Chasfab Options 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 service. This key question has been rated requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk of avoidable harm to people.

The service was in breach of legal regulation in relation to people’s safe care and treatment, the way people’s medicines were managed, staffing, fit and proper persons employed.

This service scored 53 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provided did not always have a proactive and positive culture of safety. Lessons were not documented to be learned to continually identify and embed good practice. People’s relatives and staff said they had no concerns with raising issues and they felt listed to by their management team. However, we found the provider’s accident and incident policy was not specific to delivering care to people. The policy stated that all staff were to undertake training in accident and incident reporting procedures, at the time of the assessment, staff had not received this training. This left people at risk of being cared for by staff who were not fully competent in recognising and reporting accidents and incidents should the need arise.

The provider 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. For example, for people with epilepsy, there was no epilepsy passport containing information on how to manage seizures, when to administer medicines, or steps to take if a seizure did not follow its usual pattern. This left people at risk of harm due to information not being available how to support them safely.

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. Healthcare professionals told us they had a good working relationship with the registered manager and all staff, which was effective in supporting people with their care needs[KR1][PL2]. The provider showed us information to support staff had received training in safeguarding children, and they had a safeguarding children policy in place.

The provider did not always work well with people to understand and manage risks.

We saw care plans where people required fluid intake to be monitored, however there was no recording of fluid intake or output or an accompanying risk assessment. We saw another care plan which had conflicting information in relation to how care was to be delivered. In 1 section it mentioned a person’s relative completed all of the medication administration, however, the same care plan goes on to state all staff needed to be trained to deliver medication to this person. It was not clarified who was responsible for ensuring the person received their medicines during care visits. Some care plans lacked information on how to manage people’s care safely. There were no specific medical risk assessments for people who required support with epilepsy, moving and handling, support with skin integrity or additional support with managing emotional behaviours. For example, we saw a plan which stated the person needed to be supported when emotionally distressed to prevent self-harm and attempts to lash out. However, there was no accompanying behaviour risk assessment, and no information on what might trigger an episode of emotional distress, or what staff should do to manage this. This left people at risk of prolonged emotional distress due to staff not having information on how to manage this effectively.

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 manager visited people prior to providing support. Together with people and their relatives and staff they created a home risk assessment to ensure care was delivered in an appropriate and safe environment for people and for staff.

The provider had enough staff to support people with their care needs. Staff had received training to support people with complex care needs such as gastronomical feed and epilepsy care. People told us they were happy with staff and how they cared for their relatives. However, we found issues with the provider’s recruitment process. Staff had provided conflicting identification information to the service prior to being employed. Some staff files had incomplete, or contained no information about staff work history, and one file had no up-to-date right to work in the UK confirmation. This left people at risk of being supported by unsuitable staff putting people at risk of avoidable harm.

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. The registered manager told us, " We have no issues with personal protective equipment, (PPE) I ensure we are overstocked." Staff also told us they had access to PPE and people’s relatives told us that staff always wore PPE, and people were supported to maintain good personal hygiene.

The providers medicines policy showed an awareness of STOMP, giving assurance that people, especially those with learning disabilities would not be overmedicated. We saw 1 person who had a medicines administration record in place, to document medicines they were being supported with from staff. However, we saw another person who was being supported with eye drops and topical creams by staff daily had no medicines administration record in place to state the name of medications being administered, how many eye drops were being administered to each eye, or amount of this medication left. For the topical cream, there was no body map to show areas cream had been used on. There was also no fire risk assessment in place specifically in relation to topical cream usage. The lack of documentation left people at an increased risk of medicines errors and the risk of avoidable harm.