We Care Chorlton

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.

At our last assessment we rated this key question requires improvement. At this assessment the rating changed to 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.

Staff felt confident when reporting any accidents or incidents. The process to report concerns was clear and staff felt supported to do so.

An electronic system was in place to record and monitor complaints, safeguarding, accidents and incidents. Any shortfalls were identified and actions taken to address them where required.

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.

The service worked with people and those close to them to establish their plan of care. New referrals were assessed face to face to ensure people’s needs could be met.

People and their relatives told us staff were responsive to their needs. The office staff were in regular contact through telephone surveys and adjusted people’s care when required. Staff had access to relevant information about people’s care and support needs, which they could access on electronic handheld devices. If they had a concern about people’s changing needs, staff could report back to office staff, so appropriate referrals could be made to the relevant agencies, where necessary.

Systems were in place to ensure key information could be shared with key partners when required.

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.

The people and families we spoke with said they felt safe. They told us, “[Staff] are brilliant, they really care and make sure everything is right for [relative] and [relative] is safe. For example, in the heatwave they were very particular about leaving fluids and fruit for [relative]” and “They are reliable and keep our parents safe.”

Staff had access to policies and procedures on safeguarding and received the necessary training to help keep people safe. We spoke to 7 staff to check their learning in practice. They all understood their responsibilities and how to report concerns. They were confident managers would respond appropriately.

Processes were in place to ensure people consented to their care. Staff received training in the Mental Capacity Act. This supported them to uphold people’s rights.

The provider worked with people to understand and manage risks. Staff provided care to meet people’s needs that was safe and supportive.

The management of risk had improved since the last assessment. We reviewed 3 care plans and risk assessments. They captured the support people required to stay safe.

Risks relating to people were assessed and managed appropriately, with the involvement of the person. People were positive about the support they received to manage risks. They told us, “My [relative]is a high risk of falls. The staff are well trained to look after him” and “I have a catheter and [staff] sort all that out. [Staff] spotted the redness, the beginning of an ulcer and they told us to call the district nurse out and we did that and it’s all sorted.”

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

Risk assessments were in placed to ensure the environment was safe for people and staff. This included information on smoke alarms and how to switch off the water and gas supply in an emergency.

People and their families said staff supported them to stay safe in their homes. They told us, “There are two ceiling hoists that have always been used safely” and “Our home environment is safe, [relative] has a hospital bed, and the bathroom is next to [relatives’] bedroom. [Relative] has a sofa and a TV, so things have been made very comfortable for him.”

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.

The organisation of people's visits was now managed effectively and safely. Calls were on time and staff stayed for the allotted time. The people we spoke with had a positive experience and told us staff were punctual. They told us, “The carers always stay the full time of the call and always ask if there is anything else they can do” and “The carers are very good, very prompt, have never missed a call and they always stay the full time.”

The provider had invested in more training since the last assessment. The staff we spoke with were positive about the training and support they received. Good systems were in place to ensure staff were supported when poor performance was identified.

Recruitment processes had improved since the last assessment. Further improvement was required to help ensure risk assessments for staff who had gaps in their documentation were more robust. This was completed during the assessment.

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 understood infection, prevention and control and could explain how they used their training in practice. People told us, “They are very hygienic. They wear gloves when doing everything. They wipe down my home and always clear up” and “Yes, they do wear personal protective equipment (PPE), they are always clean and hygienic.”

Regular quality assurance questionnaires with people and their families and spot checks with staff helped to ensure good practice was followed.

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

There had been significant improvements in the safe management of medicines since the last assessment. Care plans now contained up-to-date, personalised information about how people should be supported with their medicines. People, and those involved in their care, were included in discussions about their support arrangements for medicines.

The electronic medicines recording system was well embedded, with records showing no gaps. A contingency system using paper medication administration charts (MAR) charts was also in place should the electronic system stop working.

The process for checking and confirming people’s current medicines had improved, and staff understood the need to check people’s prescribed medicines with their doctor. However, the system needed to be strengthened to ensure up-to-date information was always obtained from their doctor. Systems were also in place to ensure people had regular medicines reviews and for recording and communicating changes to medicines.

There were some further improvements needed to ensure medicines were managed safely and consistently. The electronic system did not accurately record the actual time medicines were administered, which meant it was not possible to evidence that time-sensitive medicines were given safely.

There were some concerns about the way time-sensitive medicines were supplied. Medicines that needed to be given at different times were supplied in the same blister compartment. This meant that staff had to remove them from the blister pod to administer them which introduced a higher than necessary element of risk.

There were also concerns about the accuracy of electronic body maps. Some information about the application of creams was not detailed enough to show exactly where and how they should be applied.

Monthly audits were in place, but these had not always identified known shortfalls. Due to the small number of people supported with medicines, it was not possible to assess whether improvements had been made across all areas of medicines management.