Jothno Care and Support

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 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.

Systems were in place for learning from events such as accidents and incidents or complaints. Policies were in place to provide guidance in these areas. We saw where there had been complaints, the provider had reviewed them to see what lessons could be learnt. These were then shared with the staff team to help reduce the risk of similar incidents occurring again in the future.

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 needs were assessed before they started using the service to ensure the service was able to meet them. This helped to achieve a smooth transition from one setting to another. People and their relatives were involved in the assessment process so that their views and wishes were taken into account.

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.

People were protected from the risk of abuse. The provider had a safeguarding adults’ policy in place which provided guidance in this area. The registered manager told us there had not been any allegations of abuse in the past 12 months, and we saw no evidence to contradict this. Staff had undertaken training about safeguarding adults and understood their responsibility to report it. A member of staff told us, “I’d tell my manager about it straight away.” People told us they felt safe using the service. One person said, “I feel very safe. They’re excellent.”

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.

Risk assessments were in place which set out the risks people faced. These included information about how to mitigate those risks. Assessments covered risks including the environment and accessing the community. A relative told us, “They did a risk assessment before [person] moved in. They did a really good job.” Where people displayed behaviours of distress, support plans were in place to help support people in a person-centred manner. People had been involved in developing their risk assessments and they were subject to review. This meant they were able to reflect the risks people faced as they changed over time.

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

As this was a domiciliary care agency where the service supported people who lived in their own homes, the provider did not have responsibility for the safe maintenance of the property or the equipment used. However, the provider had carried out environmental and fire risk assessments of people’s homes to help ensure support was provided in a safe way.

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.

There were enough staff to support people. Staff logged in and out of every visit electronically, so the provider was able to monitor that staff were punctual and stayed the full amount of time required. A relative told us staff were, “Always punctual, everything’s okay at the moment.”

The provider carried out pre-employment checks on prospective staff. These included proof of right to work in the UK, employment references and criminal records checks. Staff received regular training and 1:1 supervision to support them in their role, for example on working with people with learning disabilities and autism.

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.

Systems were in place to reduce the risk of the spread of infection. Staff wore personal protective clothing when providing support with personal care. Staff had also undertaken training on infection control and there was a policy in place to help guide practice in this area.

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.

For the most part medicines were managed in a safe way. However, we found an instance of a gap on a medicine administration record [MAR]. This had not been picked up by the providers monthly medicines audit. The provider was able to demonstrate the medicine was not given by staff on the day of the gap on the MAR as the person was not at home on those days and therefore staff had not provided support to them. Other MARs were seen to be accurate and up to date. Staff received training on the administration of medicines.