Elmbridge

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 of the service. We have rated this key question 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 promoted a learning culture where staff shared their experiences to help improve care for people using the service. Staff recorded any accidents or incidents, and these were reviewed by the management team to identify any themes or action which could be taken to reduce the likelihood of recurrence. Staff confirmed they were encouraged to contribute their views about how people’s support could be adapted to reduce the risk of further incidents.

Any areas identified for learning and improvement were discussed at team meetings. The registered manager had created a ‘No blame’ culture in which staff were encouraged to report errors so these could be corrected, learned from and any necessary action taken to resolve the issue. For example, following a medicines error, the registered manager had reiterated to staff the importance of reporting errors, stating, ‘This is to ensure safeguards are put in place, ensuring immediate medical review is sought if necessary, and to give people the opportunity to learn from the error.’ The registered manager had also stressed the importance of staff feeling able to speak up when mistakes were made, stating, ‘No carer should feel they are less if a carer because an error has occurred, and staff should not be made to feel guilty if an error has been reported.’

Safety and consistency of care was a priority throughout people’s care journey. The provider’s referral and assessment procedures ensured people’s needs were identified and recorded effectively.

The provider worked with people and partners to establish and maintain safe systems of care. They made sure there was continuity of care, including when people moved between different services.

When people returned home from hospital, the service provided a 30-minute daily wellbeing visit for a week to support their recuperation. The provider told us longer visits could be arranged and this period extended at people’s request.

Staff worked with people to understand what being safe meant to them and the best way to achieve that. The management team understood their responsibility to notify and work with relevant statutory agencies should safeguarding events occur.

Staff attended safeguarding training in their induction and had access to regular refresher training. Staff knew how to recognise potential abuse and how to report any concerns they had, including escalating these if necessary. One member of staff told us, “If the person is in imminent danger, I would call 999 immediately then inform my manager. If the person is not in immediate danger I would report to my manager. I would document everything I have witnessed or have been told. If I suspect my manager is involved or is not taking it seriously, I will contact [nominated individual]. If they were not available, I would contact [local authority].”

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 told us they felt safe when staff supported them. Relatives were confident staff had the skills to support their family members safely. One relative said, “I feel reassured by the service we have got from them.”

Assessments had been carried out to identify any risks involved in people’s care and measures put in place to mitigate these. People’s support plans included guidance for staff about how to mitigate risks, and staff understood how to manage risks while promoting choice and quality of life.

The provider detected and controlled potential risks in the care environment. They made sure equipment and facilities supported the delivery of safe care. Staff had received training on the use of any equipment involved in people’s care and knew how to use this safely.

Relatives told us staff supported people to maintain their safety when supporting them at home. One relative said, “[Family member] has had a lot of falls since we moved here so he needs supervision when he tries to move to from A to B. They are very good and do what I would do in terms of keeping an eye on him.”

The provider made sure there were enough qualified, skilled and experienced staff, who received effective induction, training and development. They worked together well to provide safe care that met people’s needs.

Staff were always available when people needed them. People who used the service had pendant alarms which they could use to alert staff in the event of an emergency. Staff were on site at the Village 24-hours a day and available to respond should people operate their alarms. Relatives told us they were reassured by the availability of an on-call team should their family members need unplanned support. One relative said, “It is nice to know there is always someone available on call.”

People receiving care and their relatives were confident staff had the skills they needed to provide effective care. One relative said of staff, “They are very professional. They have obviously had quite a bit of training. I have never felt they are not giving good care.”

Staff completed an induction when they started work and ongoing training to ensure they had the skills to provide safe care, including training on the use of any equipment involved in people’s care. Staff told us the registered manager had supported them to achieve competence and to feel confident in the skills they learned. One member of staff said, “This [element of training] was new to me and although I found it challenging my manager was always there either in person or at the end of the phone. It gave me confidence knowing that I was not alone, that I could always call her anytime, day or night.”

Staff were recruited safely. The provider carried out pre-employment checks including obtaining a Disclosure and Barring Service certificate. Disclosure and Barring Service checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

Staff assessed and managed the risk of infection. They controlled the risk of it spreading and understood their responsibility to share concerns with appropriate agencies if necessary.

Staff attended training in infection prevention and control (IPC) and had access to personal protective equipment when they needed it. The provider had an IPC policy which set out expected working practices and roles and responsibilities relating to IPC. The registered manager was the designated IPC lead for the service and held responsibility for oversight of IPC risk assessment and staff training.

Staff made sure people’s medicines were managed safely and reviewed regularly. People received support with their medicines in line with their individual needs. The support staff provided ranged from collecting prescriptions and prompting to the administration and recording of medicines where people were not able to manage this themselves.

Relatives told us staff supported their family members to take their medicines safely. One relative said, “They are very good at organising [family member’s] medicines, that all runs very smoothly, and they seem to have good connections with the pharmacist.”

Staff received training in medicines management, and their competency was regularly assessed. Staff told us this helped ensure they had the knowledge and skills they needed to manage this aspect of people’s care safely. One member of staff said, “I have done medication training and refresher courses every year. The company does medication competency checks as well as spot checks and I have always done OK; this gives me confidence that I am doing it safely.”

The registered manager carried out regular medicines audits as part of the provider's quality monitoring processes. Where errors had been identified through audits, these had been discussed at team meetings to ensure the mistake was not repeated.