, and staff understood their responsibilities regarding the secure use of electronic devices and the maintenance of confidentiality when accessing and updating records within people’s homes.

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 provided mixed feedback about staffing. While people told us visits were generally completed and missed calls were rare, some raised concerns about timekeeping and consistency of care staff. The registered manager demonstrated they had reviewed staffing schedules and adjusted these, particularly when people first joined the service, to help ensure people received support from a consistent group of staff at their preferred times.

Staff we spoke with felt staffing levels were sufficient to meet people's needs safely and effectively. They described good continuity of care through consistent staffing arrangements, enabling them to build relationships with people and identify changes in their wellbeing. One staff member said, “At the branch in Stoke, [registered manager’s name] offers people continuity of care; therefore, we have set runs which allow us to get to know people and their families, and more importantly, the clients get to know us. They know who is going to them

daily. This also makes my job easier, as I can tell if a person is unwell, upset, or in pain.”

Staff reported receiving support from managers, senior staff and colleagues, when staffing levels had dropped during periods of sickness or annual leave which ensured people received their support as planned.

Staff had been recruited safely, and the provider had carried out checks to ensure staff were of a suitable character. Staff told us and the records confirmed they had received an induction which included training before they provided care which was tailored to people’s individual needs. Staff training was refreshed regularly to ensure they had the skills and knowledge to support people effectively.

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 consistently followed Infection Prevention and Control guidance and used Personal Protective Equipment (PPE) such as aprons and gloves. One person said, “Staff always use the appropriate PPE, and the Tissue Viability Nurse supplies a sterile pack which includes gloves in case they need a spare pair.” One relative said, “Staff always use gloves and aprons.”

Staff explained how they followed infection control guidance when they supported people and confirmed there was always enough PPE available for them to use. The provider ensured staff understood how to reduce the risk of cross contamination through training, discussions in team meetings and spot checks.

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

People’s prescribed medicines were administered and managed safely. People and relatives told us staff understood how and when they needed their medicines. One person said, “They [staff] visit 3 times a day and help me with my medicines.” Another person said, “The staff prompt me to take my medicine and make sure I have taken it too.”

People told us staff supported them with their creams and monitored their skin for areas of soreness, which ensured their skin was well maintained. One person said, “The carers are very attentive with my creams and are very quick to notice if I get a bleed through the skin.” We saw body maps were in place to provide guidance for staff to follow and identified where to apply the creams.

Staff were trained in the administration of medicines, which was refreshed annually. Competency assessments were carried out to ensure staff understood the training and they were observed administering medicines safely in practice. Medicine Administration Records (MARs) contained guidance for staff to follow and were used to record when staff had supported people with their medicines and topical creams. The MARs we viewed demonstrated these were consistently completed when staff had administered medication.

We found improvements were needed to ensure paraffin-based creams were risk assessed where there was a risk to people due to the flammable properties in certain creams. We fed this back to the registered manager who ensured all flammable creams had a risk assessment in place which mitigated people’s individual risks when using this type of cream.