Dimensions Warrington Domiciliary Care Office

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 69 (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.

Incidents were reviewed by the registered managers and operations director to ensure all actions had been completed. The provider held quarterly manager meetings where lessons were shared regionally, including the review of all safeguarding concerns. Debriefs were carried out with staff following incidents to explore what had happened, review staff wellbeing, offer further support, and identify training needs and lessons learned.

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.

Family members confirmed planned transitions into the service were in place for their relatives, which included involvement from family members and professionals, promoting effective communication and collaboration. Transition periods supported continuity of care and helped people adjust emotionally and practically. One family member told us, “I met with some senior staff and was impressed. They gave me lots of information ready for my relative to move in. I also met some of the carers.”

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 received safeguarding training and could identify the signs of abuse and action to take.

Family members and people we spoke with told us they felt safe with the care and support they received.

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.

Risk assessments were in place to guide staff in areas such as healthcare conditions and when people were communicating a need, expressing feelings or an emotional reaction. Some people had positive behaviour support (PBS) plans in place. These plans were developed collaboratively with the person, their family and a specialist PBS team. They contained detailed information to help staff understand and reduce behaviours that challenge, focusing on the person’s needs and promoting positive outcomes. Staff were knowledgeable about people’s PBS plans and could provide examples of how they had been successfully used to de-escalate situations and mitigate risks and potential harm. Staff received specialist training, and physical intervention was only used as a last resort, in line with each person’s positive behaviour support plans.

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

The registered managers completed quarterly health and safety walkarounds of the environment which generated action plans. It was evident where actions had been completed and where appropriate escalation had been made.

Safety checks, including water temperature monitoring, and electrical equipment inspections, were in place. The provider had oversight of any actions needed, for example, gaps in the completion of fire drill evacuations. Where these gaps were identified, the registered managers had assigned tasks to ensure completion by relevant teams.

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.

Staff recruitment processes were in place with relevant checks of staff’s employment history, character, right to work, and checks with the disclosure and barring service (DBS). Staff received appropriate training to support the needs of the people they supported effectively. There were enough staff on duty to support people and enable them to access the community and activities they enjoyed.

Staff members told us there were enough staff and peoples relatives told us it was a consistent team.

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.

We observed people’s homes were clean, tidy and well maintained. Staff had access to adequate supplies of personal protective equipment (PPE) and understood when and how it should be used. However, some family members felt the cleanliness of some of the homes where their relatives lived could be improved. This feedback was shared with the registered managers, who were already aware of some of the concerns. There was evidence the issue had been discussed in team meetings.

The provider did not always make sure medicines and treatments were safe and met

people’s needs, capacities and preferences.

We found guidance for people prescribed “when required” medication did not include enough person-centred information. For example, they lacked details about the signs to look out for if someone was in pain or clear instructions on the correct amount of medication to administer. This lack of guidance could lead to inconsistent or unsafe administration of medicines, increasing the risk of people not receiving effective relief.