Future Home Care Limited (Mansfield)

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

This service scored 78 (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 strong proactive and positive culture of safety, based on openness and complete honesty. Staff actively listened to concerns about safety and thoroughly investigated and reported safety events. Lessons were always learnt to continually identify and embed good practice.

We reviewed documentation which clearly evidenced that incidents were reviewed and analysed, and information gathered about themes and trends which was proactively used to make improvements to people’s lives.

We spoke with the services PBS practitioner about how they use feedback from staff and records who said, “I ask [staff] questions and tell them [I have identified] this is when the person is experiencing highest incidents. That helps me to see how we can change the routine, what can we do differently so a lot of focus of the PBS plan is to develop proactive strategies to avoid incidents from happening. ”We saw that people’s support plans and risk assessment were updated in line with these findings.

We considered closed cultures as part of this assessment. We saw that staff were recording and reporting incidents and safety concerns.

This strong and proactive culture of safety meant people were effectively supported to feel and be safe and issues were promptly addressed.

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 saw that robust assessments of people’s needs were carried out prior to them moving into the service. The PBS practitioner was recruited when the service was being built and carried out initial assessments for people moving to The Maples. They explained the assessment process to us, “I was involved in people’s assessment and was part of all meetings, assessing suitability for the proposed service to find people who would benefit from this type of service, working with external teams, social workers, the multidisciplinary team and attending ward rounds, planning transition and doing transition visits, and getting all necessary info we need. It's really person centred and respecting the persons choices.”

We explored how people were involved in the process. The PBS practitioner carrying out the assessments told us,“[Support plans] Written with collaboration with people themselves, professionals were involved, and after few months when they moved in we started to get to know people more and gain more information.”

Establishing and maintaining safe systems of care through effective partnership working, including involving people them selves, meant people experienced continuity of care which assured their safety and wellbeing.

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.

We saw evidence of concerns being logged, discussed with appropriate external professionals and reported to the local authority safeguarding teams.

Staff we spoke with told us they had received safeguarding training and understood the internal process for recording and reporting safeguarding concerns but also how this was reported externally.

The entire team understood the importance of supporting people using the least restrictive ways of working. We saw where restrictive practice was being used, they were proportionate, necessary and as a last resort and supported by the appropriate legally required documentation. Reduction of restrictive practice was considered, this extended to consideration of the physical environment. One staff member told us, “We wanted to be prepared in the environment so we don’t need to be using physical restraint, so everyone’s got their own bungalow, so already reducing a massive amount of triggers.” Relatives confirmed that this had been positive for their loved one.

This meant people were supported in a way that didn’t infringe on their independence whilst protecting their right to live in safety.

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 management and staff team understood the meaning of people’s communication including changes in their behaviour which was communicating a need or emotional reaction. This understanding was underpinned by clear support plans which clearly documented people’s communication so that people could be supported effectively and understood.

People were enabled to do things that mattered to them whilst maintaining their safety including developing relationships which was confirmed through review of daily records, support plans and feedback from people and relatives.

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 service was purpose built with construction starting in 2022. The buildings have been designed to safely support people who can experience distress behaviours. The PBS practitioner was involved at the initial development of the service and told us, “It was extremely crucial [to be clear] this is not a temporary place, we wanted to make it home so even asking [people] how do you want to decorate things was part of planning.”

We saw evidence that the registered manager and wider team worked with other professionals to ensure that the environment, facilities and technology at The Maples supported people receiving safe care. This was corroborated by professionals in the local authority commissioning team who said, “Due to the nature of the service, there is a need to work with a range of health and social care professionals to reflect on practice and adapt approaches. I find [registered managers] approach open to change and extremely proactive based on advice and decisions explored with the wider multi-disciplinary team.”

We noted that appropriate health and safety checks, including fire safety measures, were carried out at the service. We did note some gaps in records which were addressed with the registered manager at the time and had no detrimental impact on people’s safety at the time. All of these measures supported to control potential risks in the environment and support people’s safety.

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.

We saw that the provider followed a safe recruitment process which included completing appropriate vetting of applicants, securing references and carrying out a Disclosure and Barring Service (DBS) check. A DBS check is a criminal record check conducted which helps employers decide if someone is suitable for a job, especially one involving vulnerable groups of people. 

The registered manager wanted a staff team of individuals not only skilled and appropriately experienced but also that would support people in line with organisational values. They told us, “It [interview] is much better than it was before. You have more of a conversation when people [staff] are talking about scenarios and it’s values based.”

We saw evidence that staff were trained to meet people’s specific needs and received regular supervision with one of the management team to support with staff welfare, development, and ongoing good practice.

Where people received one to one support, we saw a record of people being asked their preferences. For example, one person preferred to have staff with the same interests, and staff’s skills, hobbies and experience had been matched to the needs of the person which enabled people to work towards and achieve their aspirations and potential.

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.

Fridge temperature checks were carried out consistently but had been recorded as over the recommended temperature with no corrective action taken. This was addressed by the registered manager at the time of our assessment.

The shared spaces and people’s individual living environments were kept clean and, where possible, people were involved in maintaining their home environment. We also saw records of people being supported with their personal hygiene.

There was personal protective equipment available to staff, for example gloves, and staff had received training in infection control as well as food safety.

This meant people were protected from the risk of infection impacting their health.

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.

We saw people’s care plans for medicines and risk assessments were detailed and contained clear information for staff to follow including for supporting people with topical medicines. People’s capacity had been assessed and documented, and best interest’s decisions were recorded and evidenced people and their relatives’ involvement in the process.

Medicines were stored safely, and the provider had a clear policy in place to support with safe medicines management. As required medicines had supporting protocols in place to guide staff.

We noted several gaps in recording on medicines administration records, but these had been identified by the management teams weekly audit and investigated. It was found that medicines had not been missed but had not been recorded correctly. We observed that not all actions from issues identified at audit were clearly recorded. This was discussed with the registered manager at the time who provided assurance that this would be addressed with the relevant staff to support improvement.

The registered manager was knowledgeable about Stopping over-medication of people with a learning disability, autism or both (STOMP) and we saw evidence that this was actively considered and followed up as part of medicines reviews. The STOMP project was launched by NHS England in 2016 to improve the quality of life of people with a learning disability, by reducing the harm of inappropriate psychotropic drugs which are used as a “chemical restraint” in place of other more appropriate care and treatments.

This meant people were supported to take the medicines they needed when they needed them to maintain their health and wellbeing.