Able Hands Healthcare 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.

Staff knew the systems available to report incidents. They told us they recorded incidents or any concern on the system and reported them promptly to the registered manager. They understood when to involve relatives and relevant healthcare professionals, such as GPs and district nurses. The registered manager shared learning with staff and monitored through spot checks, reviews and supervisory visits.

Records showed action was taken when risks were identified. For example, concerns were raised when a person attempted to mobilise at night without their walking frame. The provider reviewed the person's care plan and falls risk assessment, reminded staff to keep the mobility aid within reach and encourage its use, and introduced an alarm mat to help reduce the risk of falls.

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.

Systems were in place to help ensure safe transitions between services and continuity of care when people returned home following periods of treatment or rehabilitation. One person told us, “They did an assessment at the centre where I was for rehabilitation for an injury. They helped me get all the equipment in place before I returned home.”

Staff understood the importance of delivering care safely and consistently. They told us the registered manager completed initial visits alongside them to ensure they understood people's needs, risks and preferred ways of being supported before providing care independently. This helped staff develop the knowledge and confidence required to support people safely and promoted continuity of care.

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 felt safe receiving support from the service. One person said, “They are lovely carers and I feel totally safe with them.” The provider worked with people and relevant professionals to understand their needs and keep them safe while promoting their independence and wellbeing.

The provider had safeguarding systems in place to protect people from abuse, neglect and discrimination. Staff received safeguarding training and were able to describe different types of abuse and how to recognise and report concerns. Staff told us they would report any concerns immediately to the registered manager and understood how to escalate concerns externally if they felt appropriate action had not been taken. The registered manager understood their safeguarding responsibilities and worked with external agencies when required to help ensure people remained 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.

The registered manager completed risk assessments which covered areas such as falls, mobility, medicines, skin integrity, fire safety, environmental risks, personal care, mobility equipment, sensory impairments and continence needs. These assessments identified individual risks and provided staff with clear guidance on how to reduce the likelihood of harm while promoting people's choice and independence.

For example, the provider had identified that one person was at increased risk of falls due to reduced mobility, partial sight, hearing impairment and a history of falls that had resulted in hospital admission. Detailed risk assessments guided staff to ensure the person's Zimmer frame was always within reach, provide support when mobilising, maintain a safe environment free from hazards, ensure adequate lighting and encourage the use of appropriate footwear. Staff were also required to monitor and report any changes in mobility, falls or near misses. One person said, “They are very careful with me as I'm unsteady on my feet. They take their time with me and make sure nothing is around that could make me trip.”

Risks associated with skin integrity were also appropriately assessed and managed. Care records recognised the person was at risk of skin breakdown due to reduced mobility, age and continence needs. Staff were provided with clear instructions to monitor skin condition, keep skin clean and dry, support regular repositioning and use pressure-relieving equipment where required. A specific risk assessment was in place for the use of a pressure-relieving cushion to help minimise the risk of pressure damage.

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 identified and managed risks within people's home environments to help ensure care was delivered safely. Environmental and fire risk assessments were completed and reviewed regularly. These identified potential hazards, including clutter, poor lighting, electrical equipment and obstacles that could impede safe movement or evacuation.

Control measures were in place to reduce identified risks. These included keeping escape routes clear, monitoring the safe use of household appliances, ensuring smoke alarms were present and encouraging the removal of potential trip hazards. Personal Emergency Evacuation Plans (PEEPs) provided guidance on the support people would require in the event of an emergency.

The provider maintained oversight of equipment used to support people safely. An equipment log was in place and included servicing and maintenance dates, helping to ensure equipment remained safe, suitable and fit for purpose.

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 and their relatives spoke positively about the consistency and competence of staff. One person told us, “They send the same carers, and we have never had issues, they are mostly on time.” A relative said, “The staff are experienced and skilled in what they do.” These comments demonstrated that people experienced reliable care from staff who knew them well.

Staff told us they felt well supported by the management team and had received the training they needed to carry out their roles confidently and safely. They were able to access advice and guidance when required and worked together effectively to ensure people received safe and consistent care.

Staff received induction, regular training and ongoing support to enable them to carry out their responsibilities effectively. Records showed staff received supervision, spot checks and annual appraisals, which provided opportunities to review performance, identify development needs and reinforce good practice. The registered manager also provided on-the-job coaching and guidance to support staff in delivering safe, person-centred care.

The provider ensured there were enough suitably skilled and experienced staff to meet people's needs safely. Recruitment processes were robust and included the necessary pre-employment checks to help ensure staff were suitable for their roles.

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.

The provider had infection prevention and control procedures in place to help protect people from the risk of infection. Care plans included clear guidance for staff on maintaining good hygiene and following safe working practices. Staff were instructed to wash their hands and wear appropriate personal protective equipment, including disposable gloves and aprons, when providing personal care.

Care records provided detailed guidance on how care should be delivered safely. For example, staff were instructed to prepare all necessary equipment before supporting a person with personal care, including clean pads, wipes, disposal bags, clean clothing and prescribed barrier creams where required. This helped reduce the risk of cross-contamination and ensured care was delivered in a safe and dignified manner.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning Staff had received appropriate medicines training and records showed Medication Administration

We found that medicines care plans did not always provide clear and consistent information about the support people required. For example, some self-medication assessments recorded people as fully independent with their medicines, whilst other parts of the care records stated staff should prompt, supervise or support medicines administration and check medicines had been taken. We also found conflicting information relating to eye drop administration. Some records stated people were able to administer eye drops independently, whilst medication risk assessments identified concerns that required staff monitoring. Records did not clearly explain the nature of these concerns, whether they remained current, or the specific support staff were expected to provide.

However, people were clear on the support they received with their medicines. One person told us, “I know my medications. I manage them myself and I like to.” Another person said, “The carers help me with all my medications as I'm not able to take them on my own.” Staff were also able to describe the level of support people required and how they delivered this in practice which marched what people had told us. Where staff supported people with medicines, appropriate records were maintained.

Staff had received appropriate medicines training and Medication Administration Records (MARs) were completed appropriately. Staff had access to medication care plans, risk assessments and MAR charts which outlined prescribed medicines, administration times and the support people required. Risks associated with medicines management, including the administration of eye drops and prescribed creams, had been identified and guidance was available to support staff to manage these safely.