De Vere Care Partnership -Chelmsford

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 inspection we rated this key question Requires improvement. At this inspection 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.

People and relatives said staff took their concerns seriously and responded in an open and honest way. This showed the service acted on feedback and supported people to feel listened to. One relative told us, “Communication from all levels of the staff team is excellent. Staff listen and respond professionally and always provide feedback on the actions taken. The management team also call to check how things are going.” A person also told us, “The staff do a good job. They seem to be well trained and always follow up when they say they are going to take action. If staff have any concerns, they report them to the office, and I receive a call explaining the action taken. They also work closely with my healthcare professionals, such as my GP and district nurses.”

The provider had systems in place to record and review accidents and incidents. Senior staff used this information to identify themes and possible causes, take action to reduce risks, and share learning with staff to support safer For example, where incidents or concerns were identified, the registered manager reviewed what had happened and used the findings to update staff guidance, discuss learning in team meetings and strengthen risk management.

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 described a thorough pre-assessment process to establish whether people’s needs could be met safely. Records showed people and their families were involved in identifying individual needs, preferences and risks.

Following an initial assessment, the management team developed personalised care plans and risk assessments to guide safe support. For example, where people were at risk of falls, records detailed mobility needs, equipment and the assistance staff should provide.

Staff said registered managers met with them to discuss each person’s support needs. They could ask questions and review care plans and risk assessments, helping them provide safe, personalised care. One staff member told us, “Team meetings are held regularly and provide opportunities to discuss updates, share learning, improve practice and raise any concerns or suggestions. I feel comfortable contributing my ideas and feedback. Another staff member told us, “The meetings help us understand each person’s needs and what support they require.”

We received mixed feedback from one professional, who told us communication, record-keeping and the timely escalation of concerns had required improvement. They also described evidence of responsive communication: when concerns were raised, office staff acted promptly by arranging a senior visit and immediately increasing the person’s care package. They said staff had built a good rapport with people and engaged with them well.

The registered manager described actions taken to improve communication. Additional staff had been recruited, resulting in quicker telephone response times. Staff had received training on responding to concerns and communicating effectively, and a clear escalation process was in place so they could obtain support from a senior manager when an issue could not be resolved.

We found evidence that communication and record-keeping had improved. People’s daily notes were clear and recorded the actions taken. The service had also invested in an improved recording system, which management monitored to ensure staff completed records appropriately and information was communicated effectively.

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.

At our last inspection, we found that the provider's safeguarding processes were not always robust. Safeguarding concerns were not always reported to CQC, and staff lacked knowledge about who to report concerns to. At this inspection, we found improvements had been made.

People and relatives received safeguarding information before support began, helping them recognise and report concerns. One relative said, “The manager provided a welcome pack containing a range of information, including safeguarding guidance, how to report concerns, and telephone numbers we could use to contact the office at any time, day or night.” One person said, “I feel very safe with the staff who visit me. I have a number for the office which I can call if I have any concerns.”

The provider had policies and procedures to protect people from abuse and neglect and guide staff in identifying, reporting and responding to concerns.

Concerns were recorded and referred to the local authority when required. The service had notified CQC of relevant events as required. No safeguarding concerns had been reported at the time of the inspection.

Management completed spot checks to ensure people received safe support in line with their care plans and risk assessments. The registered manager said, “Spot checks helped us confirm staff followed people’s care plans and identify any areas where further guidance or support was needed.”

Safeguarding audits identified gaps and risks and supported improvement. Audit tools had been updated to reflect statutory requirements and best practice.

Training records and feedback showed staff understood how to recognise, report and escalate concerns. Staff would report concerns to managers or office staff and contact the police if someone was at immediate risk. One staff member said, “I would report any concerns straight away to the manager or office staff and contact the police if someone was at immediate risk.”

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.

At the previous inspection, call monitoring, staff induction, competency assessments, supervision follow-up and specialist training were not consistently robust. At this inspection, we found the provider had made the necessary improvements.

A relative told us the service manages risks well. When staff identified any potential new risks, they took appropriate action to ensure everyone remained safe. They told us, “Staff communicate concerns clearly and work with us to manage risks. The manager provides and reviews updated risk assessments, seeks our feedback, and arranges input from healthcare professionals when needed.”

One person said, “My risks are well managed, so I can continue living at home. It has been hard letting others help me, as I have always lived a very independent life. However, staff are not overpowering. They always ask how I want my support to be provided and never do anything without my consent.”

The provider used a person-centred and proactive approach to assessing and managing risk. People and, where appropriate, their relatives were involved in identifying and reviewing risks and making decisions about their support. Managed risks included falls, environmental hazards and community access. Regular reviews had contributed to fewer incidents and supported people to live safely and fulfil their chosen lifestyles.

Risk assessments informed detailed care plans that guided staff to provide safe support while promoting independence and wellbeing. Plans reflected people’s needs, routines, preferences and relevant medical histories, enabling them to continue their daily lives while identified risks were reduced.

Staff consistently said they were involved in assessing and reviewing risks to people’s health, safety and wellbeing. Training records confirmed staff received training in risk assessment and manual handling, supporting them to identify risks and assist people safely. One staff told us, “We are involved in reviewing people’s risks and follow their care plans and moving and handling guidance to support them safely.”

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

People were involved in assessing risks to their health, safety and wellbeing and in decisions about their care. Assessments also considered risks to staff during care visits, supporting safe and responsive care planning. One person told us, “The office visited me before my care started. They completed a number of risk assessments to ensure everyone was safe and shared this information with me.”

The management team completed environmental assessments during the initial assessment process to identify hazards in people’s homes and reduce risks. This supported people to live safely and comfortably while enabling staff to provide safe care that promoted wellbeing.

A health professional told us, “The service should review its moving and handling training to ensure staff recognise unsafe practices, report concerns promptly and seek appropriate professional support.”

We discussed these concerns with the registered manager. They told us they had worked with staff to ensure everyone understood their roles and responsibilities for reporting concerns and followed the correct training practices to help keep people safe. The registered manager tested staff understanding through discussions, supervision meetings and competency checks. We also reviewed the service’s training matrix, which showed staff had received the required training.

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.

At the previous inspection, the provider's risk management systems were not consistently effective, and staff had not always completed the training required to support people safely. At this inspection, we found that the provider had made improvements.

The improved electronic call monitoring system enabled oversight of visit times, duration and staff travel, with action taken where concerns arose.

People said staff arrived on time and stayed for the agreed duration. One person said, “Staff always arrive on time and stay as agreed. On one occasion, a staff member stayed beyond the agreed time to make sure I was safe and had everything I needed before leaving.”

Staff were allocated visits within defined areas, allowing sufficient travel time between calls. One staff member said, “Travel time is planned into the rota so I can arrive safely and on time without compromising the quality of care.”

Since the last inspection, the provider had strengthened induction, training and oversight. Questionnaires were marked, competency assessments completed and supervision records documented actions taken. Staff delivering catheter and PEG care had completed the required training. This showed the provider had acted on previous findings to improve staff competence and people's safety.

Safe recruitment checks, including identity, references, health declarations and Disclosure and Barring Service checks, were completed before staff began work, reducing risks to people.

Staff had the qualifications, skills and experience required for their roles and received supervision, support and development to maintain their competence.

Training records covered key safety areas, including safeguarding, infection prevention and control, and risk assessment, supporting staff to provide safe care and respond to risks. One staff member said, “The training helps me recognise potential risks and understand what action to take to keep people safe.”

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.

People and relatives said appropriate checks were completed before staff provided care. PPE was available in people's homes to reduce the risk of cross-infection. One relative said, “Staff leave PPE, such as gloves and aprons, in our home and replenish supplies when needed. They use it appropriately and dispose of it safely in the correct bin.” A person also told us, “Staff always wear gloves and aprons when helping me with personal care.”

Staff had access to hand gel, aprons and gloves and were expected to use them in line with infection prevention and control guidance. Outbreak procedures supported a timely, coordinated response, and training records confirmed staff had completed relevant training.

Infection prevention and control audits, including spot checks in people's homes, monitored staff practice and provided assurance that procedures were followed, supporting safe care and reducing risks to people.

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 told us they received their medicines safely. One person said, “Staff help me with my medicines. They know what they need to do.” A relative told us, “My [person] is able to take their medicines independently, but staff remind them when needed.”

Medicines administration records were complete and clearly documented, providing assurance that medicines were administered and recorded in line with the provider’s procedures.

Regular audits monitored the safe handling, administration and storage of medicines. Where concerns were identified, the provider took appropriate action, shared findings with staff and implemented measures to reduce the risk of recurrence.

Senior staff assessed staff competency to administer medicines, providing assurance that staff had the knowledge and skills to follow the provider’s medicines procedures safely.