Medistaff24

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 has 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 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.

The registered manager told us they had a system to identify, review and learn from incidents that happened in the service. We looked at their processes and whilst there had not been any recent incidents we were assured the provider was able to share learning from incidents and reduce risks to support better outcomes for people in the service.

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.

Staff demonstrated awareness of the importance of coordinated and safe care pathways. Where needed, the registered manager made timely referrals and worked alongside other health care professionals ensuring people’s needs were consistently met.

Before starting care, staff were introduced to people by a member of the office team. This allowed essential information about the persons health, care needs and preferences to be shared, and helped ensure staff were a good match.

An electronic records system enabled staff to access up to date information and quickly identify any changes in peoples assessed needs.

The service 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.

People and their relatives told us they felt supported by staff members and felt safe. One person said, “(Persons name) feels safe with them.”

All staff had completed safeguarding training. Staff we spoke to were confident in recognising the signs of abuse and describing the processes they must follow. Staff spoke knowledgably about their responsibilities and demonstrated clear understanding of how to report concerns.

The registered manager had developed a safeguarding information sheet that outlined safeguarding procedures and included contact details for local safeguarding teams. This was shared with people and their relatives so they knew what to expect and who to contact should they have concerns.

There had been no safeguarding alerts at the service. The registered manager was knowledgeable about safeguarding procedures and was confident in the steps they would take if any concerns were identified.

A staff member told us that they would contact the registered manager if they saw something that they were concerned about and were confident that they would get a positive response and action would be taken.

The service worked with people to understand and manage risks in a holistic way. Staff delivered care that was safe, supporting and enabled people to do the things that mattered to them.

People and their relative’s told us that staff understood their needs and managed risks to their safety. One person’s relative told us staff knew how to use the equipment safely and that the person liked the staff and felt safe with them.

Records showed that risks to people’s safety had been identified and assessed, with appropriate plans in place to minimise these risks. People’s care records evidenced that the registered manager regularly reviewed and updated risk assessments.

The service supported people to live safely in their own homes. People’s assessments included home safety assessments which identified any environmental risks and outlined the actions needed by staff to maintain a safe care environment.

Staff understood their responsibilities to report any concerns about people's home environments. This was further reinforced through the staff handbooks staff could refer to.

The service did not always make sure there were enough qualified, skilled and experienced staff. They did not always make sure staff received effective support, supervision and development. They did not always work together well to provide safe care that met people’s individual needs.

Staff were mostly recruited safely. Pre-employment checks were completed for most staff, including Disclosure and Barring service (DBS) checks and verification of identity and employment history. However, some staff did not have full employment history completed, which meant recruitment records were not always fully completed in line with safe recruitment practice. Dates on documents in some staff files did not evidence a timeline of safe recruitment. The registered manager rectified this during the inspection process, telling us it was an administration error.

Staff had received relevant training to their roles, this included training that met the requirements for supporting people with a learning disability or autistic people, in line with current standards. However, the service was unable to evidence that the designated trainer within the service had the necessary qualifications to safely deliver training relating to Moving and Handling, Basic Life Support and Medication from the period February 2025 to January 2026. This reduced the level of assurance around staffing safety and meant additional improvements were required to ensure expected standards were consistently met.

The service effectively assessed and managed infection risks. Policies and procedures reflected current guidance for staff to follow. Staff completed relevant infection prevention and control training, and competency assessments were undertaken. Staff were provided with appropriate personal protective equipment (PPE), such as gloves and aprons.

The service did not always make sure that medicines and treatments were managed safely or in a way that fully met people’s needs, capacities and preferences.

The service had introduced an electronic medicines administration record (EMAR) system designed to support real time monitoring. However, they discontinued its use because poor signal on staff devices meant it could not be relied upon. The registered manager told us that, instead, paper MAR charts were collected from people’s homes every 4 weeks and audited. These audits were not available during the site visit but were later submitted and evidenced monthly auditing.

We found for those who required PRN (as-required) medicines, the care plan lacked sufficient detail. Care plans also lacked details about why the medication had been prescribed, what signs or symptoms staff should monitor for, or when PRN medication should be offered or administered. Although the registered manager told us the medicine was awaiting review by health professionals and that a protocol was available in the persons home, we were not assured with the information available staff would know when to give the medicines safely and in line with the persons prescribed needs.