Breeze Support Solutions

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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 service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 72 (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 demonstrated a positive learning culture, with staff encouraged to reflect on practice.

Accidents and incidents were recorded using an electronic care management system, which enabled events and outcomes to be reviewed in real time. Information was monitored and analysed and action taken to help prevent any recurrence.

Staff worked effectively with partner agencies to support safe systems, pathways and transitions.

The provider carried out preassessments before care commenced to help ensure people’s needs could be met safely and appropriately. Staff worked in a coordinated way with health and social care professionals and information was shared promptly when concerns arose. A health and social care professional provided positive feedback and stated, “Any immediate concerns are reported promptly and their care coordination and multi-disciplinary team working are excellent.”

People were supported to live safely and felt protected from abuse and avoidable harm. Staff had completed safeguarding training appropriate to their role. Staff confirmed they had no safeguarding concerns about practice within the service and there had been no recent safeguarding incidents. This was confirmed by the local authority.

People and their relatives told us people were safe. One relative told us, “Yes, she is safe. I think that the time that they are there with her, which is every four hours she is safe because she gets her medication when she needs it. She has the same carers so she knows them well. It is a much better service than the one she had before this one.”

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. When people receive care and treatment in their own homes an application must be made to the Court of Protection for them to authorise people to be deprived of their liberty.

There were no Court of Protection deprivation of liberty applications in progress or authorised at the time of the assessment, since people using the service had capacity to make decisions about their care.

Risks to people’s safety were identified, assessed, and managed appropriately to reduce the risk of harm. People and their relatives told us they felt confident in the service’s approach to managing risks and keeping people safe. One relative said, “I have had no concerns about safety at all because the carers are so good.”

Staff used personalised risk management strategies that promoted independence while keeping people safe. For example, staff were aware that 1 person preferred to shower independently but was at increased risk of falling. Additional support had been put in place, including an extra visit to provide oversight during showering, staff remained close by and prompted the person to wear their falls detection watch.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care and promoted people’s independence. We also read how staff adapted the environment to meet an individual’s changing needs, in line with their wishes, comfort and independence.

The provider made sure there were enough qualified, skilled and experienced staff, whoreceived effective support, supervision and development. They worked together well to providesafe care that met people’s individual needs.

People and relatives told us they felt staff were well trained and competent to carry out their roles. One person told us, “The carers are trained well enough to do the jobs they need to do for me.” An induction and training programme was in place and staff had completed training to support people safely and effectively. Staff had also registered for learning disability and autism training. One relative told us they had, on occasion, found it a little difficult to understand some staff whose first language was not English; however, this had not affected the quality of care provided. Managers explained they were actively reviewing sources of support available to further improve communication. Staff received supervision and support to help them carry out their duties and maintain safe practice.

Most people felt there were enough staff to meet their needs. One relative commented that management staff sometimes supported with care duties which they felt indicated staffing pressures. We discussed this feedback with the registered manager, who explained that both he and the nominated individual chose to remain involved in direct care and visits to maintain oversight and check care was being delivered as planned.

There had been no missed visits and people told us staff arrived as planned. People and relatives described good communication and reported they could access the provider’s electronic system to see when staff were due to arrive and when visits were completed, which provided reassurance. One relative said, “They arrive on time. I can check times on the app. There have been no missed calls. They have never been late. They send me a notification to me when they are on the way to his house. I can’t fault the service; they communicate so well.”

Recruitment checks were carried out before staff worked at the service. The service was working with their electronic care management supplier to ensure records clearly evidenced when certain checks had been carried out.

The service was small, and recruitment was ongoing. The nominated individual told us they were taking a measured approach to growth, prioritising consolidation and quality of care rather than rapid expansion. They said, “Growth comes as part of the business, but to us it’s about the quality of care.”

The provider assessed and managed the risk of infection to help prevent the spread of infection and protect people’s health.

Staff had access to appropriate personal protective equipment (PPE). People and relatives told us they were confident that staff followed safe and hygienic practices. One relative said, “Gloves and aprons are worn when they are with her.” Staff attended the office to collect additional PPE when required, which helped ensure supplies were readily available to support safe care delivery.

Whilst a system was in place to manage medicines, we identified some inconsistencies within electronic medicines records. We did not find any negative impact on people’s safety or care. The registered manager told us they were liaising with the electronic care management supplier to address these recording issues and improve consistency across documentation. The provider was also in the process of reviewing and updating their medicines policy to strengthen guidance for staff and support clearer medicines governance.

People and relatives told us that medicines were managed safely and reliably. One relative said, “He has it morning and night. They put it in their notes that it has been administered.”