Collaborative Care Solutions

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. At our last assessment we rated this key question inadequate. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm. The service was previously in breach of the legal regulations in relation to safe care and treatment, safeguarding people from abuse and ensuring safe recruitment checks were completed. Improvements were found at this assessment and the service was no longer in breach of these regulations.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Since our last inspection the provider had developed a positive culture of safety, based on openness and honesty. Lessons were learnt to identify and embed good practice. Where incidents of accidents occurred, these were reviewed by the manager or senior staff and action taken to support the person. Where external agencies needed to be informed this was completed. Daily handover meetings across the staff team gave the management team the opportunity to discuss any incidents or changes to people’s support. The management team informed us they would review people’s risk assessments following incidents.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. People were supported to access health and social care professionals as needed. They were supported to attend appointments including annual health checks and medicines reviews. The provider had an electronic care planning and recording system in place. This enabled staff to update and access people’s care records in real time.

The provider worked with people and healthcare partners to understand what being safe meant to them and how best to achieve it. Staff focused on improving people’s lives while ensuring their right to live safely, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. People told us they felt safe with staff support. One person told us, “The staff know what I want [to do in life] but understand it might take me time to get there so they protect me.” A relative told us, “It’s a good step to independence with a safety net. We will all talk things through so [person] can do what [they] want without being vulnerable.” Records confirmed that where potential safeguarding concerns were identified, these were promptly reported to the relevant authorities and immediate action taken to reduce risks. Staff had completed safeguarding training, understood their responsibilities, and shared clear examples of how they supported people to remain safe from potential abuse or harassment.

The provider worked with people to understand and manage risks although additional guidance for staff in how to respond in some situations would have been useful. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Improvements had been made in the way people were supported to manage risks, these needed to be embedded and sustained into practice.

People told us they felt supported with risks to their safety. One person told us, “The staff know what to do. They do what I ask them to help me.” Information regarding the support people needed to manage risks was available to staff in areas such as how they spent their time, how to support their mental health support needs and how to respond to people’s specific needs. Although additional detail would have been beneficial for staff in written records, as people were supported by consistent staff this risk was minimised. The provider assured us they would review all written guidance following our inspection.

The provider detected and controlled potential risks in the care environment. They made sure equipment, and facilities supported the delivery of safe care. People were supported to live in a clean and safe environment. Where equipment was needed to support people’s personal care this was in place and people told us staff were competent in how they used this.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective training and supervision. However, the number of hours staff worked was not monitored. Rotas showed that in some circumstances staff were consistently working 6 long day shifts whilst also covering sleep-in shifts, sometimes at different houses which meant they also needed to travel. The manager told us they felt this was the choice of the staff member. The provider had not taken into account how effective the staff would be when working such long hours or considered staff well-being.

People told us staff were always available to them, and they did not have to wait for their care. One person told us, “I don’t have set times, I just ask when I want my support, and I have it.” We observed in addition to people’s routines, staff were available to offer support to people as they wished.

Staff had received an induction and completed training in areas relevant to their roles. They told us they felt this had been useful in understanding how to support people. One staff member told us, “The training is fantastic, management is always on hand through our meetings, they will ask if you need training or you fall short, you make it known to them and they are always on hand. Every time you talk to [manager] I’m asked if I have any training needs.” Records confirmed staff had supervisions and management support was always available to them. One staff member told us, “Supervision is monthly, I feel well supported, we have access to management by phone or email.”

Staff were recruited safely. Recruitment procedures included completing checks on staff work histories, obtaining references and conducting face to face interviews, and applying for Disclosure and Barring Service (DBS) checks. These provide information, including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. The management team were able to explain gaps in staff employment records although this was not always fully recorded.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading. People told us staff supported them to keep their home clean and tidy. One person said, “We do it together, with the staff. They will help us if we need it.” Staff confirmed they had access to personal protective equipment and people confirmed staff used this when needed. Staff completed training in infection prevention and control and food hygiene.

Since our last inspection improvements had been made to this area of people’s support. On the whole the provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. However, we found some discrepancies which although had not had an impact on people, showed systems needed on-going monitoring to ensure these were fully embedded into practice. A letter from a consultant in one person’s medicines records stated a medicine prescribed to be used as and when required (PRN) should no longer be administered. We found this had not been adjusted in the person’s records despite the letter being dated December 2024. The person had not needed the medicine, and it had not been administered since this time although there was a risk of this. The manager confirmed they were unaware of the medicine being stopped.

In other areas we found people were supported with their medicines well. Medicines were stored safely and clear records were maintained. Information was available to staff regarding how people preferred to take their medicines and people confirmed this was followed.