Turning Point - Coqbeck Support Domiciliary Care Agency

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 key question was previously rated good. This key question remains 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.

Safety was a priority for leaders. The culture was an open, proactive one, where mistakes were learned from. One staff member told us, “We meet weekly and are always updated. If we need to do something differently we’re involved in the conversation.” Communication between staff allowed for reflection and leaders gave clear advice and support.

People were always safe and protected from bullying, harassment, avoidable harm, neglect, abuse and discrimination. Their liberty was protected where this was in their best interests and in line with legislation.

People were involved in planning and reviewing their care, which helped increase staff knowledge and reduce risks.

The provider worked well with people and partners to ensure internal systems supported safer care.

Staff worked well with a range of external professionals to ensure people’s experience of care was safe, without being restrictive.

People and their relatives had confidence in staff doing the right thing to keep them safe. One person said, “This place is great – I’m in charge of what I want to do.”

External partners praised the service for balancing people’s safety with the need to encourage people to live full lives. One external professional said, “We have confidence in safety there.”

Care plans were sufficiently detailed, person-centred and up to date.

The provider worked well with people to understand what being safe meant to them. They worked well with partners to find the best way to achieve this. The provider had a clear focus on improving people’s lives whilst also protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect.

Any concerns were shared promptly and appropriately with the right external agencies.

People, and their relatives, raised no concerns about their safety. People took part in a range of independent activities, but in a way that gave people and others confidence they were safe to do so. People’s right to choose and to assess their own level of risk when going about day-to-day activities and outings, was respected.

The provider had up to date and comprehensive policies and training in place to support safeguarding. Staff were well trained in safeguarding principles and acted effectively when there were any concerns.

One external professional said, “I have found that staff are very proactive. They raised appropriate concerns re medication, general health and other GP queries. All were relevant and they took on board all advice given.”

The provider worked with people to understand risks holistically and to support people to be comfortable and safe as they explore their own independence. There were systems in place to monitor risks and to update care plans and risk assessments when required, for instance regular reviews and audits. Risk assessments were detailed, person-centred.

People’s independence and right to choose was respected, for instance using public transport and going places on their own. People and their relatives were involved in designing and planning care to ensure risks were reduced. The electronic records system used by the provider was working effectively.

Staff demonstrated a good understanding of the specific risks people may face, and how to help reduce them. External professionals had confidence in staff balancing the risks people faced, alongside their rights to take risks. One professional commented, “This positive risk taking has helped to promote his independence but also shows that they trust him to make the right decisions and this has had a great impact on his overall wellbeing.”

Staff had regard to people’s personal and shared environments, assessing for risks and ensuring they were safe.

Leaders and staff considered how environments can keep people safe from psychological harm as well as physical harm. Environments were used for positive, pro-active work, which in turn afforded people a range of positive opportunities (gardening, crafts).

Equipment used to deliver care and treatment was suitable for the intended purpose, stored securely and used properly.

People were supported to maintain their own flats independently and they took pride in developing skills in these areas.

The provider ensured there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. Staff worked well together to provide safe care that met people’s individual needs.

People confirmed staff were reliable. One relative said, “They have used bank staff in the past, but not recently. We’re happy with staffing levels.”

Staff knew people, and each other well, and there had been no recent need for any agency staff. The provider understood the importance of continuity of care and this was reflected in the feedback we received from people and their relatives.

Shifts and rotas were well planned with a new system that allowed staff to agree their rota much further in advance than previously. This gave them, and people who used the service, a clear picture of who would be supporting who over a longer period of time. One staff member said, “There is always enough staff cover for people to do what they want and the on-call arrangements are reliable.” One external professional said, “They have always had appropriate staffing levels to support with appointments.”

The provider ensured there were a range of appropriate pre-employment checks. People who used the service had been involved in recruitment processes previously and the provider hoped to continue this good practice.

People’s flats were clean and well maintained. They and their relatives raised no concerns about infection control. Staff used PPE when needed and received appropriate training and support in this area.

The provider had policies and procedures in place to reduce the risks of people and staff catching and spreading infections.

The provider ensured medicines and treatments were safe and met people’s needs, capacities and preferences by enabling them to be involved in planning, including when changes happened. Staff knew people’s medicines needs well. One relative said, “Their medical condition is controlled with medication. The staff are well aware of his needs.”

Protocols were in place for people on ‘when required’ medicines, with clear instructions for staff. Medicines records were regularly audited and any errors acted on promptly. The provider acted in line with STOMP, which stands forStopping the Over Medication of People with learning disabilities, autism or both. This is a national NHS project focused on reducing the inappropriate use of medicines.

Staff received regular competency checks of their practice in relation to medicines to ensure they were safe and confident.