Prisima 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 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. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. An accident and incident report was completed frequently to identify trends, patterns and lessons learned. This information was used to improve future practice. This included more training and supervision for staff and the implementation of new systems. The registered manager said, “If an incident occurs, we investigate what has happened, inform the person and would report accordingly such as to safeguarding. We would support staff to review the incident and look at how to improve.”

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. There were good, detailed assessments in care records which gave information to healthcare professionals when people moved between services. We saw referrals were made when required to promote safe care. Healthcare professionals’ advice was sought and followed.

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 were knowledgeable about keeping people safe and would raise concerns if they needed to. They were confident the registered manager would take appropriate actions to keep people safe.

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. Staff and leaders knew people well and were aware of risks associated with people’s care. Staff understood the importance of following up to date care plans and risk assessments to ensure safe care. Risk assessments contained clear information to support staff in delivering safe care. People and relatives told us staff understood risks associated with their care and support. One person said, “At the moment I can walk with a stick but no stairs, but I can go for a walk with a walker and the carer, and it has a seat I can sit on so it’s really safe, it has 4 wheels. I do like having the carers.” One relative said, “The carers are very well trained. They understand the importance of pad care and skin integrity.”

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

Environmental risk assessments were carried out and looked at things such as access into people’s properties such as ramps and curb side access for people using a wheelchair. Staff and leaders worked with people and relatives to manage environmental risks. Handrails and lighting (especially outside for both the person and member of staff attending the call) were all documented. Equipment used in people’s properties to deliver care such as hoists, were frequently checked to ensure they were well maintained and safe to use.

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. Staff received training and support to carry out their roles effectively. One staff member said, “I’ve had ongoing training in safeguarding, infection control, manual handling, medication and more. I feel supported to carry out my duties.” People and relatives told us staff were knowledgeable. One relative said, “The carers have formal training, and [registered manager] also comes in and works alongside the carers to build their skills and their confidence.” Everyone we spoke with told us the carers arrived on time and were kept updated of any changes. One person said, “They [staff] are really good, they come at the time we agreed, and they never miss.” The provider had a robust recruitment process in place and used this to safely recruit new staff. The provider completed pre-employment checks such as references and Disclosure and Barring Service (DBS) checks. DBS checks provide information including details about convictions and cautions held on the Police National Computer. This information helps employers make safer recruitment decisions.

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 access to personal protective equipment (PPE) and used this when appropriate. An infection control policy and procedure was in place and described the arrangements to protect both staff and people from infection and create an effective environment for safe practice. The policy included effective hand washing, use of PPE, uniforms and use of alcohol hand gels.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. We found medicines were mostly managed safely. However, protocols for medicines prescribed on an as and when required basis, could be improved to reflect how people may present when this medicine was needed. We found some documentation issues regarding patch rotation. This was addressed by the registered manager. People’s care plans included information and guidance about how people preferred to take their medicines. Staff received training and had their competencies checked to ensure they were safe to administer medicines. People and relatives had no concerns about how staff supported people to take their medications safely.