Shelagh Care Services Limited

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 service had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported incidents. The registered manager identified lessons learnt following accidents, incidents and complaints and care plans and risk assessments were updated accordingly, to ensure staff had up to date guidance to prevent similar incidents from happening again.

Management shared learning with staff following incidents, accidents, complaints and safeguarding so that the service could continually improve and develop positive outcomes for people. Information was shared with staff through supervisions and meetings.

The service did not always work well with people and healthcare partners to establish and maintain safe systems of care. They did not always manage or monitor people’s safety. They did not always make sure there was continuity of care, including when people moved between different services.

The registered manager told us, “When we get a care package, we don’t always get an opportunity to complete a formal assessment because the care packages are often required to start immediately. I visit the person we are supporting, and we discuss the needs. I then put together the care plan based on the information that has been has shared with me.”

Although the registered manager told us an initial assessment was completed for people using the service, we did not see evidence of a formal written initial assessment during the inspection. As a result, we could not be assured staff always had access to clear, documented information about people’s needs, risks and preferences to support the delivery of safe, person-centred care from the outset.

However, a relative told us, “We had an assessment carried out before the package started and the manager got to know my [relative].”

The service 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 service shared concerns quickly and appropriately.

The registered manager had raised safeguarding concerns appropriately and had worked with the local authority to investigate these to ensure people were being safeguarded.  Staff understood how to recognise the signs of abuse and could describe the actions they would take to safeguard people including informing other agencies if they were concerned about action being taken. A staff member told us, “I would report to my manager, and I would escalate to local authority if I needed to.”

The service 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 to people had been assessed and risk assessments had been put in place to help mitigate these. Risks included areas such as supporting people with physical healthcare needs, use of mobility equipment and with personal care. Staff knew the risks to people well and told us they were kept up to date if there had been any changes to risk assessments. Staff told us they always read the care plan, read the daily notes and had regular discussions with the registered manager to see if there had been any changes to the care package.

People received personal care and support in their own homes. The service detected and controlled potential risks in the environment. They made sure equipment, facilities and technology supported the delivery of safe care. The registered manager told us, ''We involve families and health professionals when formulating and reviewing the care plans and work closely with them on a regular basis.'' Risk assessments had been completed to provide staff with guidance on how to keep people safe and minimise risks. For example, there was a risk assessment in place describing risks to people's home environment.

The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. Staff worked together well to provide safe care that met people’s individual needs. The registered manager had processes in place to ensure all staff received an extensive induction and staff we spoke to confirmed this. Appropriate checks were in place before staff started work including providing full work histories, references and a Disclosure and Barring Service (DBS) check. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. The registered manager completed staff file audits which ensured that all employee records were regularly reviewed, up to date and contained all the necessary information. All staff files had been checked, and gaps in information identified had been addressed.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Staff had undertaken infection prevention and control training and were provided with personal protective equipment (PPE) which could be collected from the office. A member of staff told us, “I wear PPE when required, such as gloves and aprons during personal care and masks if needed.” A relative told us, “All staff wear PPE, and I feel very safe when they are here.”

The service did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. We found protocols missing in some records for medicines prescribed as required (PRN). Protocols are important as they help staff understand when it is appropriate to offer PRN medicines. Although improvements were needed in this area, we did not identify any evidence of harm to people as a result of the missing protocols.

Following the inspection, the registered manager updated the PRN protocols.

Staff had received training in managing medicines and had their competency checked. A member of staff told us, “I had my medicines training, and my manager carried out observations and checked my competency.” Staff we spoke to were knowledgeable about the people in the service and their medicines needs.