Fortune Smiles Service 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

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.

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.

The provider demonstrated a strong commitment to safety and continuous improvement through the implementation of systems designed to manage accidents and incidents effectively. These systems ensured that any occurrences were promptly documented and logged in accordance with the organisations policies and procedures.

Lessons were learnt following incidents The provider was able to implement targeted interventions and preventative measures following analysis of incidents and learning lessons from it. This fostered a culture of safety, transparency and accountability, ultimately contributing to the ongoing well-being of people that used the service and staff.

All staff received regular supervision sessions, which focused on the review of accidents and incidents, discussed effective prevention strategies and provided opportunities to reflect on lessons learnt. This approach ensured continuous improvement in practice and promoted a culture of safety and learning within the organisation.

A staff member told us, “The registered manager offers help and assistance and feedback on how we can do things differently.” Another staff member told us, “We discuss learning from incident in staff meeting and supervision meetings.”

Records showed the management team conducted regular spot checks, which ensured that staff effectively applied the learning identified during training. This approach not only contributed to safeguarding individuals but also supported the development and enhancement of staff skills.

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.

Pre-assessments were conducted thoroughly to confirm that the service was equipped to address the specific person that received care and support. This assessment helped to ascertain the suitability of the service, prioritising the safety and well-being of those seeking support. One relative told us, “We were fully involved with the assessment and were given copies of the support plan and risk assessments.”

After the initial assessments were completed, the registered manager clarified that detailed care plans and risk assessments were created for each person. These documents described the person's specific requirements, preferences, and any possible risks related to their care. All relevant staff received copies of these plans and assessments, ensuring they were well-informed and able to deliver safe, person-centred care tailored to each individual.

Staff confirmed that they had access to systems which would hold vital information about people they supported. One staff told us, “We have access to [people’s] care plans, which I make sure I read and understand their care plan before supporting them.”

The provider 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. The provider shared concerns quickly and appropriately.

Feedback from people indicated that safeguarding information was readily accessible to those using the service as well as to their families. People consistently stated they felt safe when supported by staff, reflecting a positive perception of the service's commitment to safety and wellbeing. One person said, “I used this service for some time, and I know I can talk to the manager if I felt unsafe. Staff know how to keep me safe as they have visited me for a long time.”

The registered manager told us that they ensured that safeguarding people and staff was their main responsibility. They expressed confidence in staff’s ability to recognise and respond to safeguarding concerns, and they tested staff’s knowledge of the correct procedures for escalation to both external authorities and internal safeguarding leads.

Staff told us that they received comprehensive safeguarding training both at the start of their employment and as part of regular professional development. The training included identifying indicators of abuse, understanding the various forms abuse can take, and learning the appropriate procedures to follow should any concerns be raised.

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 our last inspection we identified concerns around people’s risk assessments in regard to the assessments not being robust to ensure people received safe care and support. At this inspection, we found improvements had been made.’

People using the service and their relatives were actively encouraged to participate in discussions about the risk assessments. Their input was sought to ensure that all relevant information was considered, such as established routines, likes and dislikes, and any strategies that had previously helped to manage risks effectively. One person said, “The staff always talks to me about any concerns they have, and they will tell me what actions they are taking.”

The service ensured that risk management was reviewed on a regular basis or when new risks was identified. Assessments were person-centred to the individual, and they identified the evaluating risks, and by actively involving individuals and their families in the process.

For example, this included risks relating to falls and trip hazards. Such risks might arise from uneven flooring, loose cables, poorly lit walkways, or cluttered areas, which can all increase the likelihood of someone tripping or losing their balance.

Staff told us that they participated in carrying out risk assessments. One staff told us, “I am involved in completing risk assessment and taking part in the reviews”.

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

People and their relatives shared with us that they felt staff supported them in a safe manner. One relative said, “An assessment was completed by the service before staff started supporting my [person] and the information was shared with us.”

Before support was provided, assessments were completed for each person’s property. The purpose of the checks was to identify any potential risks to both staff and people they supported. We saw that once concerns were identified, suitable measures were in place to help reduce risks.

Staff confirmed that the organisation undertook risk assessments of people’s homes and shared the information with them before they started working with people. One staff said, “I have all the tools needed to do my work. The care plan, risk assessments, trainings come in handy.”

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.

The provider ensured that all staff received a comprehensive training in key areas to ensure effective support for people and to uphold good health and safety standards. The training programme included essential topics such as safeguarding for adults, infection control, risk assessment and methods for supporting individuals’ mental health and managing people’s anxiety.

The provider implemented robust systems for conducting pre-employment checks before staff commenced work. Staff files were thoroughly maintained and included application forms, copies of identification documents (such as passports or driving licences), references from previous employers, health checks, and criminal records checks. This comprehensive vetting process was designed to safeguard service users and ensure that only suitable and trustworthy individuals were employed, particularly guarding against those who might be barred from working with vulnerable people.

We saw that new staff underwent a structured induction upon starting with the service. Evidence of completed induction forms was available, demonstrating a consistent approach. The induction covered several vital areas, including initial training, familiarisation with the service’s policies and procedures, and opportunities for staff to get to know the individuals they would be supporting. This process helped new employees integrate smoothly into the service and ensured they were adequately prepared for their roles. For example, staff told us, “When I first started working at the service, I was given an in-depth induction which was really helpful”. Another staff said, “The manager was very supportive and welcoming. I completed training and shadowed staff that worked at the service for some time”.

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.

Staff at the service received training on infection prevention and control (IPC) measures. Feedback from people who used the service indicates that staff consistently wore the required PPE and actively contributed to maintaining the cleanliness and tidiness of clients’ homes. One person said, “The staff leave [PPE] like gloves and aprons at my home, so it is here when they visit me.”

Relatives also confirmed that the service ensured an adequate supply of PPE for staff and carried out spot checks to verify that staff were using it correctly, demonstrating a robust approach to safeguarding both staff and service users.

Staff told us that PPE such as gloves, masks, and aprons was always readily available, and they had been trained to us them appropriately to ensure effective infection control. One staff said, “I have access to PPE provided by my organisation”. Another staff told us,” My company provides PPE, and we can ask for more when needed”.

The provider regularly conducted infection control audits to observe and assess staff performance, reinforcing that correct IPC measures were consistently followed during day-to-day routines.

The service recently underwent an IPC visit conducted by the local authority. During this inspection, there was 3 areas requiring some improvements that were identified. In response, the registered manager promptly began working on an action plan to address these issues and ensure that the necessary actions were being completed.

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.

Staff were trained and had their competency assessed prior to administering medicines to people. One staff member told us, “I administer [medicines]. I have completed my [medicines] training. If there are any mistakes, I will record it and report to my supervisor.” Another staff member said, “I receive yearly [medicines] training, [medicines] competency test is conducted regularly by my manager.”

People and their relatives told us that they received their medicines as prescribed. This feedback confirmed that the process for administering medicines was followed appropriately, ensuring individuals received the correct medicines in accordance with their prescriptions.

Management carried out audits on a daily, weekly, and monthly basis, which helped identify any potential concerns and helped address them in a timely manner. The audit had detailed information of any actions that was required.

During our assessment, we looked at peoples' Medication Administration Records (MAR). Records confirmed that staff had consistently completed the MAR records correctly. Every entry was appropriately documented, this level of support helped safeguard people from avoidable harm.

The provider had a current medicines policy, ensuring that staff had clear and up-to-date guidance to follow whenever it was required. This policy supported safe and consistent handling of medicines across the service.