Great Grace Services Ltd

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 66 (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 positive culture of safety and learning. Staff were encouraged to raise concerns and understood the importance of reporting incidents. Systems were in place to investigate accidents and complaints, and lessons learned were shared to prevent recurrence. Staff confirmed they received feedback after incidents and safeguarding concerns, including updates on changes made to reduce future risks. Continuous improvement was evident through prompt actions taken during the assessment to address identified gaps. Staff confirmed they received regular feedback and guidance, supporting continuous improvement.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. Processes supported safe and coordinated care when people moved between services. Initial assessments considered health needs and risks, and staff worked with families and professionals to maintain continuity. People and relatives confirmed involvement in care planning and felt confident the service could adapt to changing needs. One family described how the provider supported a person returning home after a nursing home placement, ensuring appropriate support was in place. Assessments considered health needs and risks, and staff worked with families to plan care. One relative said, “We were both involved in the creation of the care plan”. This collaborative approach helped maintain safety during changes in peoples care needs.

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 understood safeguarding and their responsibilities. They received training and could identify signs of abuse, such as unexplained injuries or changes in behaviour. Staff felt confident raising concerns and described clear reporting routes. There were no recent safeguarding incidents, but staff explained they would receive feedback and guidance if one occurred. Care plans reflected capacity assessments and best-interest decisions where needed. Relatives expressed confidence in safety. A relative said, “[Named person] is happy with the carers and we cannot fault them… they feel very safe in their care.”

The service usually worked well with people to understand and manage risks. Care plans guided staff on how to ensure people were as involved as possible to manage their own risks. The service had a falls policy in place to guide staff on what to do in the event of an emergency. We identified some areas of risk management were not as detailed as others. For example, risk assessments had not considered potential increased risks associated with falls for one person who was prescribed anticoagulant medicines. The registered manager acted on our feedback and reviewed the care plans and provided staff with further guidance during our assessment. The lack of detail within risk assessments was mitigated as care staff understood the actions they should take to manage these risks. Incident logs included immediate actions and lessons learned, and staff described proactive measures like hydration monitoring and safe mobility support.

The provider detected and controlled potential risks in the care environment. They ensured equipment, facilities and technology supported the delivery of safe care. The provider ensured they assessed potential risks associated with staff visiting people's homes, for example potential access issues. Home assessments were completed and included guidance on keeping spaces clutter-free and hazard-free. Staff confirmed they maintained cleanliness and infection control during visits. Families reported that carers ensured homes were tidy and safe, promoting comfort and wellbeing.

There were enough qualified, skilled and experienced staff who received effective support, supervision and development. However, we identified not all pre-employment checks had been fully completed prior to staff commencing work. The provider took action to further strengthen the recruitment check processes and told us, “We are implementing improvements to ensure full compliance with recruitment and documentation standards. To strengthen our processes, we have now implemented a revised interview record template that includes structured decision-making notes, scoring, and suitability assessment against job criteria.”

Staff received induction, mandatory training, and regular supervision. They felt supported and able to raise concerns. Relatives told us staff arrived on time and supported people in line with their agreed packages of support. One relative told us, “My [loved one] is happy with the carers who arrive on time and stay the full duration.”

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. Infection control measures were robust. Staff had training in infection prevention and food hygiene, and PPE was consistently used. Families confirmed carers wore PPE during visits. One relative said, “They always wear PPE.”

Medicines generally managed safely. 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. The registered manager/ undertook audits to ensure staff administered medicines in line with national guidance and the prescriber’s instructions. However, some improvements to documentation were needed for “as required” (PRN medicines), such as constipation management to include when to escalate potential concerns to a health professional. These were addressed promptly during the assessment. Staff had training in medication administration and followed best-interest principles where peoples’ capacity was limited.