Living Well North 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 inspection of 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 provider had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. When accidents and incidents occurred, staff took appropriate action including seeking medical attention. The registered manager had a process in place to review incidents that occurred to identify any trends, patterns and lessons learnt and to share with staff to reduce risks to people.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. Most systems were in place to ensure there was continuity of care, including when people moved between different services. However, information such as a hospital ‘passport’ containing standardised information about people’s care and support needs was not available for all people. This meant people may not receive continuity of care when they visited another service. The registered manager told us this would be addressed.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. A relative told us, “[Name] trusts and feels safe with the carers they get at the moment.” Staff and leaders had received training in safeguarding adults and understood their responsibilities in reporting safeguarding concerns to the appropriate agencies. A staff member commented, “I have done safeguarding training.”

The registered manager had completed risk assessments for people and had put some measures in place to mitigate those risks. However, not all identified risk such as risk of falls, had been transferred to a care plan with enough detail for staff to mitigate the risks. Care plans required more detail of the measures for staff to follow to keep people safe, including how to respond when people became distressed or refused care. This included guidance for staff about triggers and signs, how to de-escalate and reassure a person if they became upset. We discussed this with the registered manager, who told us it would be addressed. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. A relative commented, “I am confident I could leave [Name] in the safety of the carers.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Risks associated with people’s individual environments were assessed before staff started supporting people within their homes.

The provider did not always make sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. Systems were not all in place for staff to provide safe care that met people’s individual needs in a timely and consistent way. Most people and relatives told us rosters were not well-managed. Their comments included, “If the care was just down to 1 carer, the service would be great, but other carers are questionable” and “There is a clear distinction between some carers doing what is needed.” Improvements were needed to staff recruitment to ensure new staff were recruited safely. New staff had some pre-employment checks in place. However, we discussed that an application form should be completed, with a more extensive work history with any gaps in employment accounted for and evidence of any qualifications. Sufficient references should be sought at least 2, including a character reference if the 2 most recent employers were not available to verify a prospective staff member’s suitability for their role. A health declaration should be completed by the applicant during the recruitment process. The registered manager told us this would be addressed immediately.

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. Staff told us they had access to the personal protective equipment (PPE) they required, and people confirmed staff wore this when required. Staff received infection control training and competency checks.

Improvements were needed to medicine management, so medicines and treatments were safe and met people’s needs, capacities and preferences. Medicines records were in place, however guidance for how medicines should be administered was not all person-centred. Medicines care plans required more detail about how a person liked and needed to be supported with taking their medicine. When creams were applied by staff a care plan and body chart was needed to show staff where to apply the cream. The registered manager addressed this immediately. There were policies and processes in place to ensure people received their medicines safely. Staff received training and competency checks to observe how they managed people’s medicines safely. A relative commented, “My relative takes medication and the carers remind them.”