Care First 24 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 81 (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.

The provider had a system in place to ensure that all incidents and accidents were reported and logged. Events were reviewed by leaders to look for opportunities for learning. When areas were identified these were shared with staff. For example, if a medicine administration error occurred, staff supported to re-train and their competency assessed to ensure they were safe to administer medicines.

The provider had a continuous improvement plan which was reviewed and updated frequently. Any learning from events in the service or in the sector was added and shared with staff.

The provider always worked with people and healthcare partners to design, establish and maintain safe systems of care, in which safety was always well managed and monitored. They made sure there was always continuity of care, including when people moved between different services.

People had received exceptional support to transition into the service. One person had experienced poor care until they transitioned into being supported by Care First 24. Staff worked with them to ensure a well planned transition took place involving the person and their loved ones with the process. Once they had transitioned into the service, staff worked with them to reduce the staffing ratio through positive behaviour support and consistent approaches. The person now takes part in meaningful activities relevant to their age, with incidents of distress significantly reduced which has increased their quality of life. We received positive feedback from stakeholders relating to the provider supporting people to transition to their service. A healthcare professional told us, “He was successfully transitioned to his new accommodation. The staff ratio was reduced, the provider worked closely with the persons loved one and they ensured that meaningful activities were put in place and incidents of distress and challenging behaviour was reduced.” A relative told us, “They transitioned really well; staff came every Saturday to get to know him.”

Another healthcare professional told us about a person supported by the provider, “Care First 24 handled themselves extremely well [during the transition], made several visits to the home. It was important to [the person and their loved ones] to keep the same team and Care First 24 made this possible, trained all the staff and bought them onto their contracts and under their governance.” A relative told us, “The transfer went very smoothly, most of the staff team have been with us for some time.

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.

discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

There were robust systems in place to ensure that all incidents of potential abuse were recorded, reported and lessons learnt from them. Staff we spoke with understood their responsibilities in relation to safeguarding and told us they were confident in reporting concerns. A healthcare professional told us, “The service is safe and they work in line with the policies of the local Safeguarding Adults Board. They raised concerns in a timely way and ensure both service users and staff are safe.”

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.

People had positive behaviour support plans (PBS) to inform staff how to support people in times of distress. PBS is a way of supporting people and involves understanding the reasons behind the behaviour such as their life history, physical health and emotional need. People had been successfully supported to reduce the distress they experienced, through consistent knowledgeable staff. A relative told us, “Staff are very friendly, they know when to step back if he’s feeling anxious, they don’t talk over him.”

People were supported to take positive risks. For example, staff identified a specialist boat which could support a person in an adapted wheelchair to access the water safely. Another person was supported to go to London to a skateboarding experience. A relative told us, “I just know my son is safe when they take him out. I go to work and don’t have to worry. They’re just amazing.

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

Systems were in place to ensure where people used equipment, this was logged on the providers electronic care system. Staff were therefore aware of the equipment people needed and used. When issues with equipment arose, staff went above expectations to support people. For example, when one person’s essential equipment broke and the spare equipment did not work, staff worked tirelessly beyond their working day to source replacement equipment. People held their own tenancies, but staff supported them to ensure their home’s remained safe and in a good state of repair.

The provider made sure there were always enough qualified, skilled and experienced staff, who received thorough support, supervision and strong development opportunities. They worked together well to provide safe care that met people’s individual needs.

People and relatives gave us exceptionally positive feedback about staff. Relatives told us, “We are very happy with the care team, some nurses we have had since the very beginning, we have built really good relationships with them, we are confident in their care.” And, “I would recommend them to anyone because I know they are competent. I know he is safe when he is with them.”

Before any care package started, staff assessed the needs of people and then worked to implement a staff team to meet their needs. This sometimes included specialist staff who completed training with external organisations including hospitals and hospices. This helped to ensure people were supported by staff who had exceptional levels of skill and knowledge to provide safe and highly effective care. A healthcare professional told us, “From my experience they do not put staff into packages where they cannot support them. If staff need more support then they get theory and practical training and then shadow shifts and a competency checks. They will make sure staff are competent.” Relatives told us they felt staff had the skills to support their loved ones safely.

Each staff member had a ‘training needs assessment’ which continuously evolved. This included mandatory training for the organisation and then individual training that staff had either identified they wanted to attend, or when a training need had been identified through supervision or observations.

The provider had launched a programme to support staff to become nurses. This programme was successful with two staff having completed it and now working as nurses. A healthcare professional told us, “To see how they develop and support nurses is amazing. That’s then reflected in the care that is delivered.”

Staff shared within their appraisals that they felt very supported. Staff commented in the wellbeing survey, “I am sufficiently supported so there is nothing to improve at the moment.” A healthcare professional told us, “It’s a pleasure to work with them. The staff are lovely. They go above and beyond nothing is too much for them.”

Staff were recruited following safe recruitment processes. Each staff member had references to demonstrate their practice in previous placements, and all staff members had a disclosure and barring service (DBS) check completed before they worked with people. A DBS check helps providers make decisions about the suitability of staff.

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.

Care plans and risk assessments provided staff with clear detailed guidance of how to reduce the risks of the spread of infection when supporting people. Relatives told us that the provider ensured there was enough personal protective equipment (PPE). Relatives also told us that their loved one’s personal care was always completed to a good standard. A relative said, “He is treated very well with his cleanliness.”

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 provider ensured that medicines management was safe and effective. The provider worked with people and their loved ones to ensure that people were as involved in their medicines as they could be and listened to people to ensure they were heard. Some packages the provider supported included supporting children, where parents wanted to be involved in medication management. The provider worked with families to ensure this was done as safely as possible, completing daily checks on medicines to ensure that if someone other than staff administered the medicine this was still documented to ensure the parent was involved. A relative told us, “I always do a stock check when I finish work, everything is always perfect, there’s never any missing.”

Some people were prescribed medicines on an ‘as and when’ or PRN basis. Where this was the case staff ensured it was in line with the providers protocols. One person had been regularly administered PRN medicines to reduce their distress. However, staff worked with the person to reduce their distress, and the person had not needed the medicine administered in over a year which improved the quality of their life.