BG Healthcare Cumbria Branch

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 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 service 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.

Staff knew how to report safety incidents which were investigated by the management team and immediate actions were taken where required. One staff member told us, “On one occasion, I found a service user on the floor. Although I quickly called the ambulance, reassured the person and reported to the office, I remember feeling panicked and stressed. The management team later reflected with me how I dealt with [the incident]. I felt better and think next time I won't be so stressed.”

Learning from incidents was shared in staff meetings and one-to-one meetings with staff.

The service analysed data from safety events, such as falls, and carried out regular audits of incidents. We observed 1 incident audit led to improved procedures around incident reporting.

The service 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.

People’s care plans contained their pre-admission assessments which included person centred information about their care needs. The service provided condensed care plans, where required, when people required hospital admission.

The service used an electronic call monitoring system which enabled them to track visits. This showed when staff had clocked in and out of a person’s home. Where required, any issues were followed up with people and staff to ensure visits took place at the time they were allocated.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that.

The service investigated safeguarding incidents and shared concerns quickly and appropriately with the relevant authorities, where required.

Staff had received safeguarding training and knew how to identify and report abuse. One staff member told us, “I have had my safeguarding training. If I saw any abuse, I would report it to my manager. I am confident they would take it seriously.” Another staff member told us, “I reported a safeguarding incident to the office. It was then reported to the safeguarding team. I got feedback about the outcome.”

There was an up-to-date safeguarding policy in place.

The service 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.

Where people had risks such as with skin and mobility, records showed staff supporting them safely and in line with their risk assessments. One person told us, “I walk with my frame, but I get the same carer who takes me out and walks near me in case I fall.” Where staff were required to support people with a hoist, they had been trained and always did this in pairs. One healthcare professional, who had observed staff supporting 1 person using a hoist, told us, “[Staff] knew what they were doing, they'd obviously been trained.”

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

Assessments of people’s home environment were made prior to care being delivered. These identified any potential risks to people and staff such as trip hazards and fire safety. One staff member told us, “When I was supporting a new service user, I noticed cigarette related burns on [material]. I discussed this with them, filled out an incident form, and reported to management. A referral was made for support from the fire service, and [person’s] social worker was informed.”

Where people smoked in their own homes, there were risk assessments in place for this, and steps had been followed to reduce the risk of fire, such as fire-retardant equipment.

The service 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 were recruited safely and appropriate background checks were completed, including for staff who were recruited via a sponsorship scheme.

Staff had received the required induction and training to undertake their roles safely. One staff member told us, “I have done all my required training. This is refreshed annually. All mandatory training is done face to face. I had an induction when I started and shadowed [more experienced staff] for a while before working independently.”

There were enough staff to meet people's needs. The service calculated the numbers of staff they needed to meet people’s needs safely.

Team meetings and one-to-one meetings were in place to support staff to provide safe care to people.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Staff were provided with personal protective equipment (PPE) and hand hygiene products. The registered manager told us, “We had issues in the early days with PPE stock supply which we learned from. We now have a robust process, ordering in batches and monitoring stock.”

Staff had received training to support with minimising the risk of infection and information about safe infection prevention and control practices was displayed in the office.

People felt staff followed safe infection prevention and control practices. One person told us, “[Staff] keep my kitchen clean, wear gloves and put them in the peddle bin.”

There was an up-to-date infection prevention and control policy in place.

While people received their medication safely, medicines records were not always effective.

People’s care plans did not always include clear information about what part of the medication administration process they could manage independently and what they required support with.

Systems to ensure people received their medication on time and at the correct intervals were not always effective. For example, staff did not always record accurately the specific time they gave people their pain medication or medication which required to be taken at least 30 minutes before eating. This meant the service could not always be assured people’s medication was effective.

While we were assured people were only given their current prescribed medications, some care plans contained out of date information about their medications.

Medicines administration records (MARs) were used by the service to record the administration of medicines. However specific instructions to guide staff about how and when to take medications were not always available. When we discussed this with the registered manager, they put a plan in place to review people’s medication instructions with the relevant pharmacists.

Processes were in place to ensure the supply of medicines arrived on time.

Supporting information to assist staff in managing medicines showed who was responsible for the ordering, collecting, storage and administering medicines.

Care workers were trained and were assessed as competent to administer medicines safely.