APT Care Central Bedfordshire & Bedford

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 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Overall, 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 understood how to recognise, record and escalate incidents. They described clear processes and timely reporting. One member of staff said, “When a safety incident occurs, I always write down what happened in the clients care notes then inform the family and office.” Another told us, “I record incidents in our reporting system and notify my supervisor immediately.”

There was a consistent approach to reviewing incidents and sharing learning. Staff said, “Managers review incidents, speak with staff involved, and look at what happened. Lessons are shared during handovers, meetings, or supervisions to prevent it happening again.” Records confirmed incidents were documented, reviewed and monitored.

Provider oversight supported learning and risk reduction. Analysis identified themes such as falls and informed actions including referrals, equipment and monitoring. Staff showed openness and reflection and contributed to lessons learnt discussions.

Records did not always show how learning from events influenced practice or improved outcomes for people. The provider recognised this and described planned system enhancements to further evidence learning and its impact on practice.

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 provided a home recovery service to support people to move safely from hospital to home. The focus was on recovery, maintaining independence and providing short term, tailored support.

People described positive experiences of discharge from hospital. One person said, “The service is very good. The carers look after me very well. They keep me safe from any risks. I think it was a smooth transition from hospital to home with the social worker involved.” Others said, “We’ve only used the service from hospital to home recently, and it was seamless for us” and “I think the transition from hospital to home was very good indeed.”

Staff followed clear processes for recording, information sharing and escalation. They worked with GPs and district nurses to ensure continuity of care. Records showed referrals were made when risks increased, including to falls teams and for wound care. Care was reviewed and adjusted to reflect people’s changing needs.

The provider worked with people and external 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.

At the last assessment we found a breach of regulation relating to safeguarding. At this assessment, systems had improved. There were clear processes to identify, record, report and review safeguarding concerns. The provider notified the Local Authority and CQC as required and demonstrated oversight through regular audit and review.

People were supported by staff who understood safeguarding and how to respond. Staff told us, “I watch for signs of abuse, such as unexplained injuries or behavioural changes, and report them to safeguarding leads” and “If I suspect abuse, I report it immediately following safeguarding procedures and do not ignore or investigate it myself.” This showed confidence in recognising and reporting concerns.

Records showed safeguarding concerns were analysed each month, with themes identified and actions taken. Learning was shared with staff and linked to improvements in practice, including communication and equipment use. Reporting had increased because of improved awareness and systems.

The provider worked in partnership with other agencies. A professional told us, “The provider is now very proactive in raising appropriate safeguarding’s and completes very detailed investigation reports when required.”

Overall, 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.

At the last assessment we found a breach of regulation relating to risk management. At this assessment there was clear improvement in how risks were assessed, monitored and managed.

Records showed risks were identified using information from hospital teams and other partners, with action taken when needs changed.

People told us they felt safe. One relative said, “He feels safe from risks. He’s not steady on his feet and the carers take care in mobilising him.” Another said, “My relative feels safe with the carers he has now, he’s starting to have a few falls, but the carers are getting a handle on this and keep me informed.”

Staff understood how to use care plans and risk assessments to guide safe care. Staff told us, “Care plans and risk assessments guide me to provide safe care while minimising risks.”

Professionals confirmed a proactive and collaborative approach to managing risk.

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

Records showed environmental risks were assessed and managed. Environmental risk assessments were completed for people’s homes as part of care planning and ongoing risk management. These identified hazards such as falls risks, fire safety and infection prevention. This helped to ensure people’s home environments were safe and suitable for the delivery of care.

Staff told us they felt safe and supported to work in people’s homes. One staff member said, “I feel safe at work because there are policies and procedures in place for health and safety” and another said, “We have proper training, good equipment and managers who respond when I raise things.”

Overall, 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.

At the last assessment, we found a breach of regulation relating to staffing. At this assessment there was clear improvement in staff training, supervision and competency systems. Most staff had completed mandatory training, with additional training linked to people’s assessed needs and the provider’s specialisms. Induction, shadowing and competency checks were established, which supported staff to feel confident in their roles.

People’s views about staff were mixed but generally positive. One person said, “We are happy with the carers being trained enough and competent in the work.” Another said, “I think the carers are well trained and professional.” However, some people told us there was variability in practice, confidence and experience among newer staff.

Staff told us they felt supported through training and supervision. One staff member said, “The training I’ve received has helped me carry out my role safely and confidently. If I need more support or additional training, I can speak to senior staff, managers, trainers, or experienced colleagues for guidance.” Staff also said, “Most of the time staffing levels are good and allow us to meet people’s needs safely.”

The provider reviewed staffing levels regularly and did not accept new referrals if there was insufficient capacity. Systems were in place to respond to short term pressures and maintain continuity of care.

Recruitment processes were robust and checks were completed to ensure staff were suitable to work in care roles.

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.

Although some people reported occasional inconsistency in practice, people were mostly confident in infection prevention practices and told us hygiene standards were generally good. One person said, “They (staff) look clean to me. They are covered up with protective clothing every visit.” Another said, “I think there’s no issues whatsoever with hygiene standards.” A further comment was, “I think both personal and domestic hygiene is very good with all the PPE (Personal Protective Equipment) and gloves which they change regularly.”

Staff demonstrated a clear understanding of infection prevention and control. One staff member told us, “I use PPE based on the task being carried out and infection control guidance, such as gloves and aprons for personal care or handling bodily fluids. I wash my hands before and after use, remove PPE safely to avoid contamination, and dispose of it in the correct clinical or waste bins according to policy.”

The provider had systems in place to support safe practice. Staff completed mandatory infection control training and received regular supervision and spot checks. PPE was readily available, and compliance was monitored through audits and feedback.

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

At the last assessment, we found a breach of regulation relating to medicines management. At this assessment there was clear improvement in systems and oversight. Electronic medicines administration records, PRN (as required) protocols and regular audits were in place. Action was taken in response to identified issues and trends.

People’s experiences were mixed but generally positive. One person said, “The main carer knows everything I need regarding medication. They are always there if I have any questions. I’ve been very pleased with them.” Another said, “There was one time when a carer delivered the wrong medication, but they re-trained on that and it’s okay now.” This showed improvement and responsiveness when concerns were raised.

Staff told us they felt confident in administering medicines. One staff member said, “I follow medication procedures carefully and only administer medication if trained and authorised to do so. I feel confident because I follow the MAR (medicine administration record), the 6 rights of medication administration, and company policies. My competency is checked regularly through observations and assessments.”

Records showed care plans included clear information about medicines, including responsibilities, storage and the involvement of other professionals. PRN protocols generally provided clear guidance on when to administer medicines and when to escalate concerns, supporting safe and consistent practice. Audits demonstrated strong escalation of supply issues with pharmacies and GPs, reducing risks from missed medicines.