Archived: Care Support Empower

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.

This is the first inspection of this service. This key question had been rated 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 shared and discussed concerns about how people were being supported. Lessons were learnt to continually identify and embed good practice.

When incidents and accidents were reported these were investigated thoroughly to see if any lessons could be learned. The management team had a good oversight of these and monitored them to see if there were improvements that could be made. One relative told us, ‘‘[Staff] will always ring me up and let me know if anything has happened, but it is always a positive discussion. They are always ready to let me know what they are going to change to make things better.’’

Information about incidents and people’s support in general was discussed between the management and staff team regularly. This promoted discussion and a learning culture at the service. Staff had reviewed and learnt how best to support one person to use a piece of equipment, and we saw this person happily accepting and using this. One relative said, ‘‘[Registered manager] is very passionate and always on the lookout to make things better.’’

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.

Staff contacted professionals such as GP’s or Speech and language therapists if people needed support. If professionals gave advice that needed to be followed, this was recorded and staff followed this. Staff knew people well and told health professionals how to best support people during appointments. Staff supported people to appointments and advocated for them to help their voices be heard. The registered manager told us how they would make any changes that may be needed for people following stays at other services such as hospitals. A relative said, ‘‘[Person] has found appointments difficult in the past, but the staff know just what to do to make them feel better.’’

People and their relatives told us they/ their family member were safe living at the service. Staff were trained in safeguarding and knew what signs may indicate potential abuse and how to report concerns to external partners such as the local authority or CQC. Safeguarding concerns were reported, and any actions were taken seriously by the management and staff team. One person showed how safe they felt by happily taking part in activities such as cooking in their house. The person looked to staff members when they felt unsure and staff guided them. The person was visibly happy when this happened. One relative told us, ‘‘[Family member] is 100% safe and I have no worries at all.’’

Risk assessments and support plans were detailed and gave guidance to staff about how to mitigate risks as far as possible. People had risk assessments in place for areas such as eating and drinking or how to support them when they felt upset or anxious. People and their relatives were involved in the creation and reviewing of care plans and risk assessments. One relative said, ‘‘[Family member’s] care plan is a massive document, and it is continually being updated. When I think of something I contact [staff], and it is all updated. There are guidelines for staff to follow and keep [family member] safe.’’

The provider detected and controlled potential risks in people’s home environments. They made sure equipment, and technology supported the delivery of safe care. People’s home environments had been risk assessed, and measures were put in place to help mitigate risks as far as possible.

Staff made sure people’s home environments were kept safe. We noted some minor areas of some people’s home where safety could be improved, and the registered manager took immediate action to address this issue. Staff completed checks to make sure the environment and the equipment people used was safe, and these checks were audited regularly. We observed people to be happy and comfortable in their home environment and to have access to the equipment they needed. Staff were trained and knowledgeable about how to use this equipment. A relative said, ‘‘[Family member’s] home is in a great location and really works for them.’’

People and their relatives told us there were enough staff to safely support them. Staff did not miss any care visits and very rarely ran late for these visits. People had the right staff support at all times including dedicated 1 to 1 support where this was needed. Staff told us they were never left to work under staffing levels, and these were covered by existing staff or the management team. People were visibly happy being supported by staff and it was clear they were used to having enough staff available for them. One relative said, ‘‘We have never had an issue with staff arriving late or missing visits. It is something [family member] looks forward to immensely.’’

Staff had the training they needed to support people and their competency to support people was checked after their training. Staff were knowledgeable about their training. One relative said, ‘‘[Staff] have all the right training, but they are also all keen to continue learning. I know if I felt they needed anything else they would be happy to do this.’’ The provider recruited staff safely in line with current legislation. One relative told us, ‘‘I feel that [registered manager] leads from the front, passing on their experience and knowledge. The staff he has taken on are of his calibre. They expect high standards and 100% commitment from them and this shines through.’’

The provider assessed and managed the risk of infection. Staff were trained in infection and prevention control (IPC) and told us they had the necessary equipment to keep the service clean. We observed people’s homes to be visibly clean. Staff told us they had the equipment and training they needed to follow safe IPC practices. Audits and checks were in place to monitor the cleanliness of the service and the effectiveness of the IPC measures in place. A person was supported to clean tabletops after finishing their meal and to wear appropriate personal protective equipment (PPE) when cooking. A relative said, ‘‘[Staff] go above and beyond to make sure [family members] home is clean after they have visited.’’

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

Staff knew how to administer medicines safely and in line with people’s preferences. They were trained to do this and had their competency to do this checked regularly. Audits were in place to help make sure medicines were being managed effectively. The management team were passionate about Stopping Over Medication of People with learning disabilities, autism or both (STOMP). They had supported people to reduce or in some cases stop their use of some medicines.

People had protocols and guidelines in place for ‘as and when required’ (PRN) medicines and for ‘homely medicine’ (medicines not prescribed but purchased by people themselves). Some of these needed minor changes to be made so they were more detailed, and this was acted on immediately. Staff made sure any specific guidelines for medicines were in place and being followed, for example if people needed to have their medicines administered ‘covertly’. One relative said, ‘‘I feel very reassured that the staff team know exactly how to prompt [family member] with their medicines. They know how important this is for them.