Favour Health Ltd - Cornwall

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.

All accidents or incidents were documented and fully investigated by the registered manager to identify any areas of learning or improvement. Any learning was shared promptly with the staff team to reduce the risk of similar events reoccurring.

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.

Information about people’s specific needs and preferences was available to be shared with healthcare colleagues in the event a hospital admission became necessary. This information was provided to help ensure people’s specific needs were recognised and understood by all.

Necessary processes to ensure people’s rights and freedoms were protected had not always been effective. However, 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 director and registered manager had agreed with involved professionals that people’s freedoms were restricted, and their care plans required authorisation by the Court of Protection. However, assessments of people’s capacity to make specific decisions had not been completed and decisions had not been documented to demonstrate they had been made in people’s best interests. Following feedback, the registered manager completed necessary capacity assessments and best interest decision making records. Professionals recognised that any restrictions to people’s freedoms were necessary and, in each person’s best interest.

Staff understood their role in protecting people from abuse and discrimination. They knew how to report any safety concern outside the organisation should this be necessary. Staff told us, “[Person’s name] is very safe. They always tell us how happy they are” and “[People] are safe, we are even planning with the social worker to find a new place for the person”.

The service had systems to support people with the management of their money and ensure they were protected from risks of financial abuse.

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.

Risks in relation to people’s care and support needs had been identified and effectively mitigated. Care plans included guidance for staff on the action they should take to protect people from harm and how to support people if they became upset or anxious. Staff knew people well and had built trusting and supportive relationships with them. Staff told us, “No restraint, we do not restrain people”, “It has been a while since we have had an incident. We have not had any this year” and “We just talk to [Person’s name] to help them calm”.

Professionals recognised the service was able to support people with positive risk taking to help people gain new skills and develop their independence. Professionals told us, “I feel that risks are managed quite well and staff being well trained and proactively supporting with positive activities and strategies has enabled good risk management” and “They have raised potential risk concerns appropriately and supported positive risk taking alongside ensuring a robust risk management plan is in place”.

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

Staff supported people to manage risks in their own homes. During the assessment process a mobility aid was installed in one person’s bathroom. Additional works were being planned to further improve this area while minimising disruption to the person’s routines.

The provider made sure there were enough experienced staff to meet people needs. However, the training provided was not entirely effective and staff had not received planned levels of supervision and support.

Records showed staff had completed online training in accordance with the service’s policies and that this training had been refreshed. However, training records showed staff had completed multiple training courses in a single day raising concerns about their effectiveness. For example, a staff member was recorded as having completed training on topics including; safeguarding children, First aid essential, Health and Safety, Fire safety, Infection prevention and control and ADHD awareness in a single day. We discussed these practices with the provider’s director and the service’s registered manager, who told us plans were being developed to provide additional face to face training to ensure staff had the skills necessary to meet people’s needs.

Staff had received some informal group supervisions during team meetings and told us they felt well supported. However planned levels of individual supervision, vital for encouraging staff development, had not been provided. This meant opportunities for staff to raise issues individually with their managers had been missed.

People told us, “There are always 2 staff”, and rotas showed planned levels of staff support had been consistently provided. Staff confirmed this and said, “There is always enough staff”, “We are not short staffed” and “If staff cannot come in, someone comes to cover. [Person’s name] always [has 2 staff]”.

Staff had been safely recruited and necessary checks completed to ensure staff were suitable for employment in the care sector. New staff completed shadow shifts, to give them time to get to know each person, before providing care. One recently recruited staff member told us, “I did shadow shifts for 1 week when I started”.

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 were able to access Personal Protective Equipment (PPE) when required and understood how to support people to manage infection control risks. People were supported to keep their homes clean and tidy.

Where risk in relation to self-neglect had been identified care plans included guidance for staff on how to offer support and respond when people refused planned care. Staff told us one person who had previously been at significant risk of self-neglect now required minimal support with personal care.

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.

Staff understood how to support people safely with their medicines. Medicine administration records had been accurately completed and demonstrated people received their medicines as prescribed. Where people refused prescribed medicine, after attempting encouragement, staff respected the person’s choice and ensured the unused medicine was disposed of properly. Where people repeatedly refused medicines this information was shared with the prescriber and alternate options explored.