All Care (UK) Limited Isle of Wight

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

This service scored 69 (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. Managers listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Safety events such as accidents and incidents had been investigated and reported with actions taken to mitigate against recurrence. People and family members confirmed they were updated following accidents and incidents. Formal processes under the duty of candour were followed where necessary.

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. Systems were in place to ensure continuity of care when people commenced a care service and there was involvement of the person, family members and external health or social care professionals. Senior staff undertook a pre-service assessment to confirm the person’s needs could be safely met prior to commencing a care service. This also ensured any required equipment or specialist staff training was identified and in place. If a person needed to be admitted to hospital or transferred to another service the registered manager confirmed relevant information about medicines, health and care needs would be appropriately shared.

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 management team had taken appropriate action in relation to any safeguarding concerns. The local safeguarding team had been informed where required and care staff understood their safeguarding and consent responsibilities. People and family members said they felt safe when receiving care. For example, one person told us, “I do feel safe as they [care staff] are all lovely and they get on with the job. I feel thoroughly spoiled but we are very happy with them.”

The provider generally worked well with people to understand and manage risks. Risk assessments were in place to ensure people’s needs could be safely met and managed but these sometimes lacked all information or were inconsistent with other information in care records. For example, records of care provided for one person detailed the use of moving and handling equipment which was not included in their moving and handling risk assessment or care plan. The registered manager confirmed care staff were using the correct equipment and ensured the risk assessment was updated promptly. Care staff confirmed they had access to risk assessments and said they could always contact the office if they were unsure about anything. There was a business continuity plan which identified people who required priority of calls based on individual risk.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Comprehensive risk assessments associated with the person’s home environment were completed before the service started supporting people. Where risks were identified discussions were held with people to help manage these risks. Assessments noted if smoke or C02 detectors were in place but not who was responsible for checking these were working on a regular basis. The registered manager agreed to add this information to the assessments. The registered manager knew how to access specific equipment should this be required and staff confirmed they had received training to use equipment safely.

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. Some people and family members told us they had continuity of care staff however, others said there was a lack of staff continuity. This was also reflected in records of staff visits. For some people these showed a high continuity of staff and for others a lot of different staff attending over the week. The registered manager told us they aimed to have a small team of care staff working with each person although on occasions other staff would need to be allocated. People, family members and visit records confirmed staff generally stayed for the full length of the call and only left early with the person’s expressed agreement when all tasks were completed.

Training was up to date and covered all relevant topics. Staff were positive about their training. Newer staff confirmed that the training had helped them and they had undertaken shadow shifts prior to working on their own.

There were appropriate pre-employment processes and records viewed showed all necessary checks had been completed.

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 had received food hygiene and infection control training. People and family members confirmed Personal Protective Equipment (PPE) was used where needed. The management team understood the actions they should take should there be a specific infection risk or concern for an individual person.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. We identified some Medicines Administration Records had been signed as administered when medicine may not have been available or were not a medicine for administration but a reminder for staff about a person’s allergies. It was also unclear if some prescribed topical creams were available or declined or not required due to inconsistent recording. Where people were prescribed as required medicines, such as for pain or constipation, there was a lack of guidance for staff as to when these should be administered or where more than one was prescribed which should be administered. The registered manager took prompt action to make the necessary improvements to staff recording of medicines administration. Medicines were administered by staff who have received training and competency assessments. People told us they were happy with the way staff supported them with their medicines.