IDG Care

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 assessment for this service. This key question has been rated good.

This meant people were safe and protected from avoidable harm.

This service scored 63 (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 understood how to investigate and report safety events. There was a system in place to learn from safety events and identify and embed good practice.

There had not been any accidents or incidents at the service. However, the provider had a system in place to record accidents and incidents, monitor for trends and patterns and mitigate further risk. Guidance for staff on managing and reporting accidents and incidents was included in the employee handbook and the relevant policy and procedure. The service user guide told people what to expect from staff and the provider in an emergency and following a safety event.

There was a proactive culture with emphasis on preventing accidents and incidents detailed throughout staff guidance and training.

The provider recognised when healthcare professional advice was needed to support people well and had discussed and sought input for the person regarding a referral to other health care professionals, staff advised they would ensure any relevant information was shared to ensure the best outcome for people.

There was a system and process for ensuring a smooth transition and handover of relevant information to emergency services and for readmitting people back into the service.

The provider understood what being safe meant to people but had not always ensured 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 knew how to share concerns quickly and appropriately.

The provider’s staff had enhanced disclosure and barring certificates (DBS) in place. However, there was no evidence that a DBS was in place for staff from a secondary provider. Therefore, we were not reassured that people were protected from the risk of abuse, the provider advised they would take action to collate this information. There was no evidence of impact on the person.

Staff were trained in safeguarding adults and children and understood how and who to raise concerns to if needed. Additional training had been completed to further develop staff in safeguarding people including counter fraud and conflict resolution. The person told us they felt safe with staff and knew how to raise concerns if they needed to.

The provider demonstrated a good understanding of the legal framework around depriving people of their liberty in their own homes and ensuring people were supported in the least restrictive way possible. There was no one using the service at the time of the assessment that had a court order from the court of protection.

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.

Risks were assessed with the persons involvement, recorded and planned into care. For example, the person had been given guidance on how to safely manage pets in the home.

Positive risk taking was supported, and the person told us they were not discouraged from independence to reduce risk.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

The environmental risk assessments required further details. For example, they did not record whether smoke and carbon monoxide alarms were present in the property or identify the location of the stopcock in the event of a water leak. However, care records detailed fire prevention methods and the person would be able to provide information on where to find equipment in the home if needed. The provider assured us they would review the risks and add more detail to records with the persons involvement and implement for future assessments of people’s care and support needs.

The provider did not always make sure there were enough qualified, skilled and experienced staff. They did not always make sure staff received effective support, supervision and development. They did not always work together well to provide safe care that met people’s individual needs.

The provider used a secondary provider to support its existing staff with regular breaks and time off. At the time of the assessment evidence was not available that outsourced staff who were working alone in people’s homes had appropriate training. This would need to be implemented and imbedded into practice to ensure people's safety. There was no evidence this had impacted on people the person told us they were happy with staff and felt safe.

Some improvements were required to staff recruitment records. For example, ensuring that staff had a health declaration form in place to help mitigate risks to people and staff and that a full work history was recorded. We discussed this with the provider who agreed to ensure a more robust recruitment procedure going forward. There was no evidence that this had impacted on people.

The provider assessed and managed the risk of infection. They understood how to detect and control the risk of it spreading and where to report an outbreak if they needed to.

Care records detailed what to clean equipment with and how often, to help maintain a safe environment and reduce the risk of infection. Staff had access to protective equipment such as gloves and aprons and understood the importance of good handwashing techniques.

The provider did not always make sure that medicines were safe, however people’s needs, capacities and preferences were well supported, and staff always involve people in planning.

Medicine administration records were not kept, this meant there was no clear record of what had been taken or when. This was a particular concern for time critical medicine and ‘as and when’ required medicines (PRN) where plans did not include information such as the maximum dose to be given in 24-hour period. A medicine administration chart was put in place post assessment. We discussed this with the provider who advised that medicine administration was recorded in the daily care notes. We found the records contained minimal information. We found no evidence of harm at the time of the assessment as the person was independent in knowing which medicine they needed when. In addition, there was person centred guidance for staff in care plans on which medicines should be taken and when, the persons preferred way to take their medicine and how to support them with independence as much as possible.

Following the assessment the provider started developing medicine administration records (MAR) for implementation going forward, this would need to be continued and embedded in practice.