Arm2Arm 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 – this means we looked for evidence that people were protected from abuse and avoidable harm. This is the first assessment for this 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. Staff took appropriate action when incidents occurred, such as raising a safeguarding where appropriate and updating care plans. The manager told us they had learnt from these incidents, and any learning was cascaded to staff through team meetings and by email.

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. The manager told us, “The service has a collaborative approach with other services”. Staff told us they received clear information when people began receiving care. One staff member told us, “We have this information shared in team meetings and care plans and risk assessments are shared prior to us visiting clients.”

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 told us they felt safe and had no safety concerns. Staff had received training in safeguarding and knew how to apply this in their role. Comments from staff included, “You monitor through daily observations, for example when giving personal care you look out for any unexplained bruises, marks, burns and any signs of behaviour change.”

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 told us staff supported them to manage risks. One person gave an example of staff ensuring they had a pendant close to them to raise the alarm if needed. People told us they were involved in the review of their care plans and told us these were regularly reviewed so they remained up to date. People had detailed risk assessments within their care plans.

The provider detected and controlled potential risks in the care environment. The service assessed risks relating to the environment, such as trip hazards, risks relating to pets, and risks relating to equipment people used. People had clear information within their care plans about how to safely use equipment. The service had a business continuity plan to record contingency plans in the event of an emergency. The manager told us any equipment people used was safety checked but these checks were not recorded. The manager told us they would take this feedback on board.

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. Staff were recruited safely in line with the provider’s policy and had completed a variety of training relevant to people’s needs. People told us they felt staff were well trained. Comments included, “Staff definitely have the right training”, and “[Staff member] is the main carer who is really good, they have built a good relationship with me.” People told us staff came on time and stayed for the full duration of the visit. There was an on-call system for staff to seek out of hours support if needed, which was covered by the manager. The manager told us when the service expanded there would be a staff rota to cover the on-call service.

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. People told us staff wore personal protective equipment (PPE) where appropriate to do so. Staff received training in infection prevention and control (IPC) and told us PPE was available. There was an IPC policy to guide staff, however this did not include details of who the nominated IPC lead was for the service. We raised this with leaders who told us they would address this.

The provider did not always manage medicines safely. There were no Medicine Administration Record Charts (MARs) for 2 people receiving support with medicines. This meant there was a risk medicines were not being administered correctly.

However, there was information in people’s care plans guiding staff how and when to support with prescribed creams, including body maps for topical medicines. Staff had recorded where this had been applied. We raised this with leaders who took immediate action to put these MARs in place. Additionally, one person’s care plan was not clear as to whether staff should support the person with medicines, or whether this was administered by a family member. We raised this with the manager who told us they would amend this. The person confirmed their family administered their medicines and the risk was reduced as they received care from the same staff member, who knew their role and responsibility.

Staff had received training in medicines administration, and the manager had checked their competency to ensure they were able to manage medicines safely. There was a medicines policy which provided detailed guidance for staff. People felt staff supported with medicines safely.