PentaCare (West Kent)

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.

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.
Systems monitored incidents, accidents, medicines concerns, complaints, staffing concerns and safeguarding matters through a range of governance processes including branch meetings, management meetings and provider reports. Evidence demonstrated incidents were reviewed, actions identified and lessons learned shared across the organisation. For example, management meetings discussed missed visits and resulting system changes, while governance reports reviewed incident trends, medication concerns and organisational learning. Staff told us they would feel confident raising concerns and gave examples where issues they reported had been acted upon quickly. We also saw evidence of concerns raised by groups of staff being investigated, resulting in changes to rostering arrangements and working practices.
One person told us they had raised a concern regarding a member of staff and explained the concern was investigated and the staff member did not return to provide support. This demonstrated people were able to raise concerns and had confidence concerns would be acted upon. These examples demonstrated people and staff could raise concerns and have confidence issues would be listened to, investigated and acted upon where necessary.

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 completed detailed assessments before accepting new packages of care and told us they preferred not to rely solely on documentation supplied by hospitals or other providers. Instead, they carried out their own assessments and completed follow-up reviews once people had returned home. This helped ensure support arrangements accurately reflected people's needs and circumstances. We saw examples where people had been assessed in hospital settings before returning home and where additional reviews were completed following discharge.
Care plans reflected advice from relevant professionals and showed how recommendations had been incorporated into people's support arrangements.

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.
Safeguarding concerns were monitored through provider’s systems and reviewed as part of wider quality assurance arrangements. Systems provided oversight of safeguarding concerns and any actions arising from investigations needed to keep people safe.
Staff demonstrated confidence in escalating safeguarding concerns and governance systems monitored safeguarding matters as part of routine oversight arrangements. Records showed safeguarding concerns were tracked, reviewed and followed through where required. Training records confirmed safeguarding training formed part of the provider's mandatory training programme and governance systems monitored compliance. Care records demonstrated consideration of people's vulnerabilities and identified actions required to minimise risks.

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.
We reviewed a range of care records relating to people with complex and varied needs. Risks associated with falls, choking, skin integrity, oxygen therapy, mobility, continence, medicines and health conditions had been considered and were supported by detailed guidance for staff. Risk management reflected what mattered to people and did not unnecessarily restrict independence. Records consistently promoted positive risk-taking and encouraged people to maintain existing skills and abilities. Care reviews demonstrated changing risks were identified, discussed and acted upon when required. They also provided opportunities to identify emerging concerns and review support arrangements.
People described staff helping them manage risks whilst maintaining independence. One person told us, “They notice things that I don't, like they check my skin.” Care records demonstrated detailed risk management relating to falls, choking, skin integrity and mobility whilst continuing to promote people's independence and personal goals.
 

The provider identified and managed risks associated with people's home environments and the equipment used to support their care. Care records included environmental considerations such as moving and handling arrangements, oxygen safety and equipment use. Where specialist equipment was required, care plans provided detailed guidance regarding its safe use. For example, care records included detailed guidance for staff supporting people who used Sara Steady equipment or oxygen therapy within their own homes.
Staff competency systems included moving and handling assessments and records demonstrated staff received training relevant to the needs of people they supported. Systems monitored equipment-related concerns and there was evidence that concerns raised by staff were acted upon promptly. Wound monitoring systems, risk assessments and reviews provided additional assurance that environmental risks affecting people's safety were being considered and monitored.

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.
People spoke positively about staff competence and professionalism. One person said, “They are definitely trained to do the work they do,” whilst a relative commented, “The staff are all great. They are very polite and very helpful. They all appear well trained.” This feedback was consistent with workforce records, which demonstrated oversight of competencies, spot checks, training and supervision.
Recruitment records demonstrated appropriate pre-employment checks were completed, including references, Disclosure and Barring Service (DBS) checks and right to work documentation. Staff completed induction programmes, mandatory training and competency assessments relevant to their role. Competency monitoring included medicines administration, moving and handling and specialist skills where required. The provider maintained oversight of training compliance, spot checks, supervision and wellbeing reviews through workforce monitoring systems. Staff consistently told us they felt supported, received appropriate training and had access to managers when required. Records demonstrated management oversight of outstanding competencies and supervision requirements.
Staff described receiving regular spot checks, supervision and competency observations. One staff member explained managers observed their moving and handling practice and sought feedback from people receiving care to ensure support was delivered safely and effectively.

The provider assessed and managed risks relating to infection prevention and control. Systems monitored infection-related concerns and included infection control auditing as part of wider governance arrangements. Training records demonstrated staff completed infection prevention and control training. We reviewed wound monitoring systems which provided oversight of people with pressure ulcers, wounds and skin integrity concerns. Records demonstrated concerns were identified, referrals made to district nurses where appropriate, and ongoing monitoring and follow-up completed. Governance systems provided oversight beyond individual care records and supported organisational monitoring of infection and skin integrity risks.

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.
Medicines support was clearly documented within care records and people's preferences and levels of independence were reflected within support plans. Staff received medicines training and competency assessments before supporting people with medicines. Workforce monitoring records demonstrated there were no overdue medicines competencies at the time of review. Governance systems monitored medication incidents and analysed trends to identify areas requiring further monitoring or improvement. Provider reports included review of medication errors and repeat themes to support organisational learning and oversight. People told us staff supported them appropriately with their medicines and ensured medication routines were followed.
One person said, “They always check with me that I've had my tablets,” whilst a relative told us, “She has time critical meds and they always make sure they are time for those.” This demonstrated medicines oversight arrangements were effective and supported safe medicines administration.