Ivy Grace Home Care LTD - Kirby Cross Branch

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.

At our last assessment we rated this key question good. At this assessment the rating has remained as 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.

People and their families told us that staff listened to their concerns and responded openly and transparently to the issues they raised. This demonstrated that people felt heard and that the service was responsive to their individual concerns and feedback. One person told us,” The staff are very good, they take their time and I always feel listened to. I don’t have any concerns however if I did, I know they would deal with it.”

Records showed the provider had implemented a system to log accidents and incidents. These records were reviewed by senior staff to identify patterns, trends, and potential causes. This supported the service to take a more informed approach to reducing risks and improving safety. These lessons were also shared with staff to improve practise and promote an open and transparent culture.

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 registered manager told us that the service had implemented a robust procedure to collect essential information in people’s pre-assessment phase. For example, completed assessments showed that the service could offer safe support to individuals. This method allowed the team to consider each person’s needs and safety requirements before they began receiving support from the service. The information also demonstrated that the people and their family were fully involved with the process.

Following the completion of initial assessments, the management team undertook the task of developing comprehensive care plans and risk assessments for each person. These documents were tailored to meet the person’s needs, preferences, and potential risks.

Staff reported that the management team arranged meetings with them to review and discuss the support requirements of each person. During these sessions, staff were encouraged to ask questions and were provided with the opportunity to read both the care plans and risk assessments, ensuring they were fully informed and prepared to deliver personalised care.

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 and their family members told us they had received information about safeguarding before support from the service commenced, which helped to ensure they understood how to recognise concerns and report them if needed. One relative shared, “we were given on how to raise concerns and who to phone if there were any issues.”

The provider had systems and processes to help protect people from abuse and neglect. Policies and procedures set out how staff should identify, report and respond to safeguarding concerns, supporting staff to understand their responsibilities.

Safeguarding concerns were recorded and referred to the local authority where required, supporting timely escalation of risk. At the time of inspection, there had been no reported safeguarding concerns.

Management completed spot checks to oversee care delivery and ensure people received safe support in line with care plans and risk assessments. The registered manager said, “I visit people while a staff member is providing care and observe the visit to check that correct protocols are being followed and that people are safe. I also ask the [Person]whether they have any concerns. If any concerns are identified, I address them appropriately, follow the safeguarding policy, and inform the relevant agencies.”

The provider completed audits and reviews of safeguarding practice to identify gaps, respond to risks and support improvement. Audit tools had recently been reviewed to reflect statutory requirements and sector best practice.

Training records and staff feedback confirmed staff received safeguarding training and understood how to recognise, report and escalate concerns to help keep people safe. Staff said they would report concerns to managers or office staff and contact the police if a person was at immediate risk. For example, one member of staff said, “if I had any concerns or thoughts that someone is being abused, I would contact my manager/ the office immediately and take things further if required.” Another staff member told us, “I would report any concerns to my line manager or if the person was not safe, I would also call the police.”

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.

One person said, “staff take their time to sit with me and talk to me about any concern and how they will support me to be safe.”

The provider had established a person-centred, proactive, and inclusive system for the assessment and management of risk. People and, where appropriate, their relatives, were actively involved in identifying, reviewing, and managing risks, with regular reviews supporting their continued involvement in decision-making. This approach had contributed to a reduction in incidents and supported people to live safe, enjoyable, and fulfilling lives. Risks identified and managed included those relating to falls, environmental trip hazards, and access to the community.

Following the completion of risk assessments, detailed care plans were developed to provide staff with clear guidance on how to support people safely while promoting their independence and wellbeing. These plans reflected people’s individual needs, routines, preferences, and relevant medical histories, helping to ensure support was both personalised and responsive. As a result, people received care that reduced identified risks while enabling them to continue with their daily lives as fully as possible.

Staff consistently described being actively involved in the assessment and review of risks to people’s health, safety, and wellbeing. One staff member told us, “I would ask the [Person] about their life and read their care plan and risk assessment before I started supporting the person.”

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 confirmed they were actively involved in the risk assessment process, which helped to ensure risks to their health, safety, and wellbeing were identified, assessed, and managed appropriately. Their involvement also supported the safe planning and delivery of care, including consideration of risks to staff when attending care visits. This demonstrated that people were involved in decisions about their care and treatment, and that risk management processes supported the delivery of safe care in a way that was responsive to individual circumstances.

One person told us, “The manager shares all information like risk assessments with me so I can read the information when I want to.”

The management team completed environmental assessments as part of the initial assessment process to identify hazards within people’s home environments and implement measures to reduce identified risks. This helped to ensure people were supported in environments that were safe, clean, and suitable for their individual needs. This supported people to live safely and comfortably in their home, while also enabling staff to provide care in a way that promoted people’s wellbeing and quality of life. The provider’s approach demonstrated that environmental risks were considered proactively and formed part of wider systems to maintain safe care and treatment.

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 demonstrated that safer recruitment practices were followed, with appropriate systems in place to ensure all required recruitment checks were completed before staff commenced employment.

Records and discussions with the registered manager showed that staff had the appropriate qualifications, skills and experience to carry out their roles safely. Staff received supervision and had access to training and development, which supported them to maintain their competence and deliver care in a safe way. This helped reduce risks to people and supported the delivery of safe, person-centred care.

Staff confirmed that they received the appropriate support and guidance from the management team. Staff comments included, “I have regular welfare meet ups in the office and appraisals are completed also, annually. Which are helpful and we discuss any issues and concerns, and training and my development.” Another staff member told us, “I received a full induction and was shadowed by the manager to help ensure I was clear of the support that was needed for the [Person] that I would be supporting.”

Training records showed staff had completed training in key areas relevant to keeping people safe. This included adult safeguarding, infection prevention and control, and completing risk assessment, this helped ensure staff had the knowledge and skills to provide care safely and respond appropriately to identified risks. One staff member told us, “There are lots of opportunities for training. We do online training and we also do training in the office. If I feel I am struggling with something I would be invited into the office and the trainer would go through it with me one-to-one, or the trainer or a member of the management team would come out to a client with me to make sure I was confident in what I was doing.”

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.

People and relatives told us the provider had completed the necessary checks before staff provided care. Personal protective equipment (PPE) was also available in people’s homes for staff to use, which supported infection prevention and control practices and helped reduce the risk of cross infection. One person said. ”Staff always wear their gloves and aprons when supporting me with my personal care.”

Staff had access to hand gel and personal protective equipment, including aprons and gloves, and were expected to use these in line with infection prevention and control guidance. The provider had procedures in place for staff to follow in the event of an infection outbreak, which supported a timely and coordinated response. Training records showed staff had received infection prevention and control training to help ensure safe practice was maintained.

One member of staff reported, “We prevent the spread of infection by good washing of hands, wearing of masks when required and wearing our PPE. If I did not feel well, I would inform my manager and ask for another carer to be sent to prevent the [Person] from coming unwell.”

The provider completed infection prevention and control audits to monitor practice and assess whether staff were following the correct procedures. This included spot checks in people’s homes, which helped provide assurance that infection prevention and control measures were being implemented. These oversight processes supported the consistent delivery of safe care and helped reduce risks to people using the service.

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 told us they received their medicines safely. One person told us, “Staff remind me when I need to take my [medicines] as I do forget sometimes.”

We reviewed people’s medicines administration records (MAR). The records reviewed were completed appropriately, with entries clearly documented, which provided assurance that medicines were administered and recorded in line with the provider’s procedures.

Regular audits were undertaken to monitor the safe handling, administration and storage of medicines. Where these identified concerns, the provider had taken action to address them. Staff were made aware of the findings and appropriate steps were taken to reduce the risk of recurrence and support safe medicines management.

Staff competency to administer medicines was assessed by senior staff to help ensure medicines were given safely. This provided assurance that staff had the required knowledge, skills and understanding to follow the provider’s medicines procedures in practice.