Care Delivered 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.

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 service had only experienced a few incidents due to its size, but robust procedures were in place for the reporting of any accidents and incidents and to support staff learning. Staff told us they were confident the management team would listen and regularly engaged in scenario-based discussions during meetings and supervision. This proactive approach ensured staff were confident to act effectively should challenges arise. A staff member added, “We always talk about accidents and incidents to understand what could go wrong and how to avoid it in the future. This helps me to understand and do things the correct way.”

The registered manager had implemented a ‘no blame’ reporting culture across the service. We saw this approach was regularly reinforced through team meetings and supervision, with information and guidance shared with the staff team about how they could report any concerns and reminders about the importance of speaking up. The registered manager added they strived for an environment where staff felt safe, supported and encouraged to report incidents or concerns without fear of punishment or criticism.

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, which ensured staff understood people’s needs. Staff were aware of the risks people faced and we saw the provider had worked with a range of health and social care professionals to ensure people’s needs were met. People and their relatives were kept updated and involved in the organisation of their care, with their views taken into account to how they wanted to be cared for. We saw examples of correspondence with the relevant health and social care professionals to ensure staff had the most up to date information to support people safely.

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.

Although there had been no safeguarding incidents or concerns at the service, there were systems in place and the registered manager and staff had a good understanding of their responsibilities. A care worker said, “To me safeguarding means making sure people are protected from harm, abuse or neglect. In my role it is my duty to look out for any signs of concerns, treat people with respect and report anything worrying straight away to the office or management. This has been explained at work and I know who to contact if I have concerns. I feel confident that I can raise issues safely and that they will be taken seriously."

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.

There was clear evidence that significant improvements had been made since the last inspection. Care plans and risk assessments were detailed and comprehensive, with important information about people’s health conditions and risks related to their care. Care plans had control measures in place and clear guidance for staff to follow to help keep people safe. Staff also had a good understanding of people’s conditions and how to manage any related risks.

People and their relatives confirmed they were fully involved when risks were being assessed and said staff knew how to keep them safe. A relative told us staff were experienced in managing their family member’s multiple risks. They added, “They know everything and know what they are doing, they are wonderful. Thank goodness everything is going well. [Family member] has never been hurt, has never had a fall and has never had a pressure sore. They are very safe and we are very lucky with this."

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Internal risk assessments were completed regarding the safety and accessibility of people’s home environments during their initial assessments to ensure it was safe for staff to provide care. This included checks around fire safety and any additional equipment that was used when providing care.

The registered manager had arrangements in place to monitor the safety of people’s home environments, which included regular spot checks to identify any issues or hazards within the home which could impact the level of care provided. Feedback from relatives confirmed staff ensured the home environment was kept safe and free from hazards. A relative said, “They [staff] are very clear with this, especially around equipment. They provide advice and guidance and can contact social services on my behalf if needed."

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. Significant improvements had been made with recruitment practices since the last inspection to ensure staff were safe and competent to work with the people they supported. Recruitment related documents had been updated to ensure they could record full employment histories and identify any gaps in employment. All required checks were in place, including criminal background and Right to Work in the UK checks.

Staff had access to regular training and supervision, which covered both mandatory and specialist topics such as dysphagia and pressure sore care. Staff competencies were assessed and refreshed, and staff told us they felt confident in their roles. Supervision records showed regular opportunities for staff to discuss their responsibilities, best practice and the people they supported. A care worker said, “I’m always reminded of my responsibilities regularly. This is through supervision, team meetings, refresher training and ongoing communication from managers. These reminders help reinforce expectations, keep everyone updated and ensure we’re working in a safe and consistent way.”

People and their relatives commented positively about the skillset and experience of their care workers. A relative said, “They provide a good service and know how to deal with [family member]. I would say they are very experienced."

The provider had an effective approach to assessing and managing the risk of infection, with policies and training aligned with current best practice guidance. Staff had clear roles and responsibilities around infection prevention and control (IPC), which enhanced the overall safety and well-being of people who used the service. Staff regularly discussed the correct use of personal protective equipment (PPE), hand hygiene and cleaning protocols during training and meetings. Staff understood escalation procedures for infection risks, and the management team had planned for winter pressures to ensure preparedness. There were regular spot checks in place to observe staff, monitor the cleanliness of people’s homes and reinforce best practice.

Furthermore, the provider had a recent external IPC audit carried out from an NHS Trust. The findings of the audit demonstrated strong compliance and robust infection control practices across the service.

Processes were in place to support the safe management of medicines. Improvements had been made and the provider had ensured their policies and procedures had been updated in line with best practice guidance, which had been a recommendation at the last inspection.

Care records included important information about people’s medicines and records confirmed they received their medicines as prescribed. Staff confirmed they completed training and had competency assessments, which helped support their role and increased their confidence. Medicines administration records (MAR) were completed accurately and audited to identify if there had been any errors. Feedback from a relative was positive about how this support was managed.