New Support Care Limited

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• 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.

We have not awarded this service a score for Safe.

Find out about when we will not publish a key question score and what we look at when we assess Safe.

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.

Learning was discussed during staff meetings. We spoke to 5 staff. They told us they were confident raising concerns about safety and when they did, they felt the registered manager listened to them. This meant the provider could be assured they were promoting a culture of learning and safety.

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.

Care plans contained a comprehensive needs assessment which was completed by the registered manager before the person’s support started. This assessment contained details of health care professionals involved with the person. The registered manager told us they met with people face to face to complete the assessment, and this could take more than one visit to ensure all of the person’s need were identified.

Relatives told us they were involved in providing information for the care plan.

Staff told us a care plan was completed and shared with them before they began supporting the person. This meant the person was supported safely when requiring input from different services.

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 provider had systems to monitor safeguarding concerns. Staff had received training to enable them to identify safeguarding concerns. Staff we spoke with were able to describe how they would recognise and raise concerns. They told us, “I would contact the manger and access documents, any safeguarding concern would be reported to the local authority and the care quality commission (CQC)”. People told us, “One of the carers suggested adding calories to support [relative] as their weight was becoming a concern”.

Staff we spoke with had good knowledge of the mental capacity act and understood how to support people who may lack capacity. Comments included, “We support the person to make a decision in their best interest”, and “we don’t assume a person lacks capacity and they are able to make unwise decisions”. This meant people were safeguarded against bullying harassment and abuse.

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. Care plans contained comprehensive risk assessments that identified and mitigated risk. These were reviewed in line with the provider policy. Staff had a good knowledge of people’s risks and told us they had access to risk assessments and were able to give feedback to the registered manager. Comments included, “Everything we need to know about the person is on the system,” and “risks are clearly described”. A relative told us they felt their family member was supported safely. This meant the provider could be assured that that people’s risks were identified and mitigated and they were supported to remain safe.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. We saw comprehensive environmental risk assessments. For example, we saw a clear risk assessment that identified and mitigated risk in the event of a fire, this included instructions for staff and audits of the environment. The registered manager told us they completed practice fire evacuations and had tested to ensure a profiling bed would fit through doorways to aid quick evacuation. Staff were able to describe what they would do to support the person in the event of a fire. Staff told us. “We test the smoke alarms and practice evacuation”.

Risk assessments had also been completed for the use of equipment. Details were included on how to use the equipment safely. Staff were able to describe how they would use equipment such as a hoist and how they regularly checked equipment. They were confident in where they could find the information related to this equipment as well as details of who to contact if there were any difficulties with the equipment. Comments included, “Equipment check is a daily task,” and “the registered manager reports faults to [equipment provider]”. This meant the provider could be assured that staff had all the information and knowledge to support people safely within their environment.

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 completed an induction which included shadowing more experienced staff and received ongoing training. The provider completed competency assessments with staff in line with good practice guidelines. The registered manager told us they were in the process of training some staff who could complete ongoing refresher training with other staff to ensure training remained up to date and effective. Staff had completed training to enable them to support people with their specific needs. This included training to support areas such as dementia and people with learning disabilities and autism. Staff told us, “The training we are put through boosts our confidence”. A relative told us, “Staff are competent and know what they are doing.” This meant staff were supported to provide safe and effective care to people.

We viewed 4 staff files which included relevant records to ensure staff were recruited safely. However, we found one record with missing information regarding references, this meant the provider could not be assured the person had been recruited safely When we raised this with the registered manager, they took immediate action to rectify this.

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 registered manager told us they completed spot checks regularly with staff. These checks included a check to ensure that staff were using good infection prevention practices such as wearing gloves and washing hands. Staff told us they had access to personal protective equipment (PPE) such as gloves and aprons and had received training to support their knowledge. One staff member told us, “We have plenty of gloves and aprons”. A relative told us, “They use gloves and aprons and dispose of them appropriately”. This meant the provider could be assured that staff were working in line with guidelines and that people were supported in a way that minimised the risk of infection to them.

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. Care plans contained details of people’s medicines and how they liked to take them. The records noted possible side effects and specific instructions. For example, one medicine required the person to avoid grapefruit, and this was clearly recorded in their records. Topical creams had instructions including a pictorial record to ensure staff knew where to apply the cream.

Medicine administration records (MAR) had been completed for each administration. The provider had completed regular audits of the medicines, these audits contained clear detail of areas identified and actions taken to address the findings. Staff had received training to ensure they could safely administer medicines.

Staff had a strong knowledge of the medicines they were administering and were able to describe how the person preferred their medicines and what support they needed. Staff told us, “We have competency assessments,” and “we have a one-to-one assessment before we are allowed to administer medicines”. Relatives told us staff supported their relative well with medicines. This meant the provider could be assured that people’s medicines were managed safely in line with national guidance.

However, as required medicines did not always have clear guidance for staff to follow, we saw records for as required medicines that did not have a protocol that clearly identified the quantity to be taken. For example, prescribed pain relief instructions stated to take 1 or 2. However, there was no guidance for staff to know when to give 1 or when to give 2. This meant there was a risk of people not receiving the required dose of medicine such as pain relief. We spoke to the staff member who over saw the medicines, and they took action to rectify this.