Aptine 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 service since its registration. 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. A staff member told us, “We normally discuss incidents during meetings as part of the learning culture. We discuss how to mitigate risks, so everyone is aware of how to stop it from happening in the future. It is a good reflection for the [staff], it will help everyone to prevent [similar incidents], and preventing is better than curing.” Incidents and accidents were reviewed by the registered manager, and case studies, including quality and safety standards, lessons learnt, and good practice, were discussed with staff. Where needed, changes were made to systems and processes the provider used to ensure people were protected. For example, the registered manager improved their risk escalation processes following an incident.

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. Staff worked well with other health and social care professionals when people’s needs have changed. The registered manager gave examples on how they supported people working in partnership with other healthcare services to ensure joined-up care. People’s relatives confirmed the service worked well to coordinate their loved ones’ care when needed.

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. People and their relatives told us they felt safe being supported by the service and with staff. Staff knew how to recognise and act on any concerns and received training in safeguarding. One staff member said, “I have to escalate (any concerns) and inform the office. I would have to inform CQC if nothing changed.” The registered manager worked with the local authority on investigating and addressing any safeguarding concerns to protect people.

People received safe support and care from staff who knew their individual needs. However, some risk assessments around people’s specific health needs were not always effective enough to provide staff with sufficient information. For example, around what staff were required to do in emergency and how to recognise and act on any symptom deterioration. Risks to people were mitigated, as staff could access additional specific healthcare guidance in people’s homes and people were supported by consistent staff team who knew them well. Following our feedback, the registered manager immediately updated people’s records to include more detailed guidance for staff. People and their relatives repeatedly told us the care they received was ‘brilliant’, ‘very good’. One person said, “I felt very, very safe (being supported by staff). I use a [specific piece of care equipment] and they had to deal with that as well. I felt they were trained to use it, and I had no concerns at all.” Staff we spoke with knew people their supported and their individual needs and risks. A staff member told us, “Safety is a priority” and went on to explain how they supported a person to remain safe and well and what they would do if there was an accident such as a fall. People’s care plans included information about support they needed around their mobility, personal care, nutrition and hydration, continence, skin care and overall safety in their homes.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People and their relatives told us staff provided care safely. The registered manager ensured appropriate environmental, and care related risk assessments were carried out to support staff to provide care in people’s homes. Staff received training in relation to health and safety and safe use of care equipment where relevant.

The provider ensured that 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. People told us that the staff usually arrived on time and stayed long enough to provide all the care as planned. They explained they were overall supported by a consistent staff team and knew who to contact if they had any concerns about their care visits. One person told us, “[Staff] very much took as much time as I wanted.” A relative commented, “[Staff] do a very good job and don’t look rushed.” Staff we spoke with felt supported in their roles, received appropriate training and supervision. Staff told us they were able to contact their managers for support when needed, and their schedules were manageable. One staff member said, “[The provider] does what is called spot checks (when managers visit with staff to observe how care is provided). The registered manager has an open-door policy; we have a lot of different communication groups. If anything needs to be discussed, we can reach out. We also have supervisions and appraisals. I think I am getting enough support. We always have different courses assigned to us, and we had a whole lot of training run by our manager.” Another member of staff commented, “They are not overworking me, which is good, when you feel tired you can’t pass good duty of care to clients. Everything is working really well.” New staff were recruited safely. This included requesting and receiving references from previous employers, identification checks and Disclosure and Barring Service (DBS) checks. DBS checks are carried out to confirm whether prospective new staff had a criminal record or were barred from working with people at the time.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and promptly shared concerns with the relevant agencies. People and their relatives told us that staff provided support with housework when needed, ensuring that people lived in comfortable and hygienic conditions. Staff used appropriate personal protective equipment and followed good infection prevention and control practice principles when providing support. People told us, “[Staff] do the housework, and they always wear gloves, apron and uniform”, and “Absolutely, they kept everything clean. They wore those hospital gloves, and aprons too.” Staff received training in infection prevention and control (IPC). The registered manager checked their practice, IPC systems and processes in the service to ensure safe practice.

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. However, medicine administration records were not always completed accurately by staff, although there was evidence in other parts of people’s records that staff supported people to take their medicines as prescribed. Those inconsistencies in recording and how staff used the provider’s systems were not identified in medicines audits at the time of the assessment. The registered manager took immediate action to investigate the discrepancies in records and provided assurances on actions taken to ensure people were not adversely affected and record keeping improved going forward. People and their relatives did not have any concerns around the support staff provided with medicines. Staff received training in medicine administration and were observed by managers to confirm their competency to support people in this area.