Companions in Care

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 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.

There were systems in place to investigate any incidents, including falls. Individual accident forms were completed with details about what happened and any immediate actions taken.

The registered manager told us they viewed each incident as an opportunity to learn, improve, and strengthen their approach to safety and care delivery.

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.

Information related to people’s care needs was assessed prior to people joining the service. This helped to inform people’s care plans, risk assessments and the support they needed. We spoke with the provider about ensuring this information was transferred over to care plans, as some of these lacked specific details.

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.

There was a safeguarding policy and procedure in place which was in date and provided an overview about what people could do if they experienced any abuse.

Staff had completed safeguarding training and understood how to report concerns. A member of staff said, “Safeguarding is about protecting people from any harmful or abusive situations.”

People who used the service and their relatives said the service was safe. One relative said, “(Person) is very safe with the staff.”

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People had risk assessments in their care plans, although these didn’t always provide sufficient details about how to keep people safe, for example the risk of falls. Moving and handling assessments hadn’t been completed to evidence people’s mobility needs were taken into account. We spoke with the provider about ensuring these were completed. These were done following our inspection feedback.

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

Home environment risk assessments were completed when people first started using the service and were reviewed regularly. This helped to keep people and staff safe from risks associated with slips, trip and falls and fire safety around the home.

Personal emergency evacuation plans (PEEP) were completed, although these weren’t dated and didn’t fully capture the support people needed to mobilise. The provider told us these would be reviewed.

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.

Staffing rotas were in place and demonstrated how many staff were available to care for people. The feedback we received from people and relatives was staffing levels were sufficient. One member of staff said, “I definitely think there are enough staff. I only work a few days a week, but it’s manageable.” A relative also said, “Staff arrive on time and I never have to chase them up.”

Staff were recruited safely, with appropriate pre-employment checks carried out before staff started working with the service which included Disclosure and Barring Service (DBS) checks. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. Staff had opportunities to learn, and any poor performance was managed appropriately.

Staff told us they received enough training to support them in their role. A training matrix was used to show the training staff completed, although this needed to be updated as it showed some outdated courses. The provider told us this would be updated.

Staff supervisions took place, although at the time of the inspection there wasn’t a formal process for annual appraisals to be carried out. The provider told us this would be introduced.

The provider assessed and managed the risk of infection. They detected and controlled therisk of it spreading and shared concerns with appropriate agencies promptly.

Staff managed the risk of infection via the use of appropriate personal protective equipment (PPE) such as gloves and aprons, and frequent cleaning and hand washing. Staff had received training in infection prevention and control, to support their understanding of best practice. Staff said there was enough PPE available to carry out their role effectively.

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 the inspection, nobody was receiving support with their medication, and this was done by families.

Staff received medication training and had their competency assessed. A medication policy and procedure was also in place. We saw medication administration records (MAR) were completed accurately for people who had previously used the service.