Progressive Support Services 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 good. At this assessment the rating is requires improvement.

This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The service was in breach of legal regulation in relation to safe care and treatment.

This service scored 59 (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 did not always have a proactive and positive culture of safety based on openness. Lessons were not always learnt to continually identify and embed good practice.

The oversight and management of safety events was not always effective. While accident and incidents were documented by staff and reviewed by the provider, care plans and risk assessments were not updated following accidents and incidents, including those where people had been exposed to risk and harm. This meant people were placed at an increased risk of harm and further events impacting their health and safety.

There was also a lack of an effective learning culture in other areas, such as a lack of regular staff meetings by the provider. This meant staff did not always have an opportunity to share and learn information to improve service delivery.

The provider did not always ensure safe systems of care. They did not always manage or monitor people’s safety.

The provider did not have effective systems of monitoring and managing safety in the service. For example, concerns regarding people’s care plans, an awareness of the principles of the Mental Capacity Act 2005 (MCA) and governance arrangements had not been identified or effectively acted upon to ensure people were consistently safe. This meant people were exposed to avoidable risk.

The provider described this process, which included obtaining information regarding people’s care and support needs so this information could be reflected in their care records. People and relatives shared no concerns regarding the transition process for people before they moved to the service.

The provider did not always protect people’s rights under the Mental Capacity Act 2005 (MCA).

We checked whether the service was working within the principles of the Mental Capacity Act 2005 (MCA). Where people had been judged as lacking mental capacity to be able to consent to their care arrangements, decision-specific mental capacity assessments and best interest decisions regarding key aspects of people’s care had not taken place to clearly demonstrate decisions taken on people’s behalf were being taken in their best interests. This meant people were at risk of their rights under the MCA not being respected.

There was a safeguarding policy in place, records showed staff had completed safeguarding and MCA training, and people and relatives told us they felt their relatives were receiving safe care.

The provider reported safety incidents that had occurred and had affected people’s health, safety and welfare. Where accident and incident records showed people had been exposedto risk of harm, these incidents were reported to external partners, such as the local authority and CQC.

The provider did not always work well with people to understand and manage risks.

Care plans did not always provide information for staff which accurately reflected people’s needs and risks. For example, care plans did not always provide information which detailed people’s physical health, mobility and safety needs. This meant people were exposed to the risk of harm by staff not having accurate information to support them safely.

There was evidence of engagement with healthcare professionals. Staff demonstrated a good awareness of the risks associated with people and how to support them. People and relativestold us staff understood people’s risks, with 1 relative saying, “[My relative] is not always easy sometimes, but the carers know them well and how to keep them safe.”

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

Staff received health and safety training and demonstrated a good awareness of how to ensure people’s home environments, including mobility equipment, were maintained to mitigate potential risks.

People and relatives told us people’s home environments were respected by staff.

The provider did not always make sure recruitment processes were robust.

The provider failed to ensure they had obtained adequate recruitment information for all staff. Staff application forms did not always contain staff member’s full employment history and, where this was the case, the reasons for this. Furthermore, some staff did not have application forms in place at all. This meant the provider could not be assured staff were suitable to work with, and support vulnerable people.

Staff did not receive regular team meetings from the provider. This meant opportunities for the provider to provide staff with consistent support and development were missed.

Staff received inductions and supervisions from leaders, and staff told us there was frequent team communication on a staff team group chat. People and relatives were mostly satisfied staff demonstrated the skills they needed to provide safe care.

The provider assessed and managed the risk of infection.

The service had an Infection Prevention and Control (IPC) policy which set out the provider’s IPC expectations. Staff had received IPC training. Supplies of personal protective equipment (PPE) were observed in the office, which staff told us they could access when they needed it.

People and relatives said staff used PPE when providing care, with 1 person saying, “They always come with their gloves and aprons.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

A medicines policy was in place and staff received training in safe medicines management. Staff we spoke with demonstrated a good awareness of medicines processes and people’s individual medicine needs. People and relatives told us they were happy with the medicines support they received from staff.

The provider completed medicines audits of people’s medicines arrangements.