Cherish Support Services Ltd

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

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 promoted a proactive, open and honest culture of safety, where staff understood that safety was everyone's responsibility. Staff felt confident to raise concerns, incidents and near misses without fear of blame.

Safety events were investigated appropriately and learning from any incidents was used to improve care planning, risk management, staff training and working practices. The registered manager shared learning through team meetings, supervision and staff communication, helping to embed good practice across the service.

People and relatives felt able to raise concerns and provide feedback and were confident these would be acted upon. Information from incidents, complaints, audits and feedback was reviewed to identify themes, trends and opportunities for improvement.

The provider demonstrated a commitment to continuous learning and quality improvement, using lessons learnt to strengthen the safety and quality of care. The registered manager told us, “At present, we have not had any reportable incidents that we can learn from, but we regularly encourage all of our staff to report any concerns or near misses immediately so that we can record them and learn from them. We also use our audits, supervisions, training, guidance and feedback from service users to continuously improve the care that we provide."

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.

The provider worked effectively with other healthcare professionals to support people safely. Care records contained clear information about people's needs, risks and the professionals involved in their care. Staff understood when health concerns needed to be escalated to healthcare services and sought professional advice promptly.

Care plans and risk assessments were reviewed and updated when people's needs changed or new professional advice was received. People and their relatives told us staff communicated well and kept them informed about changes affecting their care. Staff worked collaboratively with partners across health and social care, promoting a joined-up approach to care delivery.

The provider had systems to support safe transitions between services, including hospital admissions, discharges and involvement from new healthcare providers. Relevant information, such as care needs, risks, medicines and support arrangements, was shared appropriately to maintain continuity of care.

The registered manager maintained oversight through regular reviews, monitoring and communication with external professionals, and explained in detail about how a new package of care was received; they told us, “We will never take on a package of care unless we are confident we have the skills, trained staff and the capacity to meet the service user’s needs safely.”

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 provider had systems in place which promoted people's human rights and ensured they were protected from discrimination. Staff had access to current safeguarding policies and procedures, supported by oversight from the registered manager. Staff demonstrated a good understanding of recognising signs of abuse, safeguarding responsibilities and reporting procedures.

Staff received appropriate safeguarding training relevant to their role and training records were up to date. Staff were encouraged to speak up and raise concerns and felt confident that concerns would be listened to and acted upon. Any concerns relating to staff practice were monitored and discussed through supervision and management oversight.

The provider shared concerns quickly and appropriately. The registered manager told us, “Staff are continuously advised during supervisions and staff meetings that any concern should be reported straightaway, recorded accurately and these concerns would be referred to Bolton Council and other relevant authorities such as the police where required. We would take any action needed to keep the service user safe as that is our main priority. Any concerns would be reviewed so that we can identify learning and improve practice.”

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.

The provider had effective systems in place to identify, assess and manage risks. Risk assessments were personalised, proportionate and regularly reviewed, covering areas such as medication, mobility, skin integrity, continence, and environmental risks; these outlined potential risks and the actions staff needed to take to keep people safe.

People and their relatives were confident risks were well managed, and staff demonstrated the skills and knowledge needed to provide safe care. No one using the service was subject to restrictive interventions. Staff were given sufficient time to understand people's needs and risk management plans, and the registered manager regularly monitored staff practice to ensure risks were managed consistently and in line with good practice.

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

The provider effectively identified and managed environmental risks within people’s homes to support the delivery of safe care. Before commencing care, staff completed an assessment of the home environment, identifying potential hazards and measures to reduce risks. Individualised environmental care plans were developed for people, covering areas such as fire safety, access, lighting, flooring, stairs, furniture, utilities and infection prevention.

People had access to the equipment they needed to remain safe and independent, and any specialist equipment was appropriately maintained by the relevant supplying organisation. Risks associated with people’s homes and the use of equipment had been assessed and monitored, helping to keep both people and staff safe. There were no concerns raised by people or their relatives about the safety of the care environment.

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.

People and relatives told us staff arrived on time and care was delivered reliably by staff who knew them well. Staffing arrangements were flexible and responsive, helping to ensure continuity of care and minimise missed or delayed visits.

Staff were recruited safely and completed the training required for their roles. Training records demonstrated staff received regular updates in key areas, and staff told us they felt well supported to carry out their responsibilities. Supervision meetings, spot checks and ongoing communication provided opportunities for staff to discuss their practice, reflect on their work and identify further development needs.

Staff worked collaboratively, sharing information effectively and escalating concerns appropriately to ensure people received safe, person-centred care. There was a positive and supportive culture within the service.

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.

There was an effective approach to assessing and managing the risk of infection, which was in line with current relevant national guidance. People were protected as much as possible from the risk of infection because people’s homes and equipment were kept clean and hygienic.

The cleanliness of people’s homes was monitored to ensure standards were maintained. The use of personal protective equipment (PPE) by staff was observed by the registered manager as part of staff spot check visits.

There was an up-to-date policy on the control of infection (IPC) which staff could refer to if needed. Staff were trained in IPC and had access to PPE. Staff told us there was enough readily available PPE for their use. People and relatives had no concerns over staff use of PPE.

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Staff received training and had their competence regularly assessed around medicine management to ensure they handled and gave people their medicines safely.

Checks of people’s medicine records were regularly carried out by the registered manager to ensure people received their medicines as prescribed. There were systems in place to record any medicine errors to enable learning and improvement.

Staff used an electronic system with Medicine Administration Record (MAR) charts to refer to and make records when giving people their medicines. However, for some of their medicines on the charts we noted the written instructions needed further clarification to ensure the medicines were given safely. We discussed this with the registered manager who later confirmed changes to the written instructions had immediately been made as appropriate.

The service had considered the risks around people’s medicines. There was information available about people’s medicines to ensure staff administered them safely and consistently. There was guidance available for staff to administer “as needed” medicines (PRN). There was additional information in place to ensure topical medicines and prescribed pain-relief skin patches were given to people safely.