All 4U Care

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 ratedgood.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.

Staff told us they felt supported and able to speak up, describing managers as “approachable and supportive” and that they "have regular check ins". Learning from audits was evident, including medication checks, monthly feedback, audits and staff file audits. If these identified issues, the provider took steps to address them. The registered manager explained that they were transitioning to a new electronic system after identifying areas within their current auditing processes that could be strengthened. They felt the new system would provide more robust and comprehensive auditing capabilities.

The provider discussed incidents in team meetings and staff were encouraged to request additional training where needed.

During our assessment, the registered manager told us that since being in post, they had identified that regular oversight of staff had not been consistent over the previous 12 months. They explained they were making improvements by embedding consistent supervision, appraisals and spot checks. We could see this work in progress.

The provider worked with people could see care 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.

At the time of our assessment the service was changing their electronic system. This meant they would be implementing health passports for people transitioning into different services.

There were detailed care and support plans in place for other services to understand people’s individual needs.

One relative told us,“[Relative] fell over and was found by the carer- there was an immediate response. Paramedic ,ambulance and hospital and all the while [relative] had a carer by [their] side to help with questions. This allowed me to travel to [relative] without extra stress knowing [relative] had someone with them who cares.”

We contacted local healthcare professionals during our assessment, and no concerns had been identified about the care of the people in the service. One professional told us, "So far, I have been very impressed with their service. Their communication is excellent. They always come back to me in a timely manner. They send competent staff to hand over to, and they always make contact quickly if they have any further concerns.” 

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 leaders had received training in safeguarding and understood their responsibilities in reporting safeguarding concerns to the appropriate agencies. A staff member told us, “I know who to contact about any safeguarding concerns and feel confident they would be dealt with. "Staff and leaders shared information with the safeguarding authority appropriately. They told us they knew how to recognise potential signs of abuse and how to report these internally and externally.

A partner agency told us they had no concerns regarding the safeguarding of people in the service.

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.

Risk assessments were appropriately completed and captured people’s strengths and independence. Staff encouraged safe mobility, supported decisions about personal care, and used clear communication strategies where people needed support to express their wishes.

People were involved in decisions about their safety and care planning wherever possible. Care plans showed person-centred practice, with clear descriptions of people’s preferences, routines and what mattered to them. Staff involved families appropriately, particularly where people had reduced capacity or communication needs.

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

Where falls have happened, people told us carers have taken time and effort to ensure that all mitigating factors had been addressed ,and ongoing conversations had included suggestions for extra monitoring.

Staff had undertaken health and safety training as well as fire training. Staff knew how to escalate concerns in relation to maintenance. The systems in place meant these were addressed in a timely way. Risk assessments were in place to evaluate the safety of the environment and ensure staff were safe whilst supporting people in their own homes. This included ensuring equipment was in good working order and reporting any concerns about equipment or the environment.

Risk assessments for people considered other risk factors such as fire but did not include emollient specific risk assessments, although emollient creams were being applied. We raised this to the registered manager within our feedback and the registered manager implemented these risk assessments and assured us this would continue moving forward.

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.

Recruitment practices were safe and robust. Staff files contained Disclosure and Barring Service [DBS] checks, verified references, interview notes, identity documents and training records. Any gaps in employment had been explored.

Staff received mandatory and specialist training, including medication, moving and handling, mental capacity, dementia, and safeguarding. Training compliance was good. Staff received supervision and said they felt valued by management.

We reviewed call data and this showed that call times were mostly on time and carers stayed their 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.

The provider had policies and procedures in place relating to infection prevention and control (IPC). Staff had received training on the prevention and control of infection. Spot checks were carried out to observe staff’s practice and no one told us of any infection control concerns.

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.

One person told us, “My carers give me my medicine, and it is entered on the app, and this happens the same time every day.”

There were systems and processes in place for the safe management and administration of people’s medicines. Records showed that staff received medication training. The provider had a medication policy in place and ongoing assessment of competencies for staff. Not everyone needed support with their medicines, but when they did, people received their medication from trained and competent staff and had this need risk assessed and detailed the level of support people required. The registered manager has implemented regular audits to ensure people received their medication in a safe way. The audits were reviewed to identify any trends or patterns where medications had been missed or not given to ensure lessons were learned within branch and as part of a wide organisation.

People told us where staff administered medicines it was given in a timely manner and always recorded on the app which is accessible to all relatives.