Global Caring Gloucester

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 72 (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 were in place to monitor and have oversight of incidents and accidents. Accident and incident audits were completed monthly by the registered manager to identify the cause of the incidents and to ensure appropriate actions had been taken in response to each incident. Additional analysis of accidents and incidents audits would assist the registered manager in identifying trends or patterns of concerns in relation to individual people or staff and to implement any actions. Staff were notified of any changes in individuals care needs following incident investigations to help prevent future occurrences.

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. The registered manager said they aimed to carry out a detailed initial assessment with people prior to supporting them and worked closely with local external professionals to ensure they understood people’s care requirements. One relative said, “My husband’s needs were assessed whilst he was in hospital. His care is reviewed every two weeks by the manager.” Another relative said “The manager came to the house when my father came home from hospital. My sister was present, and I joined in via a video call. It was a very thorough assessment.”

The registered manager stated care packages were not accepted unless the service could meet peoples’ needs, including undertaking specialist training before a care package started.

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.

Managers and staff demonstrated a good knowledge of the provider’s safeguarding procedures and who to inform if they had any concerns. Staff had received training in safeguarding adults and children and knew how to recognise and report abuse. People and their relatives raised no concerns about their safety. One relative said, “We feel safe, they are very nice, you can trust them, we are used to them, they are always on time”.

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.

The service had made improvements and is no longer in breach of regulations relating to the assessment and management of people’s risks. People’s care plans and risk management plans were detailed and reflected people’s care needs and support requirements. This meant staff had access to clear guidance on how to safely support people. The registered manager provided examples of how staff had raised concerns about people’s health and welfare which were subsequently escalated and referred to the relevant healthcare professionals. People’s care records were regularly reviewed and updated based on any changes and professional recommendations and advice. However, we noted some protocols on how people should be supported and staff daily records of the care they delivered were sometimes generic and not personalised to the person being supported. This was raised with the registered manager who agreed to implement some training on personalised record keeping.

We received mixed views about the quality of care people received during and prior to the assessment. Most people and their relatives expressed satisfaction with the care and support provided, however some views of people prior to the assessment and feedback from some health care professionals did not align with this view.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

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.

The provider ensured staff had opportunities to undertake training relevant and additional to their role. Staff attended an intense 3 day classroom training course annually, which supplemented their online training in key health and social care topics and regular supervision meetings. We asked the provider about the quality and effectiveness of staff training and how they ensured staff had a comprehensive understanding of the topics covered. We were told skills and competencies of staff were regularly assessed and checked to ensure staff fully understood the topic covered in the training programme

Safe recruitment practices were carried out. People were supported by staff who had been vetted and recruited based on robust employment, and criminal checks. The provider planned to implement additional safety measures when they had not been able to obtain sufficient information about staff conduct at their previous jobs.

People reported staff were reliable and generally arrived on time and were mainly informed if staff were running late. However, some people who were unable to access the provider’s care management system felt improvement was needed from the office to assist them in understanding their care call timings and the staff who would be supporting them.

CQC was aware that the provider was working with the local authority in relation to the recording and accuracy of staff call times.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

An infection prevention and control policy was in place to guide staff in the protocols to reduce cross infections. Spot checks were carried out to ensure staff were working in line with national infection prevention and control guidance such as washing hands and wearing the correct PPE. Personal protective equipment (PPE) was readily available to staff. People raised no concerns about the infection control practices of staff and wore appropriate PPE when delivering personal care.

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.

People received their medicines as prescribed by staff who had been trained and assessed as competent in medicine administration. Medicines care plans were in place which provided staff with the information they needed to safely manage and administer people’s medicines. Informative protocols were in place to guide staff when to administer ‘as and when’ required prescribed medicines. Detailed medicines audits were completed to ensure medicines were being managed and administered in line with people’s prescription and the provider’s medicine policies.