Innovative Start 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 – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question inadequate. At this assessment the rating has changed to good.

This meant people were safe and protected from avoidable harm.

This service scored 75 (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 promoted a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and ensured incidents and events were reported and investigated appropriately. Learning from these events was used to identify improvements and embed good practice.

Where incidents and accidents occurred, the registered manager carried out thorough investigations, identified themes or trends, and implemented actions to reduce risks. For example, patterns relating to the number, location, and timing of falls were regularly reviewed to support preventative measures.

Staff told us they felt confident reporting incidents and accidents, and systems were in place to support this, including clear reporting procedures and monitoring processes. They confirmed that concerns were taken seriously and investigated appropriately. Learning was shared with the wider staff team, including through team meetings, to promote continuous improvement.

People and their relatives knew who to contact if they had concerns about safety and said they would approach the registered manager for support. Staff were clear about how to report safety concerns, and there were systems in place to monitor practice, for example spot checks, audits of care calls, and communication with people receiving care.

The provider worked collaboratively with people, families, and healthcare professionals to establish and maintain safe systems of care. Processes were in place to support continuity of care, including when people moved between services.

Before accepting new referrals, the management team carried out comprehensive assessments to ensure they could safely meet people’s needs and support a smooth transition into the service. This included working closely with individuals, their relatives, and relevant professionals to gather information and develop care plans tailored to the person’s needs.

The registered manager described a joined-up approach to care, where communication with external professionals was prioritised to promote safety and continuity across people’s care journeys. Care records were maintained electronically, enabling timely sharing of accurate and up-to-date information with healthcare partners when required.

Staff told us they received clear and relevant information about people’s needs, which supported them to provide safe care. Systems such as handovers, communication records, and team meetings ensured important updates were shared effectively across the staff team. One staff member said, “We have daily handovers, communication books, and team meetings, which help ensure everyone is updated and working together effectively.”

Feedback from professionals was positive regarding joint working and communication. One professional told us, “Communication with both the managers and carers is really good. They are approachable, responsive, and quick to follow things up.”

The provider worked with people and healthcare partners to understand what being safe meant to them and how best to achieve this. 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. Safeguarding concerns were identified, reported, and shared appropriately with relevant agencies.

Staff received safeguarding training and had a good understanding of the different types of abuse and their responsibilities to protect people. They told us they would report any concerns to the office and record these promptly on the system.

People and their relatives told us they felt safe with the staff who supported them. Comments included, “I’m safe, they announce themselves and are all lovely,” and “[Person] is very safe as he is very comfortable with them.”

The registered manager understood their responsibilities for investigating safeguarding concerns and reporting these to the appropriate external agencies, including the local authority. People also told us they knew who to contact if they had concerns about their safety.

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.

Risk assessments were person-centred and reflected people’s individual needs, including their communication, mobility, health conditions, daily routines, and personal preferences. These were completed in partnership with people and, where appropriate, their relatives, ensuring risks were managed in ways that respected people’s choices and promoted independence.

Risk assessments included clear guidance for staff on how to safely support people and reduce the likelihood of harm. Staff told us care plans provided sufficient detail to enable them to deliver safe and appropriate care.

Staff supported people to maintain their independence while balancing and managing risks effectively. Care records contained relevant and up-to-date information about factors affecting people’s safety, such as mobility needs and medical conditions.

People and their relatives told us they felt supported to remain safe in their own homes. One relative said, “They noticed a sore and they told me and now they put cream on and record this.” Another commented, “They monitor [person’s] health and tell me of any changes I may have missed.”

Systems were in place to assess, monitor, and review risks to help reduce harm and ensure people’s safety.

The provider identified and managed potential risks within people’s home environments to support the delivery of safe care. Equipment, facilities, and technology were used appropriately to help ensure people’s safety.

Assessments of people’s home environments were completed prior to care commencing. These were shared with staff to ensure any identified risks were understood and appropriately mitigated.

The provider ensured people had access to the equipment they needed by making timely referrals to relevant healthcare professionals. Records confirmed that equipment was appropriately documented and maintained in line with recommended servicing schedules.

The service worked effectively in partnership with healthcare professionals to monitor and respond to risks as they arose. One professional told us, “Joint visits and professional meetings are undertaken where required to ensure risks are identified early, understood consistently, and managed appropriately.”

The provider ensured there were sufficient numbers of suitably qualified, skilled, and experienced staff to meet people’s needs safely. Staff worked well together to provide consistent and person-centred care.

Staff told us they received appropriate training and ongoing support to carry out their roles effectively and safely. This included structured inductions, shadowing opportunities when starting their role, and regular supervision to review their practice, competence, and development.

Policies and procedures were in place to help recruit staff safely. Checks on the suitability of potential staff were completed. This included obtaining references and checks with the Disclosure and Barring Service (DBS). The DBS helps employers make safer recruitment decisions and help prevent unsuitable people from working in care services.

Systems were in place to ensure staff received training appropriate to their roles, including specialist training such as autism awareness. Staff demonstrated a good understanding of their responsibilities and told us they felt supported by management. They were confident in responding to incidents and emergencies, such as falls or medical situations, and in escalating concerns appropriately. Feedback from people and their relatives was positive; they described staff as competent and appropriately skilled, with the knowledge required to deliver safe and effective care.

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 said that staff always wore gloves and aprons whilst providing care and staff tidied up before leaving. One person told us, “They wear gloves, aprons and sometimes masks as well if we, or one of them has a cold. They are disposed of in the bin”. Staff confirmed that they always had enough (PPE) available to them and had completed infection prevention and control training and food safety and hygiene training. A separate guide for staff covering infection control had also been made available to staff.

The provider carried out regular spot checks of carers to ensure that they were completing effective hand hygiene and infection prevention and control measures

The provider made sure medicines and treatments were managed safely and met people’s needs, capacities, and preferences. People were involved in planning their care, including when changes to medicines were required.

The provider had a clear medicines policy in place, and medicines were managed safely. Staff had received appropriate training in medicines administration and regular competency checks were completed to ensure safe and consistent practice. Medication Administration Records (MAR) were fully completed and accurately reflected the support provided.

Medicines risk assessments were undertaken where needed, and staff had access to clear, person-centred guidance to support people with their medicines. ‘As required’ (PRN) medicines were supported by detailed protocols, ensuring staff understood when and how these medicines should be administered.

There were effective systems and processes in place to audit and review medicines management. Staff understood their responsibilities for reporting and managing medication errors. Following any errors, the provider carried out robust investigations and used learning to improve practice. For example, guidance on escalation for missed or late doses had been introduced, alongside a medication awareness guide for staff which included information on common medicines to support safe administration.