Advance Essex and East London

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 requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

This service scored 59 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported incidents. The support manager identified lessons learnt following accidents, incidents and complaints. Management shared learning with staff from incidents, accidents, complaints and safeguarding so that the service could continually improve and develop positive outcomes for people. Information was shared with staff through supervisions and meetings. A member of staff told us, “The manager keeps us up to date with any changes.”

The service 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 Head of Operations told us, “A meeting takes place to carry out a full assessment before we commence a support package to determine if we are able to support the individual or not. We also look at what additional training our staff may need to ensure the person receives the best support.” Staff told us they read through the care plans to ensure they had all the information they needed to provide support safely.

The service had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported incidents. The support manager identified lessons learnt following accidents, incidents and complaints. Management shared learning with staff from incidents, accidents, complaints and safeguarding so that the service could continually improve and develop positive outcomes for people. Information was shared with staff through supervisions and meetings. A member of staff told us, “The manager keeps us up to date with any changes.”

The service 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. However, not all risks to people's safety and wellbeing were assessed, recorded or provided enough detail as to how identified risks should be managed and mitigated. For example, there was no information available to guide staff on how to support a person with diabetes in the event of out of normal range, high or low blood glucose levels. This meant that staff may not be able to respond appropriately to changes in the person’s medical condition potentially placing them at risk. The management monitoring tool completed by the registered manager had not been completed every month which meant support plans were not being audited regularly. Following this assessment, the support manager updated the care plan and risk assessment.

People received personal care and support in their own homes. The support manager told us, ''We involve families and health professionals when formulating and reviewing the care plans and work closely with them on a regular basis.'' Risk assessments had been completed to provide staff with guidance on how to keep people safe and minimise risks. For example, there was a risk assessment in place describing risks to people's home environment.

The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. Staff worked together well to provide safe care that met people’s individual needs. The service had processes in place to ensure all staff received an extensive induction and staff we spoke to confirmed this. Staff files were held electronically and were not easily available on the day of our visit. The Head of Operations had to request individual staff files from the provider’s HR department. Appropriate checks were in place before staff started work including providing full work histories, references and a Disclosure and Barring Service (DBS) check. DBS provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. However, references received had not been verified. The reference audit file did not specify that verification was required. Health declarations were not kept on staff files. There was no evidence the registered manager carried out a regular staff file audit. The management monitoring tool indicted staff files had not been audited since May 2024.

We recommend the provider ensures all the necessary recruitment checks are completed in line with regulatory requirements, to ensure that only individuals who are safe and suitable to work with people who use the service are employed.

The service 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 undertaken infection prevention and control training and were provided with personal protective equipment (PPE) which could be collected from the office. A member of staff told us, “I wear PPE when required, such as gloves and aprons during personal care and masks if needed. However, the registered manager’s monthly monitoring tool indicated infection prevention and control had last been audited in May 2024. This meant audits to monitor infection prevention and control were not being completed regularly.

The service 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 support manager told us, "Staff did not support people with medicines until they had completed the required training, and medicine competency assessments were completed." Medicine competency assessments were seen. People had care plans and risk assessments in place which detailed what medicines they were prescribed and how they liked to be supported. The support manager completed regular audits. There was a system in place to identify any shortfalls and to ensure people received their medicines safely.