BMBC Reablement Service

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 newly registered 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. Staff understood their responsibilities to record and report accidents and incidents and could complete incident forms via electronic logs. Accidents and incidents were monitored and investigated appropriately. Senior staff completed reviews of incidents and records evidenced action was taken to learn lessons from these. Incidents were discussed during senior team meetings and lessons learned were shared with staff.

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. Staff understood their roles and responsibilities to keep people safe from abuse. Staff told us they felt comfortable to report concerns and action would be taken. A staff member said, “A copy of the whistleblowing procedure is available to all BMBC employees and are found on the employee hub or from my line manager. This is where employees can report their concerns, if they suspect wrongdoing, malpractice, illegality, or risk in the workplace. All information is confidential, whistleblowing process assists individuals, who believe they have come across malpractice or safeguarding issue, and they addressed and taken seriously. I would feel able to whistle-blow on poor practice, as I feel as my job role, I want to keep everyone safe, and all procedures are followed correctly.” Notifiable incidents were reported to the CQC and local authority as required. People told us they felt safe receiving support from staff. A person said, “I feel very safe with the lovely carers as they are wonderful.” Some staff required up to date training regarding safeguarding vulnerable adults. This is covered in the staffing section of this report.

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. Staff understood their roles and responsibilities to keep people safe from abuse. Staff told us they felt comfortable to report concerns and action would be taken. A staff member said, “A copy of the whistleblowing procedure is available to all BMBC employees and are found on the employee hub or from my line manager. This is where employees can report their concerns, if they suspect wrongdoing, malpractice, illegality, or risk in the workplace. All information is confidential, whistleblowing process assists individuals, who believe they have come across malpractice or safeguarding issue, and they addressed and taken seriously. I would feel able to whistle-blow on poor practice, as I feel as my job role, I want to keep everyone safe, and all procedures are followed correctly.” Notifiable incidents were reported to the CQC and local authority as required. People told us they felt safe receiving support from staff. A person said, “I feel very safe with the lovely carers as they are wonderful.” Some staff required up to date training regarding safeguarding vulnerable adults. This is covered in the staffing section of this report.

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. People's risks were assessed and mitigated. Risk management was included in people's care records, for example, people's mobility and dietary needs were explored and care plans contained guidance for staff about how to keep people safe. People had equipment in place to support them to be safe and this information was detailed in people's records. A person said, “The assessment process was quick and efficient. I got home and had care in place at 5pm that day. They [staff] assessed my needs with my input, and they deliver.” Staff accessed people's records via electronic apps, and people's needs were reviewed with them on a weekly basis or as required. A person said, “The care I receive is reviewed and I am always asked if I am happy and do the carers do the tasks that I require.”

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 received support in their own homes and safety was assessed prior to people receiving support from the service, such as if people had smoke detectors in place. A person said, “A risk assessment was carried out as they looked around my bungalow to make sure there were no hazards.” Staff completed assessments to identify if people required safety alarms, which they could press if they required emergency assistance, such as if they had a fall. Staff also had lone worker safety alarms in place, to ensure they could easily access support if required.

The provider did not always make sure there were enough qualified, skilled and experienced staff. They did not always make sure staff received effective support, supervision and development. They did not always work together well to provide safe care that met people’s individual needs. Improvements were required to ensure all staff completed up to date training and refresher training. We found several gaps in key training areas, such as the care certificate, health and safety and first aid. Following our assessment the service provided us with an action plan, which detailed timescales for staff to complete this training. Staff had allocated days and time to complete this training, and each member of staff had a professional development portal, which detailed their training requirements. Improvements were required to ensure this could be appropriately monitored by the management team and checks completed to see if training logs were kept up to date. Some staff were also overdue a supervision and not all staff had received feedback surveys. However, staff were involved in regular team meetings and told us they felt supported in their roles and could raise suggestions via a staff portal. A staff member said, “Managers are fair and approachable, we have regular team meetings. Staff morale is good, we work well together as a team.” Staff were recruited safely, and pre-employment checks were in place, including regular police records checks. Staff received a thorough induction upon commencement of employment and were provided with shadowing opportunities. A staff member said, “I shadowed both of my colleagues for a number of weeks before I worked independently, I felt confident in working on my own and I knew that if I needed support with anything I could contact my team leaders or colleagues.”

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. Policies, procedures and staff spot checks were in place to ensure staff adhered to safe infection, prevention and control practices. Staff told us they had access to personal protective equipment (PPE) and people told us staff wore PPE and kept their homes clean and tidy. A person said, “They [staff] wash their hands and change their gloves and wear aprons.” And a relative said, “They are such tidy workers always clearing up after themselves.”

At the time of our assessment no one was receiving support to take medicines. Medicines checks were in place, as part of weekly reviews for people and previous records evidenced staff had worked with pharmacists and GPs to ensure people received their medicines as prescribed. Some previous medicines errors had been identified by the leadership team and action had been taken to address this, such as meetings with staff and further training. The leadership team had identified more robust audits were needed and planned to introduce these if they commenced supporting a person with their medicines. Staff training and competency assessments were required for some staff, should the service support people with their medicines in the future.