Believe Care and Support 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 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 were appropriately trained in a range of health and safety related subjects and told us they knew it was their duty to report safety events and knew how to report concerns. Safety events were investigated by the management team in a timely manner, and lessons learnt were shared with staff and relatives when appropriate. Lessons learnt from safety events had been embedded across the service.
 

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 being supported by the provider had their own dedicated teams of staff, providing good continuity of care. Prior to one package of care being accepted by the provider, they agreed to ‘take on’ people’s existing care staff by way of engaging with the Transfer of Undertakings (Protection of Employment) Regulations, (TUPE). TUPE is a UK employment law that protects employees’ rights when the business or service that they work for changes hands. This enabled people to remain being supported by staff who knew them well and had detailed insight into their support needs.

The provider worked closely with appropriate relatives, health and social care professionals and other professionals to ensure people experienced a seamless transition between services. The provider told us how they had worked in collaboration with occupational therapists, an architect and relatives to have input into the design and layout of one person’s home prior to them moving in. This ensured it would meet the person needs and allow the person to be safely supported in the least restrictive manner, promoting the person’s right to privacy and maintaining their dignity.

People had hospital passports in place, and these contained detailed, up to date information about people’s communication, mobility, health, medication, dietary needs, sensory needs, religious/spiritual beliefs, positive behavioural support strategies and their likes and dislikes.
 

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 had received training in safeguarding and were able to explain different types of abuse, and what these may look like for people. Staff told us they knew how to raise a concern and the relevant people and organisations that concerns could be raised to. There was a designated safeguarding champion for the service.

The provider kept a safeguarding log and was able to demonstrate that concerns were recorded appropriately and raised promptly. Lessons were learnt from safeguarding incidents to improve people’s safety, such as the use of personal safety alarms which enabled emergency services to be notified quickly of people’s exact locations following an incident which occurred in the community.
 

The provider worked with people to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

We received some mixed feedback from staff and relatives in relation to how the provider managed risk. However, the provider demonstrated that they focused on the identification, prevention or reduction of risk, rather than retrospectively reacting to risk. Risks were considered holistically and risk assessments were personalised, detailed and regularly reviewed. The provider supported people to continue their hobbies. For instance, two people enjoyed fell walking, one person had been supported to overcome their fear of water and had gone swimming, another person was receiving support to enable them to achieve their goal of weight loss, with their longer-term plan being to return to competitive horse riding following a significant injury.

During a visit to two people’s home, we observed staff responding quickly, skilfully and confidently in response to a change in one person’s behaviour by using the agreed strategies identified in the person’s positive behavioural support plan. This meant that the person was supported effectively and their unease was quickly reduced.
 

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

Staff received training in food safety, health and safety, infection prevention and control and the safe storage and understanding of the control of substances hazardous to health (CoSHH). Staff and people had also taken part in practice fire evacuation drills, and people had their own personal evacuation plans in place.

The provider operated systems of oversight and governance which regularly assessed and monitored the risk within people’s home environments and took the appropriate remedial actions to resolve or reduce risk when identified. As part of our inspection process, we visited people in their own homes and noted additional measures being taken to keep people and their homes cool during a period of hot weather. Blinds were drawn, fans were on, and chilled fluids and iced lollies were readily available to help the person stay cool. The service had nominated ‘champions’ in environment, infection prevention and control, and health and safety.
 

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 and their relatives were involved in decisions about the staff who provided care. The provider arranged ‘meet and greet’ visits so that people and their relatives could meet prospective staff, spend time with them, and assess their suitability. People had dedicated staff teams, and this meant that people received good continuity of care, although it was noted that one person had recently experienced some staff changes (due to staff leaving the service), which resulted in the person feeling unsettled.

Recruitment systems and processes ensured that staff were recruited safely. References were requested that covered employees previous 10 year employment history, and all former employment within health and social care roles. If people had not been employed in health and social care roles, the provider sought extensive character references as an alternative. Staff received a thorough, well documented induction process and feedback was sought from staff at the end of this process to ascertain if staff needed additional support before being ‘signed off’. Staff completed mandatory, health condition specific, and sector specific training to enable them to best support people. Staff had the right competencies to carry out their roles effectively and received regular spot checks, supervision and appraisals.
 

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 had received training in infection prevention and control (IPC), and there was a designated IPC champion at the service. Staff had access to personal protective equipment and knew how to use and dispose of this appropriately. When appropriate people were supported by staff to maintain their personal hygiene and live in a clean home environment.

Food was managed and stored safely, and advice was available around food safety.

The provider carried out regular audits in relation to IPC, and this information was used to identify levels of compliance, any themes of around concerns, recognise good practice and drive improvement.
 

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.

People’s medicines were stored safely, and staff had received training around specific health condition medications and their safe use. The management team and staff at the service showed good understanding of the principles of Stopping the over medication of people with a learning disability and autistic people (STOMP). There was a medication policy in place, and this was reflective of current guidance and best practice. People had pro re nata (PRN) medication protocols in place, and these were reviewed regularly for effectiveness. PRN medications are medications that are only given when needed, not as standard.