Eleanor Nursing & Social Care Ltd - Brent Office

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 inspection we rated this key question requires improvement. At this inspection the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 72 (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. There was a process for reporting and recording incidents or accidents such as those involving people coming to harm.Procedures for investigating incidents, such as falls or medicine errors, included what action was taken to keep the person safe. Records showed the management team followed processes to report and investigate incidents. They listened to people’s concerns and learned lessons to identify and embed improvements.

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.Information was collected before people started to use the service. The provider worked with external professionals and partners to help establish continuity of care for people, including when they moved between different services. The provider worked closely with partners to make sure people’s preferences and wishes were understood and respected.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They 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 told us they felt safe when staff were present and did not feel they were at risk. A person said, “I am definitely safe with the carers.”

The registered manager reported safeguarding concerns to local authorities. Staff understood how to protect people from the risk of abuse and received training in safeguarding people. There were clear and up to date safeguarding systems and processes in place that considered the protection of human rights and protecting people from abuse, neglect and discrimination.

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.

Assessments were undertaken to identify risks to people’s safety and determine the level of care they required. Risk management plans were developed to support people and mitigate risks to their safety. These covered areas such as personal hygiene, medicines, mobility, nutrition and risks related to their long term health conditions.People and their relatives told us they were satisfied with how the service worked with them to keep them safe. They confirmed they had been involved when discussing risks to their health and felt staff knew how to keep people safe. A person said, “The well trained carers, understand my needs, no falls or accidents.” A relative told us, “All the carers seem to be well trained, understand me well, speak well. My care plan is kept on their phone.” Another comment from a relative was, “The carers cream applied to [family member’s] skin after washing. The hoist is used safely by staff to help [family member] as they cannot walk much now.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The service carried out an assessment of environmental risks in people’s homes during the initial stages of the person’s assessment to check if it was safe for staff to work and carry out tasks. This included fire safety and environmental hazard checks.

There were systems in place to ensure staff were deployed effectively across the community. Staff received rotas in advance and were clear about where they needed to be and when. They confirmed they had sufficient time to travel between visits, which helped them arrive punctually and maintain continuity of care. A staff member explained, “I am happy with my schedule. I get enough time in between visits and I work in the same area regularly, so it is not far to travel to each client.” People confirmed this, describing staff as polite, punctual and respectful. A person told us, “The carers always come on time, perfect. Carers can vary but all are very good and we know them well.” Another person said, “I do feel safe. Carers are on time, let me know if going to be late, never missed a visit.”

The management team worked with staff to address issues that were identified such as lateness, incomplete logs, or rushed care. This helped to develop and improve practice. At our last inspection, the provider did not effectively monitor staff when they visited people in their homes. There were not enough staff and people often received late calls.

The provider monitored staff using a new electronic call monitoring system. At this inspection, we reviewed completed staff calls and schedules and found that, overall, staff were punctual and had adequate travel time between visits. However, there were occasions when planned visits were scheduled too close together in error. The management team acknowledged these issues and provided assurance that staff performance was monitored. The registered manager took action to investigate minor discrepancies that we found with call times, for example, calls that were completed earlier than planned or with how staff logged in and out of calls. Records showed people requested shorter calls despite the original care planning agreement. The registered manager told us they reviewed people’s care and consulted social workers and the local authority, as well as people and relatives regarding their care arrangements.

The provider made sure there were enough qualified, skilled and experienced staff who received effective support, supervision and development. Staff received an induction and training and were recruited safely. They had the opportunity to shadow other staff supporting people to help them get to know them and become familiar in practices and procedures. Staff told us the training was comprehensive and developed their skills. They felt supported by the registered manager and that their health and wellbeing was considered at all times by the management team.

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. Infection prevention and control procedures were in place. Staff received training to help them maintain good standards of infection control. Staff told us they had access to sufficient supplies of personal protective equipment (PPE). A staff member said, “We have PPE and we follow procedures and have had infection control training.” A person said, "The carers wash their hands and clean up.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened.

The provider had policies in place to manage the safe administration of medicines. People’s medication administration record (MAR) charts were completed appropriately and audited and reviewed by senior staff. These were recorded electronically and staff felt comfortable using this system. The registered manager said, “All care workers in the field can see updates from medicines and care records. We previously had paper MARS which was very time consuming and there was more risk of mistakes. With [new system] it is all live with up to date information and it cuts out mistakes because it will alert us.”

Staff received medicines training and felt confident they could support people with medicines. Information about people's medicines was included in people’s care plans. Protocols for PRN (when required) medicines were in place.Staff competency checks were carried out for staff who supported people with medicines. Some people did not require support with medicines but where they did, they told us staff were helpful. A relative told us, “My [family member’s] medication is in blister packs and given correctly. It is signed for in their care plan.”