P and S Care 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 75 (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.

There were systems in place to investigate any incidents, including falls. Individual accident forms were completed with details about what happened and any immediate actions taken.The registered manager told us they viewed each incident as an opportunity to learn, improve, and strengthen their approach to safety and care delivery.

Following a recent incident where a person had fallen and been unable to open the front door to allow emergency services to enter, new protocols had been put in place to ensure appropriate access to the key safe to prevent future re-occurrence. The registered manager said this was then monitored through staff supervision and spot checks.

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.

We saw evidence of the service working with other organisations to ensure people were able to transition between services safely. For example, one person had been receiving care funded through direct payments managed by Social Services. Over time, the person’s health declined and a change in circumstances was reported to the social worker. In response, a reassessment was arranged through Continuing Healthcare (CHC) to determine whether the person now met the eligibility criteria for NHS-funded care.

Following a comprehensive assessment, CHC confirmed the person met the criteria for continuing healthcare funding, which meant that the responsibility for managing and funding the person’s care package transferred from Social Services to the NHS. During this transition, the service worked closely with both teams to ensure safe care delivery remained in place and that there were no interruptions to the person’s daily support.

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.

People who used the service and their relatives said the service was safe. One relative said, “(Person) is very safe with the staff, they know so much about them and what they need.” Another relative said, “(Person) is safe and I couldn’t ask for more.”

There was a safeguarding policy and procedure in place which was in date and provided an overview about what people could do if they experienced any abuse. A safeguarding log was maintained, with details about any incidents reported to the local authority for further review.

Staff had completed safeguarding training and understood how to report concerns. A member of staff said, “Safeguarding is about protecting people from harm, abuse and neglect. Poor moving and handling could be a safeguarding concern.”

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 who used the service had individual risk assessments in place relating to the care and support they received. Where any risks were identified, control measures were detailed about how these needed to be managed. For example, one person was at risk of choking, falls and skin breakdown. We saw risk assessments had been created for these areas.

People who used the service and relatives were involved with risks where possible and we saw the service were responsive when there were any changes to people’s circumstances. One person had become unsafe when outdoors and we saw staffing had been increased from 1:1 to 2:1 to enable them to still be able access the community safely and retain their independence.

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

CQC does not regulate the living environment with people’s own homes as the service is registered as a domiciliary care agency, however we saw the registered manager ensured appropriate systems in place to ensure people’s safety.

We saw environmental risk assessments were completed and took into account areas such as slips, trips and falls. Evacuation procedures were in place where people may struggle to evacuate safely in the event of an emergency. Where any equipment was used such as hoists, we saw these were regularly serviced to ensure they worked properly.

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.

Staffing rotas were in place and demonstrated how many staff were available to care for people. The feedback we received from people who used the service and relatives was that staffing levels were sufficient. One member of staff said, “Our rotas are well managed and they check our availability first to make sure it fits in around our personal circumstances.” A relative also said, “The staff are very organised and are often here early to make sure they are on time.”

Staff were recruited safely, with appropriate pre-employment checks carried out before staff started working with the service which included Disclosure and Barring Service (DBS) checks. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. Staff had opportunities to learn, and any poor performance was managed appropriately.

Staff told us they received enough training to support them in their role. Staff supervisions and appraisals took place where staff could discuss their work in a confidential way. A member of staff told us, “We have enough training and both practical on online courses are available.”

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.

Staff managed the risk of infection via the use of appropriate personal protective equipment (PPE) such as gloves and aprons, and frequent cleaning and hand washing. Staff had received training in infection prevention and control, to support their understanding of best practice. Staff said there was enough PPE available to carry out their role effectively.

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.

Medicines were managed safely. People received their medicines as prescribed and we saw medication administration records [MARs] were completed by staff. One relative said to us, “(Person) gets their medicines when they should and they keep accurate records of that.”

Staff told us they had received medication training, which they felt enabled them to administer medication safely. Audit processes were in place for medicine records. The management team audited people’s MARs on a regular basis and took follow up action with the staff involved where required. A medication policy and procedure was in place to provide guidance where needed.