P & N Healthcare Services Ltd - Gloucester

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 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 investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The registered manager demonstrated a good understanding of how to respond to accidents and incidents and to notify the relevant authorities and CQC. Staff were aware of their responsibility to manage incidents safely and to report any concerns in a timely way. Incidents were investigated, recorded and acted on. Incidents were discussed and reflected on with staff to reduce the risk of recurrence. The registered manager agreed to review the recording of incidents to demonstrate lessons learned had been effectively embedded and evaluated.

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’s care and support needs were assessed to ensure the service could meet their needs. People’s care records were created from discussions with people and their relatives and information from the funding authorities. People and their relatives told us they were happy with the support people had to access and to understand the service being provided to them. The registered manager committed to review their service user guide to ensure the provider’s terms, policies, and contact details were fully accessible.

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.

Effective systems and processes were in place to safeguard people from abuse. A safeguarding lead had been given additional training. The provider ensured staff understood their safeguarding roles and responsibilities through meetings and training. Staff were able to tell us how and when they would report safeguarding concerns and abuse. People and their relatives told us people were cared for safely and raised no concerns about their safety.

People who were supported with personal care at the time of the assessment had the mental capacity to make decisions about their care and support needs.

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

The registered manager assessed risks to people’s safety and wellbeing. Care plans provided staff with the information they needed to support and to assist people to reduce their risks. People and their relatives told us staff supported them safely to manage and monitor their risks. One person said, “Yeah, they [staff] really support me and know what they are doing.” Although, we found no impact on people as staff were confident and skilled in their role; we identified a small number of inconsistencies in people’s care records which was discussed with the registered manager. After the assessment. the provider took immediate action to address our concerns and implemented several measures to prevent further discrepancies and to ensure people’s care records were accurate.

Risk assessments and management plans were regularly reviewed and updated when needed.

People’s care plans provided staff with a clear escalation route if there were concerns or changes in people’s wellbeing. Staff had access to an on-call system if support was required out of hours.

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

Staff supported people to live safely within their homes. Environmental and lone working risk assessments had been completed to identify risks to people and the staff who supported them. We saw evidence of a checklist which identified risks to people and staff, including risks relating to the environment, use of equipment and risks to their safety.

The provider did not always make sure there were enough qualified, skilled and experienced staff. They did not always make sure staff received effective support, supervision and development.

New staff completed an induction to the service, shadowed experienced staff and completed a range of training. We raised with the registered manager despite the service not being registered for learning disability or autism support, the provider had failed to meet regulatory training standards for staff. The provider responded and provided assurances immediate action would be taken by booking staff onto the required training appropriate to their role.

The provider supported all staff to access regular refresher training, supervision and staff meetings. The registered manager regularly assessed staff and carried out checks on their work. Staff told us they felt supported and trained to carry out their role.

People and their relatives told us people received care from a familiar staff team. They raised no concerns about the punctuality of staff and confirmed staff were reliable and stayed to complete all their support requirements without feeling rushed. Systems were in place to monitor if staff were running late to their call’s which prompted managers to follow up.

Safe recruitment practices were being used to ensure people were supported by staff who had been suitably vetted.

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.

There were systems and processes to monitor and prevent the spread of infection. Staff had completed relevant infection prevention and control training. Staff were provided with personal protective equipment (PPE), such as gloves and aprons. The registered manager monitored staff’s infection control practices, including hand hygiene and their use of PPE. People and their relatives told us staff wore PPE when providing support with their personal care.

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.

At the time of our assessment, people were not receiving support with the administration or management of their medicines. However, staff checked with people who self-medicated that they had taken their medicines.

From our review of the provider’s information return, the provider’s policies, procedures and discussions with the registered manager and staff, we were satisfied the service is compliant in this area.