Altogether Care - Care At Home Limited Beaminster

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 felt supported to raise concerns, discuss incidents and share ideas for improvement. Although there had been few accidents or incidents, effective systems were in place to record, review and learn from events when they occurred. The registered manager used oversight processes to identify patterns, trends and opportunities for learning, with a focus on improving practice rather than attributing blame.

Learning was embedded across the service, with updates to care records, changes in people’s needs and key learning points communicated promptly to staff. This helped ensure care continued to be delivered safely and consistently.
 

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. Records confirmed people were supported with referrals to healthcare professionals when required. Staff and the manager told us they had effective, working relationships with external professionals to ensure people’s needs were met.

The service used an electronic care planning system. This meant when people’s information was updated; this was instant and available to all staff. The service ensured people had an emergency grab sheet available in case of an emergency hospital admission.

Health and social care professionals were complimentary about the service. A professional told us, “They [provider] have shown the ability to respond dynamically as people’s needs change, particularly during the transition from hospital to home.” And another said, “Communication is clear and timely, supporting safe transitions between services. They are responsive to feedback and work collaboratively to resolve issues as they arise.”
 

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.

People and their relatives told us they knew how to raise concerns and were confident they would be listened to and acted upon. People consistently told us they felt safe using the service. One person said, “yes I’m safe,” while others spoke positively about the staff who supported them. Feedback from relatives and professionals was also positive, with no safeguarding concerns raised and the service described as safe and supportive.

The provider had effective systems and processes in place to record, report and respond to safeguarding concerns. Staff demonstrated a good understanding of safeguarding in practice and were confident in recognising potential abuse and taking appropriate action. They understood how to report concerns internally and, where necessary, to external agencies. One staff member told us, “Abuse is reported to the registered manager or the safeguarding team, it is also reported to the local authorities.” Another said, “If I have concerns about someone’s safety or wellbeing, I would report them immediately to my line manager or follow the safeguarding procedure.”

Records confirmed staff received safeguarding training and had access to up-to-date policies and procedures, helping to ensure people were protected from the risk of abuse and avoidable harm.
 

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 were involved in decisions about their daily lives and how risks were managed, and were able to make choices about their routines, activities and support.

Risk assessments were detailed, individualised and provided guidance for staff on how to support people safely. Staff demonstrated an understanding of risks and how to respond appropriately, including balancing safety with people’s preferences and independence.

There was evidence of positive risk-taking in practice, with people supported to access the community, pursue their interests and maintain independence, while staff were available to provide support where required.
 

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

During initial assessments, leaders assessed risks in people’s environment and identified any equipment that was needed or in use. People’s care records contained information about identified risks and gave staff guidance on how to work safely in people’s homes. The environmental assessments were regularly reviewed alongside people’s care plans to support delivery of safe care. Staff were provided with training on any equipment in use such as hoists and slings.

Staff confirmed they could contact the office regarding any environmental changes in people’s homes. Records confirmed the service worked closely with external professionals to ensure people had access to the right equipment. This had a positive impact on people’s quality of life.
 

The provider ensured there were enough qualified, skilled and experienced staff to provide safe, person-centred care that met people’s individual needs. People told us they were happy with the staff who supported them and received care from a consistent team who generally arrived on time and stayed for the agreed duration.

Safe recruitment processes were followed to help ensure suitable staff were employed. Required pre-employment checks were completed before staff started work, including enhanced Disclosure and Barring Service (DBS) checks. New staff completed a structured induction and shadowing programme and received ongoing training to develop the skills and knowledge needed for their roles.

Staff were supported through regular supervision, performance checks and spot checks, with records showing open and constructive two-way discussions. Staff worked well together, understood the service’s vision and values, and spoke positively about the support they received from managers. This helped create a motivated and well-supported workforce focused on delivering high-quality care.
 

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.

People told us staff followed correct infection control practices, including wearing personal protective equipment (PPE) such as gloves and aprons when providing care. Staff had received training in infection prevention and control and told us they understood how to promote good hygiene and minimise infection risks. Staff confirmed they had access to PPE. The provider had developed infection control policies and procedures in line with best practice. Leaders also carried out observations of staff while they worked. This helped ensure they were following the relevant guidance. These measures helped reduce the risk of infections spreading.
 

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 received their medicines as prescribed. There were safe procedures in place for the ordering and administration of medicines. Care plans correctly reflected the level of support a person required with their medicines. People were confident they received their medicines on time and records reflected this. Medicines records were held on an electronic system; this meant they were updated as changes were made. Alerts from the system informed the manager if a medicine was late, or not given, action was then taken to support the compliance with medicines. Regular audits and checks were undertaken to identify any patterns or concerns. Staff received training, both theory and practical together with competency checks to ensure safe practices with medicines.