Nobilis Care Southampton

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 inspection we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 72 (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. Lessons were learnt to continually identify and embed good practice.

People said they felt confident staff would act to keep them safe during any accident or incident.

Staff demonstrated good knowledge of how to recognise and report incidents and accidents. They acted promptly to keep people safe and understood the importance of keeping accurate care records to evidence how they kept people safe. Incident reports were reviewed by senior staff, with immediate actions taken in response to improve care or reduce risk. For example, by making referrals to external professionals or changing the timing or focus of care calls. Senior staff completed more comprehensive reviews and analysis of incidents to identify any trends or concerns. Where professionals made recommendations to improve care, the provider ensured care plans were updated and staff were informed about changes. Learning from incidents was shared with staff through immediate messaging and reflective practice in team meetings. This helped keep people safe.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. People told us there was continuity of care, including when they moved between different services.

People told us that their care packages were organised in a timely manner and they did not experience delays in receiving the care they needed.

Staff supported smooth transitions when people moved between services, for example following hospital discharge. The provider had a ‘bridging contract’ in place, where people received short-term care packages after discharge to support their recovery and help them regain independence. The provider used an adapted assessment process for people requiring temporary care packages. This involved streamlined care plans focused on key areas and priorities. As these packages had specific outcomes and timescales, processes were adjusted to ensure a quick turnaround between the assessment and the start of care. This supported timely and effective hospital discharges.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. The provider shared concerns quickly and appropriately with professionals.

People told us they felt safe receiving care from staff. They said they had positive relationships with staff and were never assigned unfamiliar staff. Staff had a good understanding of the importance of supporting people to maintain their home security. For example, by ensuring people’s keys were stored securely.

Staff recognised signs of self-neglect and supported people to access services and support. This helped to reduce risks related to self-neglect and safety. The provider minimised restrictive practices and ensured any measures were proportionate, agreed, and regularly reviewed with those involved. For example, staff were conscious not to routinely lock medicines away from people’s access, unless it agreed with them or the decision had been made in their best interests. This helped to ensure restrictions were minimised.

The provider worked with people to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

The provider had non-entry policies and procedures to safeguard people who were not contactable at planned care times, and these were effective. Staff demonstrated a clear understanding of these procedures and the importance of confirming people’s safety and whereabouts. For example, staff contacted the fire service when a person had fallen and was unable to open the door.

People who regularly declined support had risk assessments which outlined the agreed reporting arrangements with stakeholders. In one case, a person often chose to go out during scheduled care visits and was not always reachable by phone. The provider implemented an arrangement where the person left dated messages at their property to confirm their whereabouts. This ensured their welfare could be accounted for whilst respecting their choice to decline support.

Business continuity plans detailed how staff would respond to significant risks, including extreme weather. People’s care needs were assessed and prioritised for response in emergency situations. Senior staff could access electronic systems remotely, enabling them to monitor and coordinate care outside office hours. An out-of-hours telephone based on-call system, staffed by senior personnel, was in place. Both staff and people reported it was effective, with support from senior staff available during emergencies.

The provider detected and controlled potential risks in the care environment. They made sure equipment supported the delivery of safe care.

The provider completed environmental assessments of people’s homes, balancing individuals’ right to live as they chose with staff’s safety. For example, fire risk assessments considered factors such as smoking, the environment, and the use of emollient creams, which are a fire risk.

Staff developed evacuation plans and supported people to contact the fire and rescue service where risks were significant. In some cases, people obtained equipment such as fire blankets following advice, to reduce smoking-related risks. Agreements were also in place for people to stop smoking and ventilate areas before and during visits, minimising risks related to fire and exposure to passive smoking.

Senior staff completed initial visits to people to assess the environmental risks where pre-assessments were not possible. They uploaded assessments promptly to the electronic care system, making them immediately available to incoming staff. This ensured risks were identified without delaying people’s care.

The provider did not always make sure all staff received training and timely training updates relevant to their role.

People told us they felt confident staff were suitable trained in their role.

The registered manager had identified gaps with staff completing training updates within specified timescales. They were addressing this with individual staff and provided support to help staff complete outstanding training, including adapting approaches to suit different learning styles.

The provider had not always ensured staff received training in line with people’s specific needs. For example, 4 people had a diagnosis of epilepsy, however, epilepsy training was not in place or offered at the time of inspection. Whilst the immediate risk was low, as staff were not primarily responsible for managing this condition, it remained important staff had appropriate knowledge in case of changes or escalation of symptoms related to this condition. After the inspection, the registered manager confirmed that 21 staff, including all those supporting people with epilepsy, had completed this training

New staff undertook a structured induction, including policy review, shadowing, and performance checks. Ongoing support through supervision, team meetings, spot checks, and competency assessments ensured staff maintained the required skills and knowledge.

Recruitment processes followed legal requirements. The provider had an internal recruitment team responsible for ensuring all pre-employment checks were completed and standards were met.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading.

People said staff followed effective infection prevention and control practices. They reported that staff used appropriate personal protective equipment (PPE), such as gloves and aprons, when providing personal care.

Staff confirmed they had received infection control training and showed a good understanding of maintaining hygiene standards and reducing the risk of infection transmission. They said sufficient PPE was available and understood the procedures to follow in the event of an outbreak. The provider had contingency plans in place to maintain safe and consistent care during such events, helping to protect people.

The provider had systems to monitor infection control practices, including audits and trackers to record and review any concerns. An infection control policy was in place, developed in line with current best practice guidance.

The provider made sure that medicines were safe and met people’s needs, capacities and preferences.

People told us they were supported to take their medicines as prescribed.

The provider had effective systems to monitor and oversee medicines administration. These included real-time monitoring and alerts where medicines were not administered as planned. Staff demonstrated a good understanding of checking medicines against records and reporting any discrepancies. The registered manager with people’s consent accessed GP Connect, a national service that securely connects approved care systems to GP records, to support people’s care. This enabled them to verify current prescriptions, which helped reduce the risk of errors.

Risk assessments supported the safe use of medicines. For example, where people were prescribed anticoagulants, detailed assessments addressed any risks associated with bleeding. Staff were aware of these requirements. Staff had guidance about how to safely apply people’s transdermal pain relief patches. There were monitoring systems to oversee this care was carried out as planned. This helped to ensure safe and effective use.