Enhancing Your Care Limited

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 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 relatives we spoke to said they were able to raise safety concerns and felt assured that action would be taken. We saw evidence that an incident had been reported and recorded, and the registered manager had good oversight of incidents and accidents.

Staff told us they knew how to report safety incidents or accidents and were confident the registered manager would take action as necessary. Staff received support and debriefs and lessons learned were shared with the team to help reduce future risks, maintain people’s safety and continue to improve the service.
 

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.

Initial assessments were carried out to ensure people’s needs could safely be met by the service. When people started receiving support from the service, managers and staff regularly checked to ensure their needs were being met and they were satisfied with the support provided. People and their families were involved in ongoing assessments, care planning and decision making.

There were strong links with people, their family and professionals and staff worked collaboratively with others to support individuals safely and effectively.

One professional told us staff kept them informed of concerns or changes. They said, “They have communicated medication or risk concerns to me over the phone which has allowed for consistent care and risk management. This is particularly important in my opinion as the staff see the client much more regularly than me.”

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 had not been any safeguarding concerns, but the registered manager demonstrated a good understanding of the related processes and responsibilities. A policy was in place to provide guidance about how to identify and report concerns about harm or potential abuse.

Staff received training in safeguarding and were able to describe the action they would take if they had concerns. One staff member said, “If I had any concerns, I would always report them. The team are hot on that. The safeguarding lead is easily contactable. I would always escalate concerns. I would take action asap.”

If people had been assessed as not having the capacity to make some decisions, the registered manager liaised with people’s family and other professionals to make decisions in the person’s best interests.

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.

People had individualised care plans and risk assessments which described their specific needs and strengths. Risk assessments were detailed and covered areas including personal care, communication and environmental risks. Care records were regularly reviewed with people or their relatives. This helped ensure they remained accurate, person-centred and up to date.

When risks were identified, these were clearly described, the level of risk recorded, and control measures identified. This helped ensure staff were able to manage the risk of harm whilst safely meeting people’s needs and respecting their dignity.

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 provider was not responsible for the premises because they supported people in their own homes. The registered manager carried out assessments of people’s homes to identify and understand risks or hazards and help support staff to deliver safe and effective care. This included risks relating to fire, infection prevention and control and accessing the community safely.

Staff received training in lone working, and this was discussed in a recent team meeting. Guidance was provided in a lone working procedure. This gave assurance that staff were equipped to work safely within the community.

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 and their relatives were positive about staff. One relative told us, “We have 2 staff mostly; I really rate them.” People were usually supported by a small, consistent team of staff, which promoted continuity of care.

Relatives told us staff usually arrived on time and stayed for the full duration of the visit. An electronic system enabled managers to monitor people’s care visits and follow up any concerns. Records showed sometimes staff did not log out of a visit at the time, but the registered manager was aware of this and had been addressing the issue with staff.

Staff told us they felt supported and had access to training to ensure they were skilled and knowledgeable. Records showed staff received regular supervision, and the staff we spoke with confirmed this. New staff received an induction and shadowed more experienced colleagues before working independently. Training was provided and repeated regularly to ensure staff remained up to date, and managers also carried out spot checks and competency monitoring.

Staff were recruited safely by the provider and relevant checks were carried out before new staff started working at the service. This included criminal record and employment checks to confirm staff were suitable to care for people.

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.

Training records showed staff were up to date with mandatory training requirements relating to infection prevention and control and food hygiene, and compliance was monitored in regular spot checks. Standards and compliance were reviewed in health and safety audits.

Individual infection control audits were completed regularly, and these provided useful additional information. Relatives told us staff followed safety and hygiene measures and used personal protective equipment (PPE).

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 inspection, staff did not support anyone who received personal care with their medicines. However, staff received training and their competency was checked as far as possible.

The registered manager demonstrated a good understanding of medicines management. Systems and processes were in place to support safe and effective practice and the medicines policy was clear and regularly reviewed to ensure it remained up to date.