Call on Me 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 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.

Leaders demonstrated how they shared feedback and learning with people and had systems in place to share outcomes and learning with staff, people and their relatives where appropriate, which people we spoke to confirmed.

The provider demonstrated how learning was identified, implemented and cascaded to staff through meetings, supervisions, handovers and email. Staff confirmed there was a culture of safety and learning within the service. They told us they received feedback from leaders about accidents and incidents, which were investigated, with actions implemented to manage and mitigate risks.

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 received care from a consistent staff team which people confirmed. People were supported to access health care from external professionals when needed and were given the opportunity to provide feedback to the provider about the support they received to do this.

Leaders described how they’d developed pre-assessment processes to ensure a support plan was available to staff on the first visit which allowed them to provide safe care to people. These plans were updated with additional person-centred information when staff got to know people, and this information was available in people’s homes for visiting professionals and emergency services.

Systems were in place to support, and advocate for, people to have their personal needs known and respected by other professionals. In addition, the provider ensured staff knew people and their needs well by not using agency staff due to the complex needs of the service users. This meant due to the continuity of staff and their knowledge of people’s needs, they were able to identify changes and escalate when health referrals were required.

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 consistently told us they felt safe and received safe care from staff and the provider. People were able to demonstrate they knew who to speak to if they had concerns and were familiar with leaders, and staff who they also confirmed they felt comfortable speaking to.

Staff had received safeguarding training and demonstrated their understanding of safeguarding, restrictive practices and the legal process in relation to mental capacity. Staff were able to describe their understanding of recognising improper use of restrictive practices and unlawful restrictions being placed on people and shared examples where people had capacity to make decisions others might not agree with. They demonstrated how they supported people to have confidence to make the decisions they wanted to, to understand their rights.

Leaders identified, reported and investigated safeguarding concerns effectively and systems were in place to share this learning. Also, processes were in place to monitor and review safeguarding concerns to enable identification of any themes or trends. Information was accessible to people in relation to raising concerns and speaking up. Professionals we spoke to confirmed the provider identified, reported and investigated safeguarding concerns effectively. One professional told us, “Concerns are reported promptly, safeguarding is taken very seriously and acted upon appropriately,” another said, “Call on Me are very good at raising concerns and acting on them.”

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 and their relatives said they were supported to stay safe in their own homes. People’s care plans were created with people, and where appropriate, family members and other professionals. Risk assessments were person centred and detailed for those requiring additional support. For example, one person had known risks to their own safety and effective risk assessments and management plans were in place which identified triggers and signs of escalation, with guidance for staff to follow to keep themselves and the person safe.

The management team completed regular care plan and risk assessment reviews to ensure they were up to date, accurate and communicated any changes in need to staff.

Staff were able to demonstrate how they supported people with positive risk taking, they described approaches utilised to support people to understand risks. They were able to demonstrate how they mitigated and were informed about risks for the individual people they supported. It was evident they knew people well as some of the examples shared were reflected in people’s feedback and provided corroboration. This knowledge was also reflected in discussions with leaders.

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 homes were assessed during the initial assessment process. This identified any environmental risks which may impact people’s or staff safety, which were then discussed with the person and peoples feedback confirmed this.

Staff told us about different equipment people had in place to support them within their homes. They told us how they supported people to ensure the equipment was well maintained, serviced, cleaned and fit for purpose.

Leaders demonstrated their use of technology to support people, for example to aid sharing information with staff about any changes in the safety of people’s environments. They were in the process of trialling and had a plan to safely roll out a digital record keeping system to enable this information to be accessed by management and relatives appropriately.

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.

People felt there were enough staff to meet their needs. Some people told us they had staff they preferred to speak to about any concerns, issues or personal thoughts they wanted to share, escalate or support to resolve, however they were clear all staff were able to support them to meet their needs and would be able to approach them if needed.

Staff confirmed there were enough staff. Staff told us, and records evidenced, there was a robust induction process with regular support, supervisions and team meetings in which technology was utilised to help staff increase attendance. Safe staffing levels were observed and in line with the staffing levels identified for the service. Staff were person, not task focused and appeared to know people and their needs well.

Leaders described a values-based recruitment process, which was evidenced by their recruitment records for staff recruited to the service. People and staff had one page pen pictures and people were able to be involved in recruitment where they wanted to; this took various forms, from sharing what they would like in a staff member, looking at staff pen pictures and meeting staff. Staff files had evidence of training certificates in place for staff which was relevant to their roles. Inductions, supervisions and probationary meetings and disciplinary processes were followed in line with internal policy. External professionals we spoke to provided positive feedback around staffing. One professional told us, “The staff are well matched to the clients, so this is a huge benefit to service users.”

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 told us staff wore PPE appropriately and they had the opportunity to inform management if this was not the case. Staff confirmed they had sufficient supplies of PPE and were able to detail how they supported people to ensure their homes were clean and maintained and received training in infection prevention and control.

The provider had systems and processes in place to assess and manage the risk of infection. This included risk assessments and the compliance manager conducting spot checks on staff to ensure proper use of PPE. Leaders followed internal policies with regard to infection control and were able to demonstrate an awareness of who and when to escalate concerns to.

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 had no concerns in relation to their medicines and told us staff supported them to take their prescribed medicines as and when they should.

Staff were able to describe the medicines processes in place in relation to storage, ordering and administration and were able to demonstrate their understanding of what people were prescribed and why. Staff confirmed they had received medicines training and were able to describe actions they would take in the event of a medicines error. Staff also demonstrated a good level of understanding around peoples PRN (when required) medicines including signs and indicators for people who may not request PRN medicines. For example, one person’s care records detailed staff consistently prompting the person to think if they needed their prescribed PRN medicine and supporting their decision.

The provider had systems and processes in place to have effective oversight of the safe administration of people’s medicines. People had medicines care plans in place which detailed how they wished to be supported. Regular audits were conducted of medicines to identify any shortfalls. Staff administering medicines were adequately trained and people’s medicines were kept under review with clear instructions available to staff. In addition, processes were in place to manage and investigate any medicines errors and evidence was seen of people’s involvement in their medicines administrations and reviews.