Comprehensive Care Ltd

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 registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 69 (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. However, systems needed improvement.

The provider had systems in place to review and investigate accidents, incidents and safeguarding concerns. Staff managed accidents and incidents safely; first aid support was provided where needed, medical support and advice was sought, and management were kept updated. Systems were in place for recording events, and changes had been implemented in response to lessons learnt. However, there was no robust system in place to analyse and spot trends. The provider responded to the feedback and implemented processes to analyse and spot trends during the inspection process.

Staff reported an open culture where they were encouraged to report all concerns. They told us, “I inform the manager [of concerns], the managers don’t mess around, they act on anything immediately” and “We report [concerns] to the manager, and it gets resolved.”

People were encouraged to raise concerns and staff supported them to do so.

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.

People’s needs were assessed prior to them receiving a service. Information of care needs assessed by the local authority prior to people joining the service was used to inform people’s care plans and risk assessments. Care plans also informed staff of external support input from health professionals such as support from Mental Health teams.

The provider employed a therapist who supported people with their well-being with regular one-to-one sessions.

Processes were in place to ensure people received continuity of care, for example, when people moved into new supported living properties.

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 were protected from the risks of abuse and staff were trusted to keep them safe. People told us, “Staff are here all day and night. We are safe here. We are so happy here”, “I feel safe. I am happy here” and “I feel safe with the carers.”

Staff had received training in how to safeguard people. Staff we spoke with were confident to report concerns and satisfied that action would be taken to investigate them. Staff told us, “I would report [concerns] to the manager straight away. If I needed to, I would contact the local authority” and “I would report [concerns] to the manager and record the concerns on the system.”

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 needs were assessed prior to them receiving a service. Care plans provided guidance for staff to ensure people received safe and responsive care and support. Risks were assessed and mitigated to keep people safe. Risk assessments were person-centred and regularly reviewed.

People and relatives were involved in care planning. This was reviewed regularly or when people’s needs changed. A relative told us, “I have attended a couple of meetings [about person’s care] and I do feel listened to.”

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's care plans contained information which evidenced that the safety of people’s home environment had been considered. Home safety plans and environmental risk assessments were in place. Where people required the use of aids for safe moving and handling, risk assessments were in place to support staff to be able to use this equipment safely.

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

The management team and staff carried out regular safety checks of people’s homes and communicated with their landlord to escalate any concerns and facilitate repairs and improvements.

The provider made sure there were always enough qualified, skilled and experienced staff, who received thorough support, supervision and strong development opportunities. They worked together well to provide safe care that met people’s individual needs. However, recruitment checks were not always thorough.

Recruitment systems were in place to ensure staff were suitable to work with vulnerable adults. However, the provider had not obtained a Disclosure and Barring (DBS) check for 1 staff member before they started employment and had not explored gaps in another staff member’s employment history. The provider responded during the inspection; they obtained the DBS check and information around the gaps in employment.

Staff completed an induction when they first started, received regular training and opportunities for supervision [one-to-one support sessions with their line manager]. Staff told us, “I have had training [in various areas] and we can request more training if we want”, “I have done a lot of training. We get regular supervisions, and they are helpful.”

The provider had systems in place to monitor staffing levels and ensure the supported living properties were adequately staffed and people received their care at home visits in the community. An electronic system was used to determine staffing levels, issue staff rotas and deploy staff to people’s care at home visits. Staff told us, “There are enough staff, there are no issues” and “We are not overburdened [working in this property], no concerns, and the shifts always get covered when someone is off sick.” People and relatives commented, “We have a regular set of carers” and “All the staff are regular staff.”

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.

The provider had systems and processes in place to assess and manage the risk of infection. There were cleaning programmes for each person’s home which people joined in according to their abilities.

There was sufficient personal protective equipment (PPE) at each person’s home to provide safe care. This included gloves and aprons. Staff had received infection prevention and control training and understood what to do to mitigate infection risks. We observed staff using PPE appropriately throughout people’s homes.

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.

Medicines were managed safely. People received their medicines as prescribed and electronic medication administration records [MARs] were completed daily. People told us, “I am on medication, I get them all at the right time” and “When we need the medications, they [staff] give us the medication.”

Staff were trained to administer medicines. Staff had to undertake training before they could administer medicines and received competency checks to ensure they administered medicines safely. One staff member told us, “I have had training [in administering medicines] and received a competency check.”

Audit processes were in place for medicine records. Staff and the management team audited people’s MARs on a regular basis and took follow up action with the staff involved where required.