Zi Mat Ltd

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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 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 were aware of how to report safety concerns.

People knew how to raise concerns with the service. One person told us, “I have the numbers for the office, no problem, I receive a monthly visit from the office to check I am happy with the service.”

Staff told us they knew the process for reporting concerns. Comments included, “Firstly, inform the office and call the manager. We have a portal for any documentation,” and “If it’s serious, I would call the emergency services. After that, I would always call the manager. We have an incident form we have to fill out. I haven’t had to complete it, but it was covered in the training.”

Systems were in place to report and learn from incidents should they occur , the service had not had any accidents or incidents. However, during the inspection, the registered manager identified the matrix of concern tracker was not being used effectively, this meant not all concerns were documented or investigated.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. People told us their support went smoothly when they received support from the service.

Systems were in place to capture information as part of the pre-assessment process. This helped to determine if the service could safely support people and meet their needs. As part of the transition process with the service, the provider spoke to people’s relatives, when needed. People told us, “The manager visited to complete my care plan” and “I was visited to set up a care plan, not updated yet, happy with the current 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.

Staff had received safeguarding training and were aware of their responsibilities to keep people safe from harm. Staff told us how they would report a safeguarding concern. Comments included, “Usually, I would go to my manager, or I would contact CQC or the local authority. Different types of abuse include physical, psychological, neglect and discrimination. Sometimes in training we see financial abuse or family abuse. If we see that, we have to report it as a safeguarding issue,” and “I know there is a safeguarding phone number, the local authority, a helpline, and I can speak to CQC.”

The provider had not had to raise any safeguarding concerns. The registered manager was aware of how to share concerns and told us, “I expect carers to inform me, and I would report to CQC, local authority or police.”

People told us they felt safe using the service. Comments included, “I feel very safe as I have known the carers a long time and we know each other well, I never feel worried” and “I feel very safe and comfortable with the carers.”

The provider did not always work well with people to understand and manage risks. Risks to people had been assessed, however some risk assessments required additional detail to support staff in fully understanding the risk.

For example, one person’s moving and handling risk assessment said staff were to support with certain manoeuvres but did not contain clear guidance on how the manoeuvres were carried out. Another person’s risk assessment said they were able to walk using mobility aids, their care plan said they required support from two carers and used a hoist to transfer.

People who had specific risks such as diabetes had a risk assessment in place which contained clear guidance on signs and symptoms of high or low blood sugars and what actions staff needed to take.

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

People had environmental risk assessments in place which included a full review of all potential hazards present in people’s home. Staff had access to details on where the stopcock, fuse box and gas shut off valve were located.

People’s PEEP (personal emergency evacuation plan) did not contain clear guidance for staff on how to support them in the event of a fire. However, staff knew people well and knew the support people required. We informed the registered manager who was responsive to our findings.

The provider did not always make sure there were enough qualified, skilled and experienced staff.

Recruitment checks were carried out by the provider to ensure staff were safe to work with people. Pre-employment checks included a job application form, an interview, and references.

One staff members reference date did not match the employment dates on their application form, the provider’s recruitment process had not identified this.

All staff were required to complete an enhanced Disclosure and Barring Service (DBS) check before starting employment. A DBS check provided information about any convictions and cautions held by police. The provider completed a risk assessment for any criminal convictions shown on a DBS, and for staff who were waiting for their DBS. However, risk assessments did not contain details of the measures put in place to mitigate risk.

People living in different geographical locations were supported by the provider, however, the provider did not have sufficient staff in each area. This meant in the event of absence, there were not sufficient staff to support people. The provider told us they were looking into this.

New staff had an induction which helped them understand the role, training was regularly updated. People told us they felt staff were well trained and saw regular carers. Comments included, “I see the same staff of about 5, all well trained for my needs.”

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 an infection prevention control policy and staff received regular training on infection control. Supplies of personal protective equipment (PPE) were available to staff. When staff were unable to visit the office to collect PPE, the provider arranged for PPE to be delivered.

One person told us, “The service orders it for me and sends it to me by delivery.” Management carried out spot checks to make sure staff were using PPE correctly.

People told us staff regularly used PPE when delivering care. Comments included, “[Staff] always wear appropriate PPE” and “PPE worn as necessary, masks if I have a cold.”

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

Systems and processes were in place for the safe management of medicines, however, not all management staff were aware of the procedures they were expected to follow. On the day of the inspection, a PRN (when required) protocol was not available. Following the inspection, the provider supplied the protocol, however, it was unclear how this was being used, as the document did not contain a start date.

One person’s care plan contained conflicting information on the level of support they required with managing their medicines.

All staff had received medicines training. However, not all staff had been assessed as competent to administer medication. The registered manager told us this was because not all people using the service required support with medicines. This meant if people’s medication needs changed, staff were not trained to support them.

Staff who were signed off to administer medicines were able to clearly describe how to support people with their medicines safely, comments included, “Before providing any medication, make sure it’s safe to be administered, check the MAR chart, recognise the side effects and errors. Important it has to be written in the MAR chart” and “PRN you can administer, it’s on a needs basis, if they need it, they take it, document on the mar chart, have to report it to the manager.”