Goldsmith Personnel Limited (East London)

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 good. At this assessment the rating has remained 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 shared lessons learned from incidents and accidents with staff to help reduce future risk. Staff confirmed that learning was appropriately shared through team meetings and supervision. A member of staff reported, “Yes, lessons learned are further discussed during team meetings and supervision.”

The provider maintained appropriate systems and policies to support learning from accidents, incidents, and complaints. Staff maintained comprehensive incident and accident logs, with actions taken and lessons learned recorded to support learning, reduce risks, and improve 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.

The service completed an initial needs assessment before people started using the service. The registered manager reported, "Assessment is done within 24-48 hours of receiving the care package. We assess their care needs, nutritional needs, moving and handling, capacity, equipment, health needs, and undertake a holistic risk assessment. We identify if there is anything that needs to be escalated. We provide feedback to social services and write the care plan and risk assessments. People and their families, and other professionals where appropriate, are involved in the assessment process."

We found that the provider involved people and their relatives to develop the care plan. People told us they felt involved in planning their care and were able to make decisions about how their care was provided. People reported, "I have been able to make decisions about what help I need, for instance with cleaning and tidying," and "We choose what [family member] wants to eat and what tasks we want staff to do."
The provider ensured that people were given a copy of their care plan to support their involvement in the delivery of their care and support. Care plans were also shared with staff to guide the delivery of care and support.
 

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 promptly and appropriately with relevant authorities, including the local authority safeguarding team, and submitted notifications to CQC where required.

Staff reported that they understood how to raise concerns and had received training in both adult and child safeguarding, enabling them to recognise signs of abuse or neglect. A staff member of told us, ‘‘Safeguarding means protecting people from abuse, neglect, discrimination, and harm by recognising signs of concern, reporting them appropriately, and following policies and procedures to ensure individuals are protected.’’

People reported they felt safe with staff and were aware of who to contact if they had any concerns regarding abuse or neglect. Relatives told us, People told us, "Yes, [family member] is safe. We have been using them for a long time," and "Yes, [family member] is safe because they respond well to the staff."

The provider had safeguarding and whistleblowing policies in place that were in line with best practice guidance.
 

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.

Staff assessed risks to people’s safety and wellbeing to help keep them safe. Risks were rated using a risk matrix according to their likelihood, severity, and overall risk score. Staff recorded risk reduction measures and reviewed the measures in place to ensure they remained effective in managing risks and supporting people's safety and wellbeing.

Overall, staff told us they read care plans and risk assessments regularly to ensure they had up-to-date information and could provide safe and appropriate care and support. A staff member reported, ‘‘I review them regularly and whenever updates are made.’’

Staff completed risk assessment forms in full, which contained sufficient detail in areas including diabetes, eating and drinking, falls, pressure ulcers, medicines, community access, behavioural, and moving and handling. This ensured staff had the information they needed to provide safe care and support.
 

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Staff received appropriate health and safety training, including fire safety, to help them respond effectively in an emergency.

Staff completed robust risk assessments to identify and manage environmental risks. These included equipment and fire safety assessments to promote and maintain a safe environment for people using the service.
 

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 received training relevant to their roles, including diabetes care, autism, learning disabilities, dementia, pressure area care, epilepsy, percutaneous endoscopic gastrostomy (PEG) feeding and colostomy care, to support them in meeting people's individual needs. PEG feeding involves providing nutrition, fluids, and medicine through a feeding tube, while colostomy care involves supporting people who have a stoma and colostomy bag.

Staff reported they felt supported in their roles. The provider supported staff through regular supervision, annual appraisals, competency assessments, and spot checks to assess their knowledge and skills. A member of staff reported, ''Yes, I generally find supervision sessions and appraisals beneficial to my work. They provide an opportunity to reflect on my performance, discuss challenges, receive constructive feedback, and identify areas for professional development.''

The provider followed safe recruitment practices, ensuring that all required pre-employment checks were completed prior to staff commencing employment. The provider had completed Disclosure and Barring Service (DBS) checks or Right to Work checks appropriately prior to staff starting their roles. A DBS check is a record of a person’s criminal convictions and cautions. These checks help employers make safe recruitment decisions.

There were enough staff employed to meet people’s needs to ensure people get the care they need when they want it. People experienced continuity of care from a regular staff team who knew them well and understood their care needs. People using the service reported, ‘‘I am comfortable with them now. The familiarity, I used to feel uncomfortable and nervous, but I started receiving regular carers and then got comfortable with them’’ and ‘‘Yes, the carers are mostly the same. The familiarity makes [family member] feel better. They know what is required and where everything is.’’

People reported that staff were well trained and had the skills and knowledge to meet their needs. People told us, ‘‘They do seem to be trained to meet [family member] needs. They seem to be on the ball and ‘‘They are highly skilled.’’
We found that the electronic monitoring system was not operating effectively to monitor staff arrival and departure times during visits. However, people did not raise any concerns about the timing or delivery of their visits. They confirmed that staff arrived at the planned call time and stayed for the agreed visit length. The provider took prompt and appropriate improvement actions in response to the concern identified during this assessment.

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 and control policy in place, in line with best practice guidance, covering infection prevention and control (IPC), personal protective equipment (PPE), and personal hygiene. Staff received infection prevention and control training to ensure they understood safe working practices. Staff also completed food hygiene training to ensure they knew how to handle, prepare, and store food safely to reduce the risk of illness.

Staff reported that they understood infection prevention and control (IPC) policies and wore personal protective equipment (PPE), such as disposable gloves and aprons, to help prevent and control the spread of infection. A staff member reported, ‘‘Yes, I have completed IPC training. It taught me about hand hygiene, correct use of PPE, and how to prevent infection and keep people safe. We ensure we pick our PPE from the office.’’
People confirmed that staff wore appropriate personal protective equipment (PPE) and followed infection prevention and control practices. Relatives told us, ‘‘They are very tidy’’ and ‘‘They wear gloves and protective coverings on their feet.’’
 

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.

The provider had a medicines management policy and procedure in place to support the safe management of medicines in line with current guidance and best practice. Staff received medicines administration training to ensure they had the knowledge and skills required to administer medicines safely.

The provider regularly assessed staff competency through supervision and direct observation of practice to support the safe administration of medicines. We observed that medicines administration records (MAR) had been completed in full, with no gaps, confirming that people had received their medicines as prescribed and at the correct times.

Staff had completed regular medicines audits to monitor medicines management and help ensure people received their medicines as prescribed. Information about people's medicines was clearly recorded in their care plans to support the safe and effective management of their medicines.