Epicare

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 registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 63 (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. We found that incidents, accidents, and complaints were appropriately recorded and completed in full. These were reviewed to identify themes, trends, and appropriate actions were taken to support learning and prevent recurrence, thereby helping to keep people safe. Staff told us that safety events and the actions taken were shared appropriately to support learning.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. The service completed an initial needs assessment before people started using the service. Staff involved people and their relatives to develop the care plan. A family member told us, ''We are involved in [our family member’s] care planning.'' Care plans were shared with staff to guide the delivery of care and support.

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. Staff told us they knew how to raise concerns and had completed safeguarding training to recognise signs of abuse or neglect and to follow the appropriate procedures to keep people safe. People reported they felt safe around staff and had been aware of who to contact if they had any concerns about abuse or neglect. A relative commented, “Yes, I feel safe with the agency supporting [family member], and they have built a good rapport with them.”

The provider did not always work effectively with people to understand and manage risks. Overall, staff assessed risks to people’s safety and wellbeing to keep them safe. Risks were rated according to their likelihood, potential impact and categorised as low, medium and high. Staff recorded control measures and action plans to reduce identified risks

However, risk assessments had not been completed or were not sufficiently detailed in some areas, including diabetes, choking, community access, and the use of specialist equipment. This meant that staff did not always have the necessary information to provide safe care and support. We spoke with the registered manager, who told us they would update risk assessments where required to ensure people’s safety.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment supported the delivery of safe care. Staff had not ensured the regular servicing and maintenance of equipment. However, staff had completed appropriate environmental risk assessments to promote a safe environment for people using the service.

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. There were safe recruitment practices to make sure that all staff were suitably experienced, competent and able to carry out their role. The provider had completed appropriate employment checks, including Disclosure and Barring Service (DBS) checks. A DBS check provides information about a person’s criminal convictions and cautions and helps employers make safer recruitment decisions.

Staff reported feeling supported in their roles and confirmed they had completed an induction programme before working independently. This included regular supervision, annual appraisals, and spot checks to assess their knowledge and skills. Staff had received training that was appropriate and relevant to their roles. However, a need for additional training in learning disability and autism was identified to minimise gaps in staff knowledge and to ensure the delivery of consistent, person-centred support that meets individuals’ communication, sensory, and behavioural needs. The registered manager informed us that plans were in place for this training to be provided to all staff.

People using the service told us staff arrived at the planned call time and stay for the agreed visit length. They told us, ''The times of the visits have been agreed and the two regular staff I have are always punctual and stay for the agreed duration of the visits” and “The staff are punctual and stay for their allotted time, they are very helpful and responsive if times need to be changed.”
 

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. Staff told us they understood infection prevention and control and wore personal protective equipment, such as disposable gloves and aprons, to help prevent and control the spread of infection to people. People using the service confirmed staff wore gloves and aprons during visits. People using the service told us, ‘‘Yes, the carers always use PPE when assisting with my personal care.” and ‘‘I have seen the staff wear gloves, aprons and other PPE equipment.”

The service did not always make sure that medicines and treatments were safe and met people’s needs. Two people had medicines prescribed on an as required basis (pro re nata- PRN). However, individualised PRN protocols were not in place for those who required them. This meant staff lacked clear guidance on when to administer ‘when required’ (PRN) medicines and how to accurately record their administration. However, staff completed the medicines administration record (MAR) when administering prescribed medicines and had undertaken medicines administration training to ensure people received their medicines safely.