Optimum Care 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 – 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.

Staff understood the importance of learning lessons from safety events and taking action to embed good practice. This included staff reviewing people’s risk assessments prior to each care call visit.

Meetings, such as daily handovers within the office and staff meetings discussed shared learning from incidents, and any actions needed to reduce the risk of recurrence. A staff member told us that staff, “Shared learning at staff meetings. Share experiences so (other staff) can learn and understand.” Staff signed to confirm they had read and understood their individualised learning and development feedback following audits undertaken at the service.

There had been leadership learning following the findings of the previous CQC inspection. Efforts had been made to make the necessary improvements needed. The leadership team were open to our feedback and demonstrated a willingness to continue to improve.

Staff worked with people and healthcare and social care partners to establish and maintain safe systems of care, in which safety was managed or monitored. This helped make sure there was continuity of care when people moved between different services. People had hospital passports in place that included important information about the person, such as known allergies.

Information of care needs assessed by the local authority prior to people joining the service was used to inform people’s care plans and risk assessments. This also informed staff of external support input from health professionals such as district nurses or the speech and language therapy team (SALT).

Improvements had been made in relation to safeguarding since the last inspection and the service was no longer in breach of the regulation relating to safeguarding. Staff told us and records showed that they had received safeguarding training and understood the different types of abuse and poor care. Staff knew the importance of raising concerns they had with the management team to ensure people were safeguarded.

Most people, and their relatives told us they felt safe when supported by staff. Relatives said, I know my [named person] is safe and if [they] were not, then I would be moving [them],” and “Always feel safe. Any care [named person] needs, they will do.”

We talked through with the provider some of the mixed feedback received and they were open to our feedback and were able to give explanations.

Staff had training and could evidence to us their understanding of the Mental Capacity Act 2005 (MCA) and how they supported people's right to make choices.

Improvements had been made since the last inspection and the service was no longer in breach of safe care and treatment. A lot of work had been undertaken to improve the individualised information held within people’s care plans and risk assessments. This ensured staff were able to support people and monitor their well-being in accordance with good care plans and risk assessments.

Most people, and their relatives told us they, felt involved in their care decisions. A relative when asked replied, “Yes completely (involved).”

We talked through with the provider some of the mixed feedback received and they were open to the feedback and gave us explanations.

When new to the service, the leadership team assessed people’s home environment, and an environmental risk assessment was put in place. These documents included information such as exit routes in case of an emergency such as a fire were documented and the location of utilities such as where the fuse box could be found. The locations of smoke alarms and carbon monoxide alarms were also recorded and when the unit and or batteries needed to be replaced.

Records were also held of any specialist equipment in place to support the delivery of safe care. Information included who was responsible for the servicing of the equipment and when.

There were enough qualified, and skilled staff to meet people’s needs. Records showed staff had inductions when new to the service, and they told us they received effective support, supervision and development. Spot checks to establish staff competencies were also carried out.

Improvements had been made since the last inspection as analysis of people’s care call visits demonstrated that in the main staff were punctual. Where there were timekeeping anomalies, such as late care calls or short care calls, the reasons were explained by the provider. Most people were happy with staff’s attendance at their care call visits. Relatives confirmed, “The continuity of care and [staff] is excellent and just what was needed,” and “If [staff] are running late, they will always let you know, or if there's a problem they will let (you) know. They always get a replacement and always send someone.”

The manager told us that no new staff had been employed since the publication of the last inspection report. Staff told us they had pre-employment checks completed to ensure they were safe to work with the people they were supporting. Staff said they had an interview, and their Disclosure and Barring Service (DBS) was checked and previous employment references sought. DBS checks provide information including details about convictions and cautions held on the police national computer.

Staff told us they had plenty of Personal Protective Equipment (PPE) and that they knew the importance of changing their PPE after every care and support task. Records showed that staff were trained in infection prevention and control. However, one person said staff did not wear uniforms. We fed this back to the provider who told us this would be investigated.

In line with their infection control policy, the provider undertook infection control audits with the last audit undertaken in December 2024. These audits demonstrated positive outcomes for people.

Improvements had been made since the last inspection and the service was no longer in breach of safe care and treatment. Medicines audits were carried out regularly to check that systems were safe. Any issues were quickly identified, and action was taken to improve.Staff had completed medicines training, and they had their competency assessed regularly. Staff worked with external healthcare professionals and raised concerns promptly when needed.Records showed that people received their regular medicines safely.Some records about medicine management needed improvement. For example, staff did not always record where creams and patches were applied.Guidance for 'when required' medicines, such as pain relief, was person-centred. However, it did not include details on expected outcomes or what to do if symptoms did not improve.People’s capacity to take their medicines was assessed and recorded. Best interest decisions to give medicines hidden in food or drink were made with family or advocates. Pharmacy advice was sought on how to do this, but instructions were not clearly recorded on medicine administration records. It was also not always clear from records when medicines had been given this way.People had mixed opinions about the support staff gave them with their medicines. One relative told us that their family members medicines was given and well documented. We talked through with the provider some of the mixed feedback received and they were open to our feedback and were able to give explanations.