Somerset

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 the first assessment of this service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 69 (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 reported safety events. The registered manager, administration manager and care staff worked closely with each other. There was a good sense of teamwork and communication was good.

The registered manager carried out an audit on any incidents which occurred. This ensured lessons were learnt to continually identify and embed good practice. There was a clear vision for the service to deliver high quality and safe care to people. There was a focus on learning and improving the service wherever possible.

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.

People were supported by health care professionals to help maintain and improve their well-being, including GPs and the district nursing team. The registered manager and care staff had worked with staff at a local hospital to ensure continuity of care for 1 person. This person told us how much they had improved following surgery and returning home. They said, “When I first came back from hospital, I lived downstairs and they [care staff] were coming three times a day. Now they come once a day in the mornings because I have improved so much."

Staff worked with people to understand what being safe meant to them and the best way to achieve that. Staff ensured people lived in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People told us they felt safe with care staff who treated them well. One person said, “I feel completely safe with any of the [care staff] that come. All of them are wonderful, kind people.”

There were appropriate policies and procedures in place to protect people from the risk of abuse. Staff knew how to recognise and respond to abuse correctly. They had a clear understanding of the procedures in place to safeguard vulnerable people. One staff member told us, “I believe the care we provide is safe and that people are protected from abuse, neglect and avoidable harm.”

The provider’s risk assessments were not always sufficiently detailed in identifying and managing risks associated with the person’s care and support. However, staff knew people well and provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People’s care records included information about risks. However, risk assessments did not include some key details such as who could be at risk (other than the person). They did not assess the risk before and again after any action was taken to reduce the risk or always state clearly staff responsibilities. This was discussed with the registered manager and administration manager who confirmed the necessary improvements would be made.

People told us they did not feel at risk when care was provided. One person said, “[Care staff] understand exactly what I need in terms of help and keep me from having any accidents.” One staff member told us, “We take the safety and wellbeing of the people we support very seriously and aim to identify and manage risks appropriately."

The provider assessed potential risks in each care environment. This was designed to ensure all equipment and environments supported the delivery of safe care.

An environmental risk assessment was included as part of the care planning process. However, these risk assessments needed more detail to ensure people’s welfare and safety. For example, 1 person’s assessment did not include any checks on mobility aids to ensure they remained safe to use. It also was not clear what the person was able to do to keep their environment safe or what staff needed to do. This was discussed with the registered manager and administration manager who confirmed the necessary improvements would be made.

Staff told us they would report any safety concerns to the registered manager promptly so appropriate action could be taken.

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.

People spoke very highly of care staff, both in relation to the care they provided and their caring nature. One person said, “I'd have to say they [care staff] are just wonderful. I couldn't ask for better carers, and I wouldn't change them for anybody else in the world to care for me. I cannot fault them as carers. They are absolutely fabulous.” Another person told us, “All of the carers are excellent.” A relative had complimented the service stating, “It’s such a fabulous [staff] team, who are all very professional, experienced, diligent and caring.”

Staff told us they had enough time to provide the right care for each person. The provider insisted on a minimum of 1 hour for each care visit to ensure high-quality care was delivered. One staff member said, “We are not rushing from client to client; we are able to spend quality time with them which is so important for them.”

Staff were well trained and well supported. One staff member said, “Staff are supported to maintain and develop their skills, with regular training and opportunities to refresh our knowledge and keep our skills up to date.” Staff had completed training in areas such as first aid, infection control, communication skills, person centred care and how to care for people who were living with dementia. Where staff needed to complete training or required a refresher, this was organised for them.

Formal supervision meetings, 1:1 meetings and 3 monthly reviews following their employment were held with staff. Spot checks and observations of their care practice were carried out, and regular staff meetings were held. Records of staff meetings showed these were well attended, covered a range of topics and staff were encouraged to raise any issue they wished to discuss.

Staff recruitment practice needed to be improved. The current staff team (6 staff members) were either related to the registered manager or known to them personally prior to their employment. Some safety checks had been carried out on these staff to ensure they were able to work in the UK, of good character and safe to support vulnerable people, but not all information required had been gathered such as their full employment history. This was discussed with the registered manager and administration manager who confirmed they would audit the existing staff files and ensure that all necessary information was obtained and added to each staff member’s personnel record. They also confirmed a more standardised, comprehensive recruitment process would be implemented before any new staff were recruited.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and would share concerns with appropriate agencies promptly.

Systems were in place to reduce the risk of cross infection; this included the use of personal protective equipment (PPE) where necessary. People told us staff regularly used PPE and were aware of safe hygiene and infection control practices. Infection control practice was reviewed each time a spot check was carried out on staff caring for people. Records of these spot checks showed staff practice was good.

The provider had an infection prevention and control (IPC) policy in place and staff had received appropriate training.

The provider made sure that medicines and treatments would be safe and met people’s needs, capacities and preferences. Staff would involve people in planning, including when changes happened.

People currently supported looked after their own medicines or were supported by family members. Care staff did not administer any medicines to people. The provider had clear guidance and policies for staff to support people with medicines if this was required in the future. Staff had also received training in the safe handling of medicines.