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 78 (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 confirmed any concerns they had were investigated and responded to. For example, one person described an incident they had experienced and were able to describe what had been put in place in response. They told us they had been able to discuss the incident and had felt supported.

Leaders also showed how they shared feedback and learning with people and had systems in place to share outcomes and learning with relatives where appropriate.

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 received feedback from leaders about accidents and incidents, which were investigated, with actions implemented to manage and mitigate risks.

The provider worked exceptionally well with people and partners to design, establish and maintain safe systems of care, in which safety was always well managed and monitored. They made sure there was always continuity of care, including when people moved between different services.

Leaders described how they developed their pre-assessment processes in response to concerns raised around one person’s rights and understanding of mental capacity. This led to working with local colleges to ensure people and their families understood their legal rights when transitioning to supported living and adult services. This included ongoing work with the person and their families to ensure the person’s independence, decision making and human rights were supported.

One staff member told us one person’s whole support team met them before transitioning to the service and people told us they were consulted and involved in making decisions about their transition.

Processes were in place to ensure people were treated as individuals and their needs were discussed prior to moving into the service. This included regular visits to a local college, speaking to young people and their relatives about the services offered. Also, people were involved in determining who they lived with by meeting current tenants prior to any move which meant all people were treated as individuals. In addition, people were able to meet their staff team prior to transitioning, one person said, “When it was getting close to moving in, I came over to meet everyone at head office.”

We received positive feedback from external professionals regarding transitions between services and when people moved from children to adult services. One professional told us, “Every effort was made to transition safely and to ensure nothing was rushed and it was taken at the pace of the service user,” another said, “The transition was very well organised when my client moved in, with additional hours provided.” Evidence was also provided of positive work with one person to reduce their reliance on emergency services as they moved to being supported by Call on Me Ltd. The support provided to the person during this change had significantly reduced their need for emergency response, which was confirmed by the emergency services.

People were happy in their home and confirmed continuity of staff supporting them. For example, one person described their staff team positively, knew them all by name and was able to describe who they would like to support them in different situations. People also confirmed they were involved in the décor and layout of their personal spaces before moving in which meant people’s choices were included in their transition.

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. They knew who to speak to if they had concerns and were familiar with leaders, and staff who they felt comfortable speaking to. One person told us, “My parents even feel safe to go away now since I’m here, they didn’t before.”

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. For example, they were able to share examples where people had capacity to make decisions which their relatives might not agree with. They demonstrated how they supported people to have confidence to make the decisions they wanted to, to understand their rights. For example, accessing public transport independently as and when they wanted to, along with preferences regarding food they ate.

We observed one person being supported through the process to raise a concern relating to the use of the shared kitchen where the system of taking turns had not been fair or equal. We also observed people were familiar with staff and interactions were positive.

Leaders identified, reported and investigated safeguarding concerns effectively and systems were in place to share this learning. In addition, systems and 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/ 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 were able to demonstrate how they were supported with positive risk taking. For example, 1 person was able to explain why visitors needed to sign in and out in relation to fire evacuation needs. They were also able to detail how fire risks within the home were managed and mitigated.

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.

We observed staff providing support and reassurance to people around positive risk taking. For example, one person was sharing a story which led to them voicing a lack of confidence in the task. A staff member spoke to them, providing reassurance in a kind and gentle way, to help them. This demonstrated a high level of knowledge of the person’s individual needs.

People’s care plans were created with people, and where appropriate, family members and other professionals. One professional said, “Call on Me provide individualised, holistic care plans for the residents.” Risk assessments were person centred and detailed for those requiring additional support such as skin integrity, mobility and falls prevention. Some people were able to detail the risks and how staff supported them to navigate them, they were able to tell us how they were supported to approach risk management, consider the risks and consider risk mitigation. It was evident from our discussions, this approach enabled dynamic responsive and proactive risk management; it developed people’s independence and decision making. For example, having more options and flexibility in their decision making. People were able to demonstrate they knew how to access additional support from staff when needed and shared how they were able to access this support when away from the service via their mobile.

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 told us how they were supported to report maintenance concerns if they arose. They said the environment met their needs and maintenance needs were addressed within a reasonable timeframe. In addition, one person we spoke to described the process they were following, with staff support, to receive a new prescribed bed, they said they felt supported and kept informed and updated about progress with this issue.

Staff told us about different equipment people had in place to support them in their homes. They told us how they supported people to ensure the equipment was well maintained, serviced, cleaned and fit for purpose. For example, one person had a perching stool in their kitchen which was checked before use and cleaned weekly and when needed. Leaders and staff were able to demonstrate how they supported people to access equipment they needed, escalated maintenance concerns and supported people to maintain safe environments, for example in relation to fire safety.

We observed people’s homes were well maintained and there were no obvious defects or maintenance concerns. The homes were different in décor, furnishings and layouts which tenants confirmed were arranged how they agreed which meant people had choices regarding their environment.

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 were in accordance with the staffing levels identified for the services. Staff appeared person, not task focused and were observed to provide support to people which was not rushed and was led by the person. Staff appeared to know people and their needs well.

Leaders described a values-based recruitment process, which was evidenced by their staff recruitment records. 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.” Another said, “Staff numbers are adequate for the needs of the residents, additional staff have been provided at more difficult times.”

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 they were happy with their homes and felt they were clean. Some people told us how staff supported them to keep their homes clean; how often they cleaned their bedrooms, did their laundry and cleaned communal areas. One person told us, “It is our home, so we keep it tidy.” People we spoke to also confirmed they were consistently offered opportunities to develop their skills in relation to household tasks and one person explained how staff supported them with effective handwashing.

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. Leaders described how they visited the homes regularly and visually checked cleanliness.

We observed staff wearing PPE when using potentially hazardous products, washing their hands effectively when cooking and staff changed PPE appropriately. We also observed cleaning schedules with allocated tasks on display in communal areas of one home where shared tasks had been agreed by the people who lived there. The homes were visually clean with no malodours observed.

The provider had systems and processes in place to assess and manage the risk of infection. This included the compliance manager visiting each home and completing an independent Infection Prevention Control audit of the cleanliness of each home. Leaders followed internal policies with regard to infection control, for example, when an infectious illness was identified, the registered manager took action to identify, report and manage the illness to reduce the risk of spread. Afterwards, the registered manager reviewed systems in place and introduced a new policy to manage this illness, shared the information with staff and liaised with external professionals appropriately throughout.

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. People were able to detail where their medicines were stored and how they were supported to manage these. People understood what their medicines were prescribed for and confirmed they had their medicines when they needed them, including when required medicines. They told us staff supported them to have their medicines where they chose and their consent was gained from staff. One person told us, “[Staff member] will sit and explain the meds to me; show me what the packaging looks like so I am familiar with it, I’m second signature for my meds now.”

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.

We observed one person being safely supported with their medicines. They were asked where they wanted their medicines, what drink they wanted to take them with and staff gained consent prior to administration. They informed the person what their medicines were and checked their wellbeing after each tablet was swallowed. They were not rushed, had open body language and as the person sat down, they lowered themselves to be eye level with them.

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.