Firstchoice Consultancy 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

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained 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.

The registered manager told us since the person using the service there had not been any significant accidents or incidents, safeguarding allegations or complaints received. People we spoke with also confirmed this with us.

The service had a policy for staff to follow should things go wrong, and we saw there was an incident form template to use should staff need to. The registered manager and staff we spoke with demonstrated a good understanding of how to respond to any such incident. Relevant policies provided guidance about how to respond if necessary.

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 person moved between different services.

The people’s needs were assessed before they started using the service to ensure the service was able to meet them. This helped to achieve a smooth transition from one setting to another. People were involved in the assessment process, so their views and wishes were taken into account. A person told us, “The registered manager came to do an assessment at the beginning. Everything was fine and I had no problem.”

Staff demonstrated good knowledge about how to provide care and support when the people started using their service.

The provider worked with the 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 told us they felt safe receiving a service from the provider and also confirmed they knew how to raise complaints or concerns. A person said, “I know the registered manager’s phone number and email address. There has been no accident or incident and safeguarding issues.”

The registered manager told us there had not been any safeguarding allegations since the person started receiving care and support. Appropriate systems were in place to help protect the person from abuse and neglect. The provider had relevant policies including policies on safeguarding adults. The safeguarding policy made clear the providers responsibility for reporting any allegations of abuse to the local authority and Care Quality Commission.

Staff knew about safeguarding processes and had received training in this area. Staff told us that they received safeguarding training. A staff member told us, “I regularly discuss with my boss about the person’s needs and if I have any concerns. There have not been any safeguarding concerns. If there will be any concerns, I will tell my boss. If she will not listen to my concerns, I will report it to CQC.”

The provider did not always work well with the people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled them to do the things that mattered to them.

The registered manager and the staff confirmed that a person using the service was being supported with preparing and cooking food but there was no risk assessment completed for them to use the kitchen, including using the equipment safely. However, we found no evidence the person had been harmed by these risks. Following our recommendations, the provider completed a detailed risk assessment.

The provider completed other relevant risk assessments to keep the people safe. These included information about the risks the person faced and action to take to mitigate those risks. Risks covered included those associated with moving and handling, personal care and environment. This covered lighting, flooring, trip hazards and appliances at the property where care was provided.

Staff were aware of the risks to people and the steps they would take to keep them safe from harm. A staff member told us, “[Person] uses mobility aid to move around, and I make sure that the floor is clutter free for them to move around safely.”

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

The provider had carried out environmental assessments which involved risk assessments relating to the environment which covered things such as slip and trip and hazards, electrical appliances, and gas appliances, to ensure support was provided in a safe way.

The provider did not always make sure there were enough qualified, skilled and experienced staff. They did not always make sure staff received effective support, supervision and development. They did not always work together well to provide safe care that met people’s individual needs.

The registered manager told us as they only had 1 person using the service. It was easy to monitor staff punctuality. There was a staff rota in place. The registered manager told us that if the service grew, they had plans to introduce a system of electronic monitoring to check staff punctuality and that staff stayed for the full amount of time.

The person using the service confirmed care visits were regularly carried out by the same staff member, so there was continuity of care.

The registered manager told us they had one to one informal meeting with staff but did not keep records of those meetings. This was contrary to the providers supervision policy which stated supervision would be undertaken the first week of employment and at every 3 months intervals. We found the same issues in our last inspection and recommend keeping records of supervision meetings so both parties have a clear record of what was discussed and of any agreed action. The registered manager acknowledged this and gave us assurances to address this.

There were robust and safe recruitment practices to make sure that all staff were suitably experienced, competent and able to carry out their role. Disclosure and Barring Service (DBS) checks were carried out. These provide information including details about convictions and cautions held on the police national computer. The information helps employers make safer recruitment decisions.

All the staff undertook a comprehensive induction programme which included inductions, mandatory trainings and refresher trainings courses.

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 had a process in relation to managing infection prevention and control. The provider had a policy in place on infection prevention and control to provide a clear guidance to staff in this area. Staff confirmed they had completed training in infection prevention and control and demonstrated a good understating of the measures to manage and prevent the spread of infection. Staff were provided with personal protective equipment [PPE].

Staff collected PPE from the head office. Staff told us they had access to enough PPE to keep the person safe when providing care.

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.

The person using the service was assessed by the provider for self-administration of medicines. The person confirmed with us they manage their own medicines themselves. The staff only reminded the person whether they had taken their medicines.

There was a medicine policy in place which covered the obtaining, administration and recording of medicines. The policy made clear that if staff did provide support with medicines, they would be required to undertake training in this area beforehand. Staff had received training in medicines administration.