Closer Care Services - Main Office

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. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

The provider was previously in breach of the legal regulation in relation to people’s safe care and treatment and the ways people’s medicines were managed safely. Improvements were found at this assessment and the provider was no longer in breach of this regulation.

This service scored 75 (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 provider had improved care plans and risk assessments since the last inspection. This helped them identify and manage risks to people's health and safety. When accidents or incidents happened which could not have been predicted, leaders looked into what had happened, made changes where needed, and shared learning with staff to help keep people safe in the future.

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.

Since the last inspection, the service had introduced new assessment forms to make sure important information about people's needs, risks and preferences was recorded clearly. This meant staff had up-to-date information about people and could share it with other healthcare professionals, such as paramedics, if someone needed to go to hospital.

The provider made sure they gathered all the information they needed about a person before providing care. One person said, "The manager came to see me to discuss everything that I needed and made a note of all my requirements."

People and relatives told us staff worked well with other healthcare professionals when people became unwell. The registered manager told us they arranged for a staff member to stay with a person while they waited for paramedics, so they were not left alone. One person said, "I had an occasion [recently] to ring for emergency care, and the carer was here when I did that, and instead of just staying for the length of time she was booked for, she stayed until the assistance arrived, that was so comforting. And apparently that was a standard procedure for Closer Care."

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.

People told us they felt safe when staff delivered their care. Relatives told us the staff looked after their family members kindly and safely. One person said, "All the carers are very good, and they look after me very well."

Staff had training in how to keep people safe, and what to do if they were worried about a person. A staff member said, "Safeguarding is protecting people from abuse and neglect and harm.”

If concerns were raised, the registered manager knew who they needed to report these to, and that this should be done quickly.

The provider had an updated safeguarding policy in place, which all staff could access.

The provider 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.

Since the last inspection, the provider had started to use a new digital care planning system. This system allowed the registered manager to include specific information about people’s health risks, and included space to clearly write the steps staff should follow to reduce the risks.

For example, 1 person had a catheter (a flexible tube used to empty the bladder) and their care plan and risk assessment had clear information for staff to help them identify a potential urinary tract infection (UTI) and what to do if they were worried the catheter was not working properly.

Where people had a diagnosis of diabetes, we found specific diabetic care plans were in place with advice for staff to follow if the person became unwell with their diabetes.

People were involved in discussions about their care, and the registered manager regularly reviewed people’s care plan records with them to make sure they were up to date.

The registered manager told us they had arranged more training for staff since the last inspection. Staff told us they had completed the additional training and now felt more confident.

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

Since the last inspection, the provider had created specific fire risk forms for each person. These contained personalised information so staff knew what to do if a fire started in the person’s home during a care visit. People and their relatives had helped to complete these forms.

The registered manager completed environmental risk assessments in people’s homes to make sure there was no hazards such as trip hazards, uneven flooring, or poor lighting.

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.

Since the last inspection, the registered manager had sourced training for staff in different languages, such as Hindi and Gujarati. This meant all staff could complete training in their preferred language. The registered manager told us documents could be translated into alternative languages for staff if required.

Staff completed the training they required and this was updated and refreshed. This included face to face training as well as online training.

At this inspection, staff were able to talk confidently about training they had completed, and what they had learnt. Staff also told us the registered manager had arranged training for them on how best to complete the daily notes which recorded what tasks had been completed and how the person was at each care visit. We found an improvement in daily notes at this inspection.

There were enough staff to look people. People told us staff arrived on time and stayed for the full length of the visit. One person explained, "As far as Closer Care is concerned, I've got regular staff that come, at regular times, if there are any issues on their side, they let me know and we have a discussion about it." The registered manager said, “If a carer is running late, we still give a courtesy call even if it’s within 15 minutes as we know people are sat there waiting for carers. It takes us 30 seconds but eases their minds also."

The registered manager completed regular supervisions with staff, as well as annual appraisals. This meant staff had access to ongoing support from the registered manager.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

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 registered manager made sure medicines were managed safely. People who needed help from staff to take their medicine had clear care records which described what medicine should be taken, at what time, and included any side effects staff should be aware of.

The registered manager had created detailed medicine records for people who took ‘as required’ medicines. This meant staff now had clear instructions on when they should offer these medicines, and the correct dose to give.

Staff had completed training in administering medicine safely.

The registered manager completed regular audits to check staff administered medicines safely and as prescribed. We saw evidence to demonstrate the registered manager took swift action to investigate and resolved any minor concerns identified by the audit.