Citywide Care Agency- Bristol

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 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. The provider had developed systems, to help them learn from any accidents and safeguarding incidents. The registered manager told us that, at the time of are assessment, no accidents or safeguarding had occurred. The registered manager used a tracker to record any incidents that may occur. Lessons learnt with to improve people’s care were shared by the registered manager with the staff at staff meetings.

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 ensured people received continuity of care. A pre assessment was completed when people started with the service. This helped to support a safe transition to the service, ensuring staff were aware of people’s needs.

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.

Staff had received safeguarding adults training and had good awareness of how to report any concerns. A staff member told us, “Previously I worked with vulnerable people and know that I have a legal obligation to ensure they are safe from harm. I also completed the training required.” The provider had a good awareness of how to report any concerns. At the time of are assessment, no safeguarding concerns had been raised or reported. The registered manager had systems to log any concerns enabling them to monitor progress.

People who used the service had a service user guide given to them before care commenced. This contained details of how to report any concerns about their care. A relative told us, “I feel my relative receives safe care. If I had any concerns, I would speak to the staff and the manager.”

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.

Risks to people were being managed, with risk assessments in place to help manage this. We looked at 1 person’s care records, which contained the appropriate risk assessments, related to their needs. We spoke to the registered manager about updating the person’s epilepsy risk assessment. This was because it was not clear for when staff, when they should seek medical assistance. It had been a few years since the person had a seizure and therefore updated guidance for staff was required.

The registered manager and staff had received manual handling training. They told us when new staff were recruited, this training would be mandatory.

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 registered manager carried out an assessment of people’s needs in person. During the assessment, an environmental risk assessment was undertaken of people’s homes. These included checks on fire safety, slip and fall hazards and how to help keep people safe.

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 registered manager ensured that safe staffing levels were maintained. The service employed a small team of staff to help oversee people’s care. Staff recorded the times they started and finished at each visit and the duration. We spoke to a relative about staffing levels at the service. They told us they had not experienced any missed visits or lateness, and continuity of staff was maintained.

The provider had a recruitment policy which contained information about how staff were safely recruited. This included the application and interview process, criminal record check, references obtained and there right to work checked. This was being followed for the current staff employed.

Staff received a comprehensive induction and completed shadow shifts when they started working for the service. The registered manager kept a log of the training that had been undertaken. This included for example, moving and handling, medicine administration, food hygiene safeguarding vulnerable adults and infection control. Staff received regular supervision and appraisal meetings.

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 registered manager carried out infection control audits at the service. Personal protective equipment (PPE) was worn by staff, when carrying out personal care. This included gloves and aprons. Clinical waste was safely disposed of. The registered manager carried out spot checks, which included checking the staff were following good hygiene practices. A relative told us, staff kept their home clean and always washed their hands.

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’s medicines were administered safely, and the staff had received the appropriate training. Medicines administration charts were in place and signed by the staff. Information was recorded about the medicines prescribed to people and the dosage. When changes were made to people’s medicines, this was communicated with the service.