121 Health&Care Limited

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 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.

People and staff were encouraged and supported to raise concerns, they felt confident they would be treated with compassion and understanding.

Staff told us they were updated about incidents and changes. Incidents and accidents were discussed in meetings and group supervisions. One staff member told us, “By involving clients [people] in decisions and providing support, many incidents can be avoided, helping them [people] live safely and independently with the assistance of carers [staff].”

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 provider worked with a number of professionals to ensure continuity of care within the service and made appropriate referrals to healthcare professionals.

Staff knew people and their risks well and told us how they worked with professionals to keep people safe. One relative told how staff arranged a person’s medicine with their GP. They said, “[Staff member] has got the GP to write up all [person’s] medications, so we are relieved about that.”

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.

People using the service and their relatives told us they felt safe and were happy with their care. We were told, “I am sure [person] is safe with them [staff],100%”, “I am very safe with them [staff]” and “Well, it’s been wonderful, they [staff] come twice a day, am and pm, to get [person] up and washed and then later, to go to bed. [Person] is very safe with them [staff].”

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.

A risk management system was in place and risk assessments were held in care plans. These assessments guided staff on how to support the person safely. For example, one risk assessment detailed how to support the person to have a shower. This included prompting the person to do what they could for themselves, and what the person required staff support with.

One staff member told us, “I consider risk assessments mandatory and believe it is important to involve clients [people] in their own care and assessment. This helps them understand how to live safely in their own home and enjoy the activities they like while avoiding unpleasant incidents.”

A relative told us, “They [staff] certainly know what they are doing.”

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 carried out assessments of people’s home environments to identify and reduce any risks related to the delivery of care. Staff told us they checked the inspection dates and condition of equipment before use, and ensured it was the correct equipment for each person.

The provider had invested in technological solutions to aid the delivery of safe care. This included electronic care planning systems and mobile care applications. This helped to improve safety and the provider’s ability to monitor how care was delivered.

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 had robust recruitment systems in place to ensure people were supported by well trained, experienced staff. Background checks were conducted to ensure staff were safe to work with vulnerable people.

People told us there were enough staff. We asked people if staff were punctual. Their comments included, “Well they [staff] can be 10 minutes late, no they don’t come any later than that. I do understand they can be held up but I would like them spot on, at least it’s always the same girls [staff]” and “I have never had a problem really, it's all worked OK.”

One staff member commented, “Taking into account the number of our [people], in my view, we have enough carers [staff], even to cover emergencies.”

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.

Staff wore personal protective equipment (PPE) during personal care. Staff understood the need to wear PPE and how to manage the risk of infection. Infection control policies were in place and up to date.

People told us staff used PPE appropriately. One person said, “They [staff] always wear their gloves and aprons.” Another said, “They [staff] wear their PPE.”

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 medicine as prescribed. Staff had been trained to administer medicines and their competency to do so was regularly checked. Records confirmed any medicine errors were reported and investigated.

One person told us, “They [staff] sort all the medication.” Another person said, “I have lots of pills that are delivered but they [staff] put them up into the pill boxes for me check that I have taken them, such a help, they order everything from the Chemist for me.” We spoke with the registered manager about this practice of secondary dispensing, which could put the person at risk, and they took immediate action to safeguard the person.

People’s medicines were regularly reviewed by the GP and regular audits monitored medicines to help staff manage people’s medicines efficiently. Medicine records were accurate and up to date.