BBcare10 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 75 (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.

We discussed with the provider how they could strengthen their documentation to clearly record the roles, responsibilities of staff, parent/carers, and relevant decision makers in the event of an incident to help to prevent any conflicts in managing the incident.

The provider had a positive learning culture. The registered manager and staff responded to incidents with transparency and with a commitment to continuously improve the care provided to the children they supported. Staff reported incidents were kept to a minimum as there was a positive culture of good communication with parent/carers about emerging risks leading to potential incidents such as identifying if a child was becoming unwell.

Incidents were reported and recorded by staff and overseen by managers. Following incidents, reviews of children’s care delivery and associated records were undertaken, with debriefs and lessons learned shared with staff. Accidents and incidents were analysed for trends and patterns, and action was taken as needed.

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.

The provider demonstrated they responded promptly and flexibly to support children during complex transitions into the service and when the needs of children or their parents/carers changed, including by providing additional staffing and resources where required.

Comprehensive systems and protocols were in place to ensure children transitioned safely into the service. An initial assessment of the children’s and parent/carers needs were completed. The service worked closely with the funding authority and parent/carers to ensure each child’s health, emotional, communication and social needs was fully understood prior to care starting. Time and resources had been allocated to create an initial relationship with the child to help build a trusting relationship between the service, the child and their parent/carers.

The registered manager explained in addition to the initial assessment, they reviewed staff capacity, training and compatibility before a decision to start providing care was confirmed. They told us, “We wanted to ensure each parent/carer who supports a child with additional complex needs has access to holistic respite support which benefits the child and their families.” The provider’s vision statement stated, ‘We empower their families to lead full and contented lives whilst caring for their loved one.’ This ethos was confirmed by parent/carers who consistently shared positive feedback and had been reassured about their child’s transition into the service.
 

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.

The safeguarding lead, managers and staff had received safeguarding training for adults and children appropriate to their role which equipped them with skills to identify signs of abuse and act. The provider’s safeguarding lead and protocols helped to ensure any concerns were managed and notified to the relevant authorities in a timely manner. The registered manager explained they kept safeguarding children at the heart of all staff development and regular supervisions.

The provider maintained a comprehensive safeguarding log, recording all concerns. Records showed all allegations were acted on, this demonstrated a strong commitment to safeguard children.
 

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.

Children’s care plans and risk assessments were highly personalised, detailed, and comprehensive. Risks were clearly identified, assessed, and managed in accordance with each child’s individual needs. Records reflected the children’s health, behavioural, and personal care requirements, and staff worked collaboratively with parent/carers to support safe and effective care delivery.

The service demonstrated a strong commitment to ensure each child received safe care. Detailed and personalised risk assessments and care plans addressed the child’s holistic and complex needs. Staff were provided with clear guidance on managing specific risks, including epilepsy, enteral feeding via percutaneous endoscopic gastrostomy (PEG) (a tube used to deliver liquid nutrition, fluids, and medications directly into the stomach), respiratory care, medication, moving and handling, fire safety, and community-based activities.

The service promoted a balanced, positive risk-taking approach in partnership with parent/carers. Staff understood how effective risk management could enable children to safely develop new skills, make informed choices, and build on their strengths and independence, rather than unnecessarily restrict opportunities.

Managers held weekly risk management meetings to review emerging risks and ensure appropriate action was taken to mitigate them. Systems were in place to ensure staff had read all relevant and updated documentation in relation to changes in children’s care needs.

Staff were knowledgeable about the children they cared for. They were aware of the importance of providing constant supervision to some children with complex needs and higher levels of risk such as choking.
 

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

Environmental risk assessments were in place, and staff demonstrated an understanding of the safety arrangements within each child’s home. The registered manager confirmed home risk assessments were completed prior to the commencement of care packages. Ongoing monitoring systems were in place to assess environmental risks, including fire safety and the safe use and maintenance of equipment, to promote the safety of both children and staff.

The provider worked collaboratively with parent/carers and relevant professionals, including occupational therapists, to ensure equipment such as hoists, bath equipment, wheelchairs and environmental adaptations were appropriately assessed, maintained and used to support each child’s safety.

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.

We discussed with the provider strengthening recruitment records to clearly evidence the exploration of employment histories and the assessment and management of risk in relation to staff, where insufficient assurances regarding staff conduct had not been obtained. However, staff were recruited safely, to ensure only suitable staff with values aligned with the providers were employed to support children and their parent/carers. Appropriate pre-employment checks were completed prior to commencing work, including enhanced Disclosure and Barring Service (DBS) and barred list checks for working with children

A small number of parent/carers identified areas where responsiveness could be strengthened, including advance notice of rotas and more direct communication with carers in certain situations.

There were enough staff to meet each child’s assessed needs and funded support hours. Systems monitored the allocation and use of funded hours, ensuring children and their parent/carers received the agreed respite support.

Records and staff feedback demonstrated supervision and spot checks of staff practices were undertaken and monitored in line with the provider’s requirements. Staff had been trained to carry out their role safely. Staff reported feeling well supported and appropriately trained for their roles. One staff member said, “I think it [training] is brilliant - if I want more, I can have more…… we have regular supervisions and spot checks.” Another staff member said, “The training gives you the confidence going into people’s homes, but you are constantly learning with experience from other staff, service users and parents.”

The provider maintained a training matrix to monitor staff training. However, the matrix could benefit from recording accreditation expiry dates to enable the provider oversight of when re-validation or refresher training would be needed. This would contribute to the safety of staff working with children with complex needs. The provider had transitioned to a new training platform and agreed to strengthen their training matrix to provide clearer oversight of staffs completed training.

Parent/carers reported staff were highly skilled, knowledgeable and trained to meet complex health, care and behavioural needs.

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 ensured staff had access to appropriate personal protective equipment (PPE) and received training in infection prevention and control (IPC). Staff demonstrated an understanding of the importance of maintaining good hand hygiene, the correct use of PPE, and the maintenance of clean working environments to reduce the risk of infections.

Where required, the provider demonstrated how they had taken a proactive and supportive approach when an incident of infection had occurred for one child. They worked closely with parent/carers and staff to effectively manage and safely implement infection control measures.

Staff confirmed they had received appropriate training, and their IPC practices were regularly monitored and checked. These practices helped reduce risk and protected children from the risk of infection or contamination.

Parent/carers reported no issues about the infection control practices of staff. They reported staff used PPE and associated equipment such as sharps bins appropriately.
 

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.

Where medicines support was required, children received their medicines as prescribed. Medication administration records were well maintained and consistently aligned with the children’s daily records. Staff had been trained in medicines management and their skills were monitored. The provider agreed to review their systems to ensure transferring medicine information onto medication administration records were checked and verified by a second person to reduce the risk of errors.

Parent/carers reported their child’s strict medicine and administration protocols were followed by staff. They reported staff took time to understand their child’s medicines needs prior to the start of their support hours or the management of their child’s medicines when they were supported in the community.