Crown Care Services 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 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.

The provider had a policy and process to record and monitor incidents. Staff knew what to do following an incident and there were specific forms for staff to fill in to be reviewed by the registered manager. Due to the small size of the service, there had not been any incidents to report or review and monitor.

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 provider received referrals from the local authority or Integrated Care Board (NHS organisations in England responsible for planning and funding local health services). The registered manager checked information received with people and their relatives and completed their own pre-admission assessments to make sure important information about people’s needs were captured and shared with staff. Staff worked alongside other services such as the hospice at home team and shared information to make sure people’s health was monitored effectively.

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.

The provider had a safeguarding policy which contained information to guide staff about what constituted a safeguarding concern, and how to raise this appropriately. Staff completed safeguarding training and knew what to do if they were worried. There had been a low number of safeguarding alerts and investigations within the service although the registered manager had a system to collate and monitor when they did arise.

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.

The registered manager completed thorough risk assessments, for example consideration of the risk of choking, and risk of skin breakdown. These were reviewed at regular intervals to make sure information was up to date and accurate. Risk assessments contained detail for staff about what to look out for and how to respond appropriately.

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

The provider conducted environmental risk assessments considering issues like access to buildings, lighting, key codes and pets. The service provided training about how to use equipment safely. Staff checked when moving and handling equipment was last serviced and conducted visual checks to make sure items were not broken or in need of replacement. Staff completed fire safety training and risk assessments contained information about what support people would need in the event of a fire.

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.

The provider recruited staff using safe processes including staff who were recruited via the sponsorship scheme.

Staff completed both face to face and online training to support their knowledge and skills. Both the registered manager and other leaders were registered nurses and provided training in medicines and health conditions to their staff and checked staff competency regularly.

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.

There were appropriate policies and procedures, and staff understood how to keep people safe from the risk of infection. Staff had access to protective clothing such as aprons, gloves (PPE) and hand gels. Managers completed spot checks at people’s homes which included consideration of hand washing and bare below the elbow (this is guidance to make sure staff do not wear clothes or items below their elbows to reduce the risk of infection).

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.

The provider was not supporting anyone to manage their medicines at the time of the assessment. There were thorough medicine management policies in place and staff completed medicines training. The provider worked closely with the local pharmacy who could provide relevant information on medicine administration records. Staff completed training about how to observe and monitor people’s pain levels and shared this with district nurses or the hospice team if they had concerns.