Parry Healthcare Wiltshire

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.

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.

We spoke to 5 staff. They told us they were confident to raise concerns about safety and when they did the provider listened and acted. We were told incidents were discussed during staff meetings and supervision. We saw action plans were developed to identify learning and these were shared during staff meetings and supervision. This meant the provider could be assured they were promoting a culture of safety.

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.

We reviewed care records for 5 people. Care plans contained clear details about people’s needs and risks. Each person had a comprehensive needs assessment, which meant the provider had the information available to ensure they met people’s needs and preferences. The registered manager told us they met with people to complete their needs assessment and develop their care plan. People we spoke to said they had an assessment completed when they first began support with the provider. Comments included, “We had a meeting when we first started”.

We spoke to 5 staff who told us information about new people was shared with them using email and care plans. We were told, “When someone new comes for support a care plan is developed quickly. This meant the provider could be assured that there was continuity of care for people.

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 a safeguarding policy which outlined procedures for staff. Staff had completed safeguarding training and were able to describe how they would identify safeguarding concerns and how to report them. Comments included, “I would report it to the manager or safeguarding lead”. People told us they felt safe. This meant people were supported to live their lives free from harm.

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.

We observed care records for 5 people. These records included clear risk assessments. For example, a person who had reduced mobility was at higher risk of experiencing difficulties with their skin integrity. This risk had been fully assessed and mitigated. Another person was at higher risk of falls. We saw a risk assessment that contained clear guidance for staff to follow to mitigate the risk of these falls for the person. These risk assessments had been reviewed regularly in line with the provider policy. Staff told us they had access to risk assessments and were updated when there were changes. Comments included “Managers inform us if risk assessments have changed” and “We must read them and understand them before visiting”.

People told us they were supported safely. This meant people were supported to manage risks within their lives and staff had the knowledge to support people safely.

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 had assessed people’s environmental risks and identified measures to mitigate these risks. Care records contained details of equipment people used and how to use them. We also saw risks related to people’s environment had been assessed and mitigated. Guidance was available for staff to enable them to use people’s equipment safely, they had completed training in relation to equipment used and their competency had been assessed by a trained staff member. Staff told us they had completed training to enable them to use equipment safely. This meant people were supported safely within their 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.

Staff had completed relevant training to enable them to provide the support needed to meet people’s needs. For example, all staff had completed training in moving and handling, medicines administration and dementia care. Staff’s competency had been checked where required to ensure they were providing support safely and in line with people’s needs.

The provider had an induction policy. Staff told us they had completed an induction when they started this included shadowing competent staff. Comments included “Everything I needed was covered in the induction” and “I was shadowing other staff”.

The provider had a recruitment policy. Recruitment records contained the required documents to safely employ staff. These included references and work history for staff and evidence of a comprehensive interview completed by the Registered Manager. The Registered Manager told us they had been making improvements to the recruitment process which included a focus on recruiting new staff with previous experience. This meant the provider could assure themselves staff had been recruited safely and in line with guidance.

The provider had an induction and supervision policy. We observed induction records and supervision for 5 staff. Supervision records contained discussion in relation to developmental opportunities available to staff and training requirements. The Registered Manager described how support was currently being offered to a staff member to enable them to progress and gain further qualifications. Staff told us they had supervision each month and these were supportive. Comments included “They listen if I need something”. This meant staff received the required training and support to complete their role safely.

People told us they felt staff were trained well. One person said, “They know what they are doing”. This meant people were supported well by staff who had the right skills and knowledge.

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 (IPC) policy to provide guidance to staff. Staff had completed infection prevention control training. Staff told us there was personal protective equipment such as gloves and aprons available to them. Comments included, “If we need gloves, we tell them and they have it for us in the blink of an eye”. People told us staff wore this equipment.

The registered manager told us about the spot checks completed regularly, part of these spot checks included observation of staff compliance with IPC procedures and good practice. Staff told us the registered manager completed spot checks with them to ensure they were working in line with IPC guidance. This meant staff had the equipment and support to reduce the risk of infection to themselves and people they supported.

We saw that infection risks had been assessed and mitigated for people. For example, we saw that a person whose skin was at high risk of infection had a risk assessment which identified this risk and had control measures to reduce the risk for the person. This meant people were supported to control their risk of infection.

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.

During our visit we reviewed the providers training records. Staff had completed training and their competency assessed to administer medicines safely. Staff told us they had received training for administrating medicines and changes in people’s medicines were communicated to them quickly. Comments included, “I get an email or telephone call if peoples medicines have changed”.

The provider completed medicines audits to enable them to identify any shortfalls. We saw that errors in administrations were investigated fully and actions taken to mitigate risk of reoccurrence.

Medicines administration records were fully completed by staff, and contained accurate and detailed information to enable staff to administer medicines safely.

The provider had assessed the risk to people who took medicines with side effects. For example, we saw a risk assessment for a person who was taking a medicine that increased the risk of bleeding, the risk for this had been clearly identified and mitigated. People said they were happy with the support they received with their medicines. This meant people were supported to manage their medicines safely.