Three Sisters Care 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 positive culture of safety. Lessons were learnt to continually identify and embed good practice.

There was a system to record accidents and incidents within the service. Staff recorded any accidents and incidents. The management team then investigated and identified the root cause of any accidents and incidents to minimise the risk of recurrence and learn from lessons. This helped to ensure people remained as safe as possible whilst using the service.

We saw staff had contacted the management team for advice when there had been an accident or incident. For example, a person had a fall and was refusing the staff to call the emergency services. Appropriate advice was given to the staff member.

Staff were informed of the outcomes of any investigations and lessons learnt. They were encouraged to report any concerns they come across when providing care and support to people. The provider had a system where staff were alerted of any incidents or accidents to make them aware if there was a change in people’s needs.

The provider worked with people and healthcare partners to maintain safe systems of care, in which safety was managed or monitored.

People's needs were assessed before they started to receive care and support from the service to ensure they could be met. The assessment included all aspects of care, such as the person’s physical, social, psychological and cultural needs. The management team obtained as much information as possible from people, their relatives, and local authorities to ensure they had enough information to enable them to meet people’s needs.

Information gathered from assessment was used to develop care plans and this enabled staff to care and support people in a person centred way.

The management team ensured people received appropriate support as they moved between services, such as from hospital to their home.For example, if a person needed any equipment in their home such as a hoist to help them transfer from bed to their chair. The management team engaged people who used their service in decisions about their care pathways and transitions.

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.

People said they felt safe with the staff. A person said, “Yes, I do.” when we asked them if they felt safe with staff. A relative told us, “I am able to leave [person] with the carers when I go out.”

The provider had policies and procedures in place to inform staff how to deal with any allegations of abuse. Records showed that staff had received training to support their knowledge and understanding of how to keep people safe.

Staff understood what their role and responsibilities were regarding the reporting of safeguarding issues. For example, it was evident from their comments that they knew which external agencies they needed to contact without delay should they witness, be informed, or suspect that people who use the service were being harmed or placed at risk of harm. A member of staff told us, “There is several types of abuse, mental abuse, emotional and physical. If I see abuse, I need to record it then report to my line manager.”

Adult and children safeguarding were discussed during staff meeting and staff supervision. The registered manager was aware of their responsibilities on how to protect people from abuse. We noted they had reported safeguarding concerns to the local authority in a timely manner.

The provider worked with people to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Potential risks about people’s safety were assessed to ensure care and support was planned and delivered in a safe way. Where people were identified at risk, appropriate measures were put in place, for example, when people were at risk of falls. Guidance was in place for staff to follow on what actions to take in relation to managing risks to make sure people remained as safe as possible.

The management team reviewed and updated people’s risk assessments to reflect any changes in their needs, for example, when a person experienced more pain when mobilising following a fall.

Staff monitored people's health and welfare, and they reported any new risk to the management team so actions could be taken to ensure people continued to remain safe.

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 management team carried out an assessment to identify any potential hazards in people’s homes and put measures in place to mitigate those risks. For example, they ensured the environment was safe and free from trip hazards for people as well as for staff.

Any equipment used by staff such as hoists were checked to ensure they operated properly. This helped to ensure people receive safe care from staff.

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.

The registered manager told us people were supported by the same group of staff members who were familiar with their care needs. Staff rotas confirmed this. People were supported by the same staff members unless staff were on leave or not well. This helped with consistency and continuity of care as staff were aware of the needs of people they were caring for.

The provider had an electronic system to monitor if all calls were taking place, and there had not been any missed calls. This helped to ensure people received their visits on time and the office staff could inform people if staff were running late, for example due to traffic on the road.

The provider had increased their staffing level by recruiting staff through the international sponsorship scheme. This had made a positive impact on the local services such as preventing delays in hospital discharges and reducing the waiting lists from local authorities, which were waiting for a care agency to provide care.

The provider had an effective recruitment and selection processes in place to ensure people were protected from the risk of receiving care from suitable staff. We looked at staff recruitment files and found pre-employment checks required had been carried out. We saw the files contained an application form, references, identity checks and evidence of a criminal record check.

People and their relatives felt the staff had the knowledge and skills to look after people who used the service. A person told us, “The staff are very knowledgeable and very helpful.” Another person said, “They (staff) do everything they can do, and they are friendly and helpful.”

The provider had a training programme for all staff to complete to ensure they had the skills to meet people's needs. Staff completed training in a number of key areas such as moving and handling, infection control, fire safety, food hygiene and working in a person-centred way to ensure they were competent in their role. Staff had also undertaken the Oliver McGowan training on learning disability and autism. This helped them to have better skills, knowledge and understanding of the needs for people with a learning disability and/or autistic people. A staff member said, “When I need specific training I can ask, and they (line manager) enrol me.”

New staff received an induction when they started work for the service. This covered a number of areas including training and familiarising themselves with policies and procedures and getting to know people who used the service. Before staff worked on their own, they were given opportunities to shadow experienced staff.

Staff had regular one to one meetings with their line manager to discuss any issues or concerns they may have. During these meetings, a number of areas were discussed such as any training needs or any personal matters that might be affecting the staff work or performance as well as people’s needs. Staff felt well supported by the management team.

The provider had an effective approach to assessing and managing the risk of infection, which is in line with current relevant national guidance.

The provider had systems in place for the monitoring and prevention of infection. There was personal protective equipment such as aprons and gloves available to staff.

Staff had received training in infection control and were aware of their responsibilities in this area. For example, they were aware of the steps to take to prevent the spread of infectious diseases, such as ensuring good hand hygiene. People and relatives told us staff wore the appropriate personal protective equipment when they visited them.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

Some people told us staff assisted them to have their medicines as prescribed, and they were happy with the arrangements. Details about what medicines people were prescribed were within the care records. Medicine administration record sheets contained information about whether people had any allergies.

Medicines administration records we looked at, were all signed appropriately and there were no gaps in signatures. Medicines administration records were audited by the management team to ensure people had received their medicines as prescribed

People were supported with their medicines by staff whose competency to administer people’s medicines had been assessed. This helped to ensure they maintained a good understanding of safe medicines administration.

There were protocols were in place for medicines prescribed on a ‘when required’ basis (PRN), to enable staff give these medicines consistently.