Jigsaw Homecare 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. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 72 (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. The management team listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. The provider ensured people and staff did not experience a closed culture by offering differing points of contact for feedback as well as different methods of giving feedback including anonymously. A closed culture isa poor organisational culture that increases the risk of harm, abuse, and human rights breaches to those receiving care. Staff told us they received updates and lessons learned as part of their supervision and through regular electronic updates provided by the management team.

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 management team ensured they supported people to document their needs and wishes, and care plans were developed with guidance for staff, so staff understood people’s needs prior to their package of care commencing. Where needed, we saw appropriate referrals to other services such as district nurses and their advice and recommendations were documented. One professional who worked with the service said, “Staff know people really well, this keeps people safe.”

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. The registered manager kept clear records and logs of all safeguarding concerns. If any actions were needed the management team developed an action plan and shared the outcome with staff. We saw evidence that concerns were raised in a timely way with the local authority and CQC as per legal requirements. Staff undertook regular training in safeguarding to ensure their knowledge remained current. Staff we spoke with told us the provider was responsive and acted to keep people safe when they raised safeguarding concerns.

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 were empowered and supported to take risk to improve their health. One person said, “I used to have 3 calls a day but through staff support I now just have 1 call a day as I am much better.”

Care plans were routinely reviewed and we saw evidence that needs and wishes were updated as people requested or as their needs changed, this ensured people received safe care consistently. One relative said, “They set us up on the portal the day we started, the carers write everything down that they have done and things they have noticed. They keep logs and this information can be given to the GP. The carers know when [relative] is well, and they notice when [relative] is unwell and act upon it quickly.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Care plans contained environmental risk assessments to ensure staff remained safe whilst working within people’s homes. Where needed, staff checked equipment prior to use to ensure its condition, where needed external companies were contacted for repairs and servicing. This ensured people received care safely in their own homes.

The provider did not always make sure there were enough qualified, skilled and experienced staff. The provider did not have a clear understanding or log of the required mandatory training for staff such as fire safety, health and safety and learning disability and autism training. We spoke with the management team who acted immediately to ensure this was in place. Where a minimal number of staff were found not to have the required training the provider facilitated this immediately to ensure staff were upskilled. Despite this concern there was no evidence this had impacted the care or safety of people. People and relatives told us staff were competent, knowledgeable and well trained. One relative said, “I feel the continuity of regular carers has been responsible for saving [relative’s] life on quite a few occasions.” Another person said, “The carers are marvelous.”

Care plans we reviewed contained clear guidance for staff on how to support people in a person-centred way whilst protecting them from infection prevention and control risks. Best practice guidance was also documented for staff such as processes for disposal of medical waste. People we spoke with told us staff consistently used personal protective equipment (PPE) where needed and staff confirmed that have access to a consistent supply of PPE.

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. Not everyone we spoke with was supported with medicines. Where people were, they told us staff were knowledgeable about medicines and ensured they received their medicine safely and timely. Where people had raised concerns, the provider had been responsive. One person said, “Staff get me my tablets, they are very good and know what everything is for.” Where people required time sensitive medicines evidence and feedback confirmed this routinely happened. The provider had a clear contingency plan for emergencies such as adverse weather or staff absence to ensure people remained safe and still received their required medicines.