Consider Care Limited

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 newly registered 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. 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 reported there had been no specific accidents or incidents since actively delivering the regulated activity of personal care.

There was a positive culture relating to people’s safety. Both staff and the registered manager were very clear about their role and responsibilities if an incident occurred. Staff stated they would take immediate action to reduce further risks to people safety after an incident had occurred and report and record any incidents. The registered manager explained they would investigate and take action to mitigate further risks to the person. They confirmed their responsibility to monitor incidents for patterns and trends and to notify relevant authorities including CQC.
 

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.

Prior to people starting at the service, the provider carried out an initial assessment with people and their relatives to assess and understand their care and support needs. A service user guide was made available which provided information on how to make a complaint, compliments and provide feedback.

People’s relatives confirmed the service involved them in decisions about people’s care to ensure people’s needs were understood by the service and care was provided based on their needs and preferences.
 

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 registered manager reported there had been no safeguarding incidents since actively delivering the regulated activity of personal care.

We were assured effective safeguarding processes, and practices were in place to safeguard people from abuse. Both staff and the registered manager were clear about the actions they would take in response to any safeguarding concerns, including reporting to the appropriate authorities and notifying CQC. Staff were clear about reporting safeguarding concerns internally and externally if required. A staff member told us, “I would report any abuse straightaway to my manager, and if necessary, I would report it to the police or CQC.”

The registered manager and staff had received training in safeguarding appropriate to their role and responsibility.

People’s relatives confirmed their family member felt safe when staff supported them and felt confident any concerns about people’s safety would be listened to and acted on by the registered manager.
 

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

The provider had not always ensured people’s care records were complete. Care plans and risk assessments included basic information about the management of people’s risks but lacked detailed guidance for staff to follow about how to manage assessed risks to ensure people’s safety. We found some aspects of people’s risk management plans lacked sufficient detail about the specific actions staff should take to manage and mitigate identified risks. For example, there was limited information about the care and management of people’s catheters and how to recognise and escalate concerns about their catheter care.

People’s care records identified the risks associated with the person's lifestyle choices; however, they did not consistently set out all the additional monitoring, observations or interventions staff should undertake to help reduce these risks and support the person's wellbeing such as risks relating to people’s environment.

Staff demonstrated a good understanding of the person's individual needs and risks and worked with people to make informed choices about their care and support needs. For example, staff were able to describe one person’s dietary needs; however, the rationale or the specific food required was not recorded.

People’s care records did not provide staff with detailed information about how staff should safely access people’s homes and the correct use of equipment to help mitigate risks. There was not a consistent approach in ensuring people’s care records had been regularly reviewed and updated with people’s changing needs. Improvements were needed to ensure records provided a clear audit trail of reviews undertaken and any changes made to the person's care and support arrangements. However, we found no negative impact on people. People’s relative reported that staff’s delivery of care was personalised and 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.

Risks to people and staff as a result of their environment had been assessed and were known by staff. However, the control measures required to reduce risk to people and staff had not been documented in detail.
 

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 provider had not always ensured safe recruitment practices had been fully followed. Interview records, staff health information and some employment checks had not been fully explored and documented to demonstrate staff’s suitability for the role or identified required workplace adjustments.

Staff were knowledgeable and skilled to carry out their role. However, the provider had not verified the skills of staff when depending on training given to staff by other care providers. The registered manager frequently monitored and assessed staff care practices, however their documented observations of staff practices were not recorded in detail.

New staff received an induction schedule which included an introduction to the organisation, training and shadowing of experienced staff.
 

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 confirmed they had access to personal protective equipment (PPE) and had been trained in infection prevention and control (IPC). Staff IPC practices were checked by the registered manager.
 

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

The provider had not always ensured people’s medicines care records were complete and accurately reflected people’s medicine support needs, such as who was responsible for ordering and collection of people’s medicines. Protocols were not in place to guide staff on how to manage medicines that been prescribed ‘as required’. Medicines administration records had not been completed in line with people’s prescriptions. However, we found no negative impact on people. Relatives of people reported the staff management of people’s medicines was in line with their prescription and raised no concerns.

The registered manager was responsive to our feedback and reviewed and updated people’s medicine records during the assessment.