First Option Support 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

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 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.

Staff understood their responsibilities in responding incidents and told us they knew what action to take if a person experienced a fall. This included assessing the person's immediate wellbeing, contacting emergency services if required, informing next of kin, maintaining contact with those involved and ensuring the incident was fully documented. Staff described reviewing incidents to understand what had happened, identify whether anything could have been done differently and discuss learning as a team to reduce the risk of recurrence.

Records demonstrated the provider's incident reporting system encouraged staff to document a description of the incident, actions taken and lessons learned. For example, following an unwitnessed fall where a person had attempted to switch on a light in their living room, staff recorded the circumstances known at the time and identified actions to reduce future risk, including maintaining a clutter-free environment.

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.

Before commencing a service, the registered manager met with people and, where appropriate, their next of kin to understand their needs, preferences and risks. They checked that any equipment used to support people was working correctly and suitable for their needs.

Information about the person's care and support needs and any risks was shared with any new staff before they provided care to the first person.

The registered manager told us if the people required supported to contact other professionals or make referrals, they would support people to do so.

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.

A person said, "I totally feel safe with them," and described staff as attentive, kind and caring. Another person told us, "I feel safe and comfortable with the care provided,"

There had been no safeguarding concerns at the time of our assessment. The registered manager understood their safeguarding responsibilities, including recognising the signs of potential abuse, carrying out investigations, making referrals where appropriate and ensuring concerns were shared promptly with relevant agencies.

The registered manager ensured staff received safeguarding training and understood how to recognise and report concerns.

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 provider took assessed risk to people and care plans included guidance for staff on supporting people with their health conditions, mobility, communication needs and daily living activities. For example, a person's care plan included detailed risk assessments relating to their catheter, with staff instructed to monitor for signs of infection, blockages, leakage, pain, reduced urine output and skin irritation, and to report concerns promptly. Another person's care plan identified risks associated with visual impairment, mobility and shower transfers, and provided clear guidance on how staff should support them safely while maintaining their independence.

People told us staff who supported them understood their individual risks and supported them in ways that helped them remain independent. A person told us they worried about falling because of their condition, but staff were careful when supporting them with personal care and took steps to reduce risks. They said, "Staff are careful when helping me with personal care and makes sure the risk is reduced." Care plans reflected this approach by instructing staff to keep routes clear of hazards, remain nearby when people mobilised, monitor for changes in mobility and confidence, and report any concerns promptly.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

People's care plans included risk assessments relating to their home environment, and use of equipment. Staff were expected to monitor for hazards, equipment faults or changes that could affect people's safety and report concerns promptly. Equipment was checked to ensure servicing and maintenance records were up to date.

Care plans also contained guidance for staff on using equipment safely, such as mobility aids, home lifts and shower facilities, to reduce the risk of accidents and injuries.

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.

People told us they received support at the agreed times and in line with their care plans. A person said, "I have never had any issues," and explained that staff worked flexibly to meet their needs and preferences.

The registered manager completed most of the care visits but had a team of staff who covered for them in their absence. Records showed staff completed mandatory training relevant to their roles, and the provider maintained record of training completed to monitor staff learning and development. Staff demonstrated a good understanding of people's individual needs, risks and preferred ways of being supported. The registered manager told us staff received induction, training and shadowing opportunities to help ensure they were competent before working independently.

Recruitment processes were robust and helped ensure staff were suitable to work with vulnerable people. Appropriate pre-employment checks had been completed before staff commenced work. This helped provide assurance that people received safe care from staff with the required skills, knowledge and experience.

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 received infection prevention and control training and had access to personal protective equipment (PPE) to help reduce the risk of the spread of infection. Care plans included guidance for staff on maintaining cleanliness within people's homes.

The registered manager told us there were procedures in place for responding to infection concerns and sharing information promptly with appropriate healthcare professionals where necessary.

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.

At the time of our assessment, the provider was not supporting anyone with the administration of their medicines. Care plans reflected people's capacity and preferences regarding medication management. For example, people told us, and records confirmed, that they managed their own medicines independently and did not require staff to administer, prompt or order medication on their behalf.

The registered manager had completed medicines management training and told us that, where medication support was required in the future, staff would receive appropriate training and competency assessments before providing support. Procedures were in place to guide safe medicines management and ensure people's needs, choices and independence were respected.