AQS Hampshire East

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.

At our last assessment we rated this key question good.At this assessment the rating has remained 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. The provider had processes in place for staff to report incidents and near misses. This included reviewing and learning from incidents and adjusting people’s care accordingly to keep them safe. Staff confirmed they would report any concerns to the office straight away.

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. The provider supported people to transition into the service including from hospital and kept in contact with health professionals to support people safely back to their home.

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 and the manager knew how to recognise the signs and what to do if they suspected someone was at risk of abuse or neglect. The provider had effective policies and procedures in place to promote people’s safety. This included procedures around handling people’s money and ensuring their safety was accounted for if they were not contactable at the time of planned care call times. This helped to promote their safety and security. One person told us, “With the care worker I feel safe and comfortable.” A relative said, “I have no safety concerns. I’m listened to if I raise a concern.”

Although the provider aimed to work with people to understand and manage risks, these were not always clearly documented. The provider considered risk to people as part of their assessment, which included personal care, moving and handling and health conditions. However, how staff were to support people to reduce the risk of harm was not always comprehensively documented in people’s care plans to ensure staff would always know how to support people. For example, in relation to the risk associated with eating and drinking, bedrails and skin health. Some mitigation was evident. Feedback from people using the service indicated they felt safe and supported, and that staff understood their individual needs and risks. Staff demonstrated a good understanding of how to support people safely, and feedback from staff suggested they knew people well and could describe how they managed risks in practice. The staff team was stable and consistent, which helped reduce the risk posed by gaps in documentation. The provider told us they have taken immediate action to address these shortfalls.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.The provider carried out assessments of people’s home environments to identify and reduce any risks related to the delivery of care. However, these were not always robust or in line with the provider’s fire safety policy and procedure. For example, Personal Emergency Evacuation Plan (PEEP) were not in place to describe the support people required in the event of a fire for 1 person who had an air mattress in place there was no risk assessment in place to support the risk of fire as outlined within the policy. They told us people’s Personal Emergency Evacuation Plans (PEEP) were in their homes, which described the support people required in the event of a fire. However, copies of these records were not available for us to review.Where people had manual equipment in place to support them, including hoists, there was no information as to when these were last inspected and due an update to ensure these were safe to use under health and safety legislation. The manager told us environmental risk assessments were incorporated in people’s care plans, however we were not provided with these records. They also told us if any concerns with the risk of fire in people’s homes were identified a referral to the local fire service would be made to carry out safety checks.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. People told us they received consistent staff at the agreed times and staff were trained and competent in their role. Comments included, “They arrive on time”, “If she is going to be late, she lets us know”, “Sometimes they’re short staffed due to sickness. They stay for the time they should and quite often over run.”

Staff received training relevant to their role and systems were in place to promote their ongoing learning and development, including supervision and checks of their competency. Staff were recruited safely. While supervisions had fallen behind last year an improvement was seen this year and staff felt supported.

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. People raised no concerns in relation to infection control. They told us staff wore appropriate personal protective equipment (PPE) whilst they were providing care. The provider had effective infection control policies and procedures in place. The service carried out spot checks on staff to ensure they were following correct infection control procedures and wearing PPE safely.

Although the provider aimed to work with people to understand and manage their medicines, these were not clearly documented. Records did not show people’s medicines and treatments were safe and met people’s needs, capacities and preferences. The provider had policies and procedures in line with national guidance, to help ensure staff were following best practice when administering people’s medicine. However, records did not show good practice were followed when supporting people with their medicine which increased the risk of medicine errors occurring. For example, for people prescribed as required medicines (PRN) records did not include the reason for giving the medicine, what the medicine was for and how it needed to be administered. Medicine risk assessments were not in place including for people who managed their own medicines. People’s medicine administration records had gaps and we could therefore not be assured people received their medicines safely as prescribed. Body maps were not available to direct staff on where to apply creams. For people who were prescribed flammable creams risk assessments were not in place to ensure safe use. Staff had a good understanding of best practice in medicines administration.

The manager informed us they carry out compliance checks in people’s homes to ensure paperwork was still in place for example body maps for staff to apply creams to ensure these were being applied to the correct part of the body. However, we did not see any evidence of these records in the office to ensure people were receiving their creams and medicines safely.