All4One Care Services 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 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. The provider had not experienced incidents or complaints at the time of inspection but did have systems and processes in place, which would support learning from incidents where people may have been at risk. We saw the provider’s systems and processes promoted people’s safety as a priority, whilst not limiting their choices. People were supported and empowered to make informed choices and take calculated risks as safely as possible.

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 ensured that easy read and clear information was available for external health providers, should a person require emergency support. These were called hospital passports. They provided professionals with detailed information about how a person liked to be supported, potential triggers to distress and important contacts for them.

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.

Staff understood how and when to share concerns. A member of staff told us, “If I had concerns I would speak to my line manager. If they didn’t listen; to their manager and, if still no one listened, I would report to CQC or local safeguarding authority.” At the time of inspection there had been no safeguarding concerns raised about the service.

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.

A person using the service did things that had the potential to leave them vulnerable. However, staff had processes in place to protect them from harm, without limiting their ability to take part in things that brought them joy, such as visiting the local park. Staff were trained to support people who displayed signs of distress. They completed charts that were monitored by managers, which helped identify and reduce potential triggers that could cause distress.

People unable to verbally contribute had care plans that clearly described various nonverbal communication cues for staff. This helped enable staff to identify triggers that might cause a person to become distressed and subsequently become a risk to themselves.

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. Staff had received a robust induction that comprised of online and in person training, shadowing experienced staff and competency spot checks, before supporting people independently.

The provider ensured that if staff required additional training to meet people’s individual needs, they were supported with this. For example, training in the management of epilepsy and positive behaviour approaches. The service sponsored some overseas staff. Staff records showed that staff had undergone safe recruitment checks prior to supporting people.

There were sufficient staff to always provide support, including backup staff in cases of shortages, as some people required 2 members of staff to support their needs.

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. Staff had received a robust induction that comprised of online and in person training, shadowing experienced staff and competency spot checks, before supporting people independently. The provider ensured that if staff required additional training to meet people’s individual needs, they were supported with this. For example, training in the management of epilepsy and positive behaviour approaches. The service sponsored some overseas staff. Staff records showed that staff had undergone safe recruitment checks prior to supporting people. There were sufficient staff to always provide support, including backup staff in cases of shortages, as some people required 2 members of staff to support their 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.

Staff understood the infection prevention control policies and procedures and had undertaken appropriate training. Staff undertook regular cleaning of a person’s home that included high touch areas and safe management of bodily fluids. The provider ensured that all staff had appropriate access to protective equipment and means to safely dispose of waste.

Staff had identified a piece of furniture that had torn material on the arms and reported this for repair or replacement. The manager told us there was a long wait for this and had not considered what could be done in the interim but gave assurances that they would take action.

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.

Staff ensured that medicines kept in a person’s home were stored safely in a locked cupboard and room temperatures were taken daily, to identify any risks to safe storage. Staff documented the date of opening on open medicines and had safe processes for ordering and returning medicines. The provider carried out regular medicines audits, which included reviewing all the administration records on an electronic system. They also undertook medicines administration spot checks.