CaringSmart Ltd - Dorset

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 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 and shared with staff to continually identify and embed good practice.

The provider had promoted ongoing development and a learning culture. This was evidenced by the provider investigating, reviewing and responding to complaints, incidents and accidents.

People and their relatives told us staff made changes when necessary to keep them safe and well.

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 and care requirements were detailed within their care plans and risk assessments. A summary was available if the person went into hospital or moved to another service. This supported continuity of care for people.A staff member said, “The staff work closely together to ensure consistency and follow the same care plans and risk assessments. Handover notes, daily records, and communication help staff stay informed about any changes in a person’s needs or well-being”.

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, staff had access to current safeguarding procedure and policy.

Staff had received training in safeguarding and were aware of their responsibilities to keep people safe. They said they would report any concerns immediately. Management told us they were always open and transparent and promoted this ethos within the staff team. One member of staff told us, “If I have any concerns about the well-being of someone I support, I will immediately inform my line manager. I am confident that the matter will be handled appropriately according to our organisation's safeguards procedures.” Records show concerns had been reported appropriately.

Everyone we spoke with told us they, or their loved one was safe. Comments made included, “Very safe, they [staff] are really very good. They [staff] talk nicely to him and they [staff] take care, and are very thorough.” Another said, “I feel at ease with them [staff] and have from day one.” People and their relatives knew how to raise a concern but said they had not needed to. They were confident they would be listened to, and any issues would be satisfactorily resolved.

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.

Risks to people were assessed, reviewed and managed well to ensure they remained safe. Risk assessments were in place to guide staff in areas such as falls. Care plans were personalised and provided sufficient guidance to staff to keep people safe. Staff told us about daily tasks completed to keep people safe. These included equipment safety checks and reporting any concerns identified so these could be rectified.

The service used an electronic monitoring system, which identified if staff were running late or had not arrived at a person’s property. This minimised the risk of any support being missed and ensured a reliable service. Everyone we received feedback from described staff as being “Reliable, consistent and on 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.

Records showed risks associated with a person’s environment were assessed during their initial assessment. This included adequate lighting, security of the home and any equipment used. Staff told us they completed checks to ensure the environment was safe and reported any concerns they may have.

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.

Recruitment procedures were in place to ensure all necessary pre-employment checks were completed before staff began work. This included enhanced Disclosure and Barring Service (DBS) checks, which provided information about convictions and cautions held on the police national computer to support safer recruitment decisions. Any new staff completed a comprehensive induction and were introduced to people and worked alongside a familiar staff member. This ensured confidence and consistency. People told us, “I mostly have the same five carers, it’s very consistent. If they replace someone it’s with someone I know. We both spend time getting to know each other, they wait until we are both clear of what I need.” And, “They stay the right amount of time and they often arrive five minutes early.”

Ongoing support for staff included scheduled supervisions and regular spot checks. Records demonstrated these meetings were meaningful, two-way discussions. Staff told us they received regular training and support that enabled them to meet people’s individual needs. Comments from staff included, “I have regular supervisions with my line manager, and I find them very beneficial. Additionally, they are a good time to review my training needs, personal development goals, and any updates to policies or procedures. We also address any issues that arise and help me maintain good communication.”

People described staff as being “very professional, open and honest, very smiley and very kind.” However, a few people found the language barrier being an issue for them. For example, one person told us, “I don’t always understand what they [staff] are saying and they [staff] don’t understand what I’m saying. It’s accents and different use of words, but they are very patient. There are still difficulties with language, although it has improved now.”We informed the provider of this who told us they would continue to monitor via spot checks, training and feedback from people and relatives.

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.

Infection prevention and control measures included a robust infection prevention and control policy and staff had a good understanding of this.Spot checks included whether staff were wearing the correct level of PPE for the task undertaken.

Staff told us their training included hand washing and how to safely put on and remove personal protective equipment. Staff said they could help themselves to personal protective equipment which was available in the office.

People told us staff demonstrated good infection prevention practice. They said staff regularly washed their hands and changed their personal protective clothing when required. Comments made included, “I have seen them change their gloves between creaming my legs and preparing food.” And, “They wash hands and wear gloves; they are very efficient”.

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.

Care plans detailed who was responsible for supporting each person with their medicines, who ordered them, how they were disposed of, and which pharmacy supplied them. A person told us, “They make sure I have my medication at the right time with a glass of water”.

For topical medicines, such as creams, body maps were used to clearly indicate where the medicine should be applied. Staff received training in medicines management and had their competency regularly assessed to support safe practices.

Records showed medicines were given safely and as prescribed. The electronic monitoring system highlighted to management if people had not received their medicines. This enabled action to be taken to minimise the risk of error.

The service maintained effective communication with GPs and pharmacies to ensure people had access to the correct medicines at the right time. A detailed medicines policy and procedure were in place to guide practice.