Nationwide Care Services (Northfield)

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 inspection for this service. 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 service 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. When accidents and incidents occurred, staff took appropriate action, including seeking medical attention. Systems were in place to review incidents that occurred to identify any lessons learnt and to share with staff to reduce risks to people. People and relatives told us they could contact the service if they had any concerns about their care. A relative told us, “If I had any concerns, I know who to contact, I have the office and out of hours number.” Where complaints had been raised, evidence that managers reviewed outcomes and actions and discussed these openly with people and where appropriate acknowledgment by apology letter was completed. Managers told us that wider learning was shared from lessons learnt across the company.

The service 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’s records of care were stored electronically which enabled the service to provide up to date information to healthcare partners when required.

Staff had received appropriate training and demonstrated an awareness and understanding of types of abuse people may experience. Staff told us they would report any concerns to the branch manager. The manager understood their responsibilities in reporting safeguarding concerns to the relevant agencies, including the local authority. People felt safe with staff supporting them. A person said, “So very happy with all the carers who are like family to us.” However, during the inspection staff had failed to escalate a safeguarding concern. The service responded retrospectively, and additional training was completed. Staff had access to safeguarding polices, attended face to face induction training and complied with mandatory training, Staff were able to explain what safeguarding meant to them.

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 and their relatives told us they were supported to stay safe in their own homes. Staff and the management team confirmed that risk assessments were completed with people who used the service and their representatives. This helped them to understand and manage the various risks they encountered in their daily lives. People’s care plans and risk assessments were regularly reviewed and updated as soon as any changes were needed. The management team completed regular audits of people’s care plans and updated as soon as there were any changes or new risks were identified. Care plans included individuals’ medical history and risk assessments detailing the identified risk such as medications prescribed and included how staff should recognise and respond to the control measure. The care plan for one person who had an identified health need, lacked guidance for the staff to show how to support them with the risk, However the Branch Manager was able to describe ways the staff managed this, and additional guidance was added to the care plan.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Environmental risk assessments were carried out by the service to ensure people and staff were identified and risks were mitigated. The provider understood who to contact should they feel people may benefit from additional aids or equipment which staff knew how to use.

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 did not experience missed or late care visits as staff rotas were effectively managed to ensure people’s needs were always met. Staff told us they had received training and ongoing support from the service to carry out their roles safely. Staff rotas were made available to people and their relatives which meant people had information on which staff member was going to support them for each of their upcoming care visits. A staff member told us, “I always know what I am doing, the rota gets sent to me every week.” People told us, “Staff always attend for the full, allocated time and try hard to arrive on time.”

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. Staff followed guidelines for infection control to keep people safe and healthy and personal protective equipment was always available to them.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. Safe systems were in place and followed to ensure people received their medicines as prescribed. Care staff and training records confirmed staff had received medication administration training and had their competency assessed on a regular basis. Medication Administration Records were added electronically by staff and oversite was monitored on a daily basis by supervisors. Staff understood people’s needs. However, whilst a person who self-administered Insulin had a care plan in place, staff demonstrated a good understanding of the signs of hypoglycaemia and hyperglycaemia, and diabetic training was also delivered during staff induction. During inspection this guidance for associated risks with diabetes was not available in people’s care plans. During our assessment the provider updated the care plans to include guidance for staff.