Sunderland

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 good. This meant people were safe and protected from avoidable harm.

This service scored 66 (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 provider 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. Systems were in place to ensure there was continuity of care, including when people moved between different services. The provider visited people to assess people’s needs and agree the level of support people needed. New staff were introduced to people, and information shared with staff about people’s care needs via an electronic system.

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. Staff and leaders received training in safeguarding adults. Staff members’ comments included, “I have done safeguarding training” and “If I had any concerns, I would report them to the registered manager.” A safeguarding record of incidents was kept, but it did not include when safeguarding incidents were reported to the relevant local authority. It also did not record the outcome and investigation report, so audits could identify any themes and trends. This was immediately addressed by the provider.

The provider had completed risk assessments for people and had put some measures in place to mitigate those risks. However, not all risk had been identified, with the identified risk transferred to a care plan with detail for staff to reduce those risks. We discussed this with the provider, who took immediate action to make improvements. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

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 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 told us rosters were well managed, and they worked in the same geographical area, so did not need to travel far between calls. Staff told us they received training and ongoing support from the service to carry out their roles safely. Staff comments included, “I work with the same people”, “We get training,” “I receive face to face and online training”, “There is plenty of training” and “I shadowed staff and had induction training before I worked on my own.”

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. The service was not currently supporting people with medicine administration. However, a medicine care plan, Medicine Administration Record [MAR] and body map were not in place for a person who was prescribed a topical cream. This was addressed immediately by the provider, and they were put in place to ensure there was a record and staff had accurate information for the application of the cream. 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 staff member commented, “I have done safe handling of medicines training.”