Local Solutions Liverpool Branch

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 inspection since the provider changed registered address. Their rating at the last inspection was requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

At the last inspection the provider was in breach of regulations in relation to medicine. Improvements were found at this inspection and the provider was no longer in breach of this regulation.

This service scored 72 (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. For example a tracker was used to monitor safeguarding concerns, complaints, missed visits, and medication errors. Lessons learned were documented and shared with staff, and actions such as training, spot checks, and care plan updates were implemented. Following a series of missed medication incidents involving 1 person, the provider arranged refresher training and introduced additional checks to prevent recurrence.

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. People’s care plans were reviewed regularly and included key information to support safe care and staff were aware of people’s needs.

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. Staff understood their safeguarding responsibilities and were confident in reporting concerns. They described safeguarding as protecting people’s health, wellbeing, and rights. All safeguarding concerns were appropriately reported to the local authority or CQC, with internal investigations and follow-up actions taken. Staff received safeguarding training and demonstrated a good understanding of how to keep people safe from harm. There was no person subject to a Deprivation of Liberty Safeguarding. Unlike care homes or hospitals (where DoLS applies), community DoLS must be authorised by the Court of Protection.

The provider did work well with people to understand and manage risks. However, some information needed further improvement. For example, 1 person with epilepsy had no clear guidance on managing seizures, and another with a history of falls had limited information on preventative measures or use of falls aids. In some cases, risk assessments were not updated to reflect changes in people’s needs, such as sensory impairments or mental health triggers. We raised this with the provider, who has since reviewed and update the relevant documentation.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Environmental risks were assessed and documented in care plans. For example, 1 person’s care plan included measures to support safe use of a commode due to the layout of their home. Staff were aware of the importance of ensuring people wore lifeline pendants and used 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. Staff rotas were consistent, and people appreciated having regular carers. Some staff noted weekends could be more difficult if someone went off sick but they ensured all calls were covered.

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 followed infection prevention and control procedures, including the use of personal protective equipment (PPE). Care plans included guidance on hygiene and infection control, such as applying prescribed creams and maintaining kitchen cleanliness. People told us their homes were left clean and tidy after visits.

The provider now made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. For example, staff now safely supported people with medication administration and recorded this on electronic systems. However, 1 care plan lacked clarity around 1 person’s PRN medication. The provider was aware of these issues and had taken steps to address them through care plan reviews and staff training.