Nottingham DCA

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. At our last assessment we rated this key question good. At this assessment the rating has remained 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.

People did not indicate they had any concerns about safety events or raising concerns about safety. Staff told us lessons were learnt to continually identify and embed good practice. For example, one staff member said, “We discuss improvements and ideas at team meetings.” All staff we spoke with told us they felt able to raise safety concerns and were confident management would respond quickly.

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. We saw evidence of detailed assessments being undertaken prior to people receiving a care package to ensure the provider could fully meet their needs safely. A relative we spoke with said, “The company are very good, they continually check in with me and [name] to make sure the care is meeting our needs or if we need support with anything else.”

People told us they felt safe from abuse. Staff understood the importance of safeguarding and how to report concerns including reporting to external agencies, for example, the local authority. The provider had appropriate policies in place and information for staff on the procedure for reporting safeguarding concerns both internally and externally. The provider had implemented training for staff in safeguarding, both children and adults, equality and diversity and the Mental Capacity Act.

The provider worked in a way that met people’s needs and provided care that was safe and supportive. Care plans detailed known risks to people and gave staff guidance on how to support people to identify these. For example, one person was at risk of self-neglect. Their care plan detailed how staff should communicate the risk to the person if they saw a pattern or concern developing such as a refusal to have support with personal care. This meant the person was supported to make decisions in their best interest safely.

As people were supported in their own homes the management team had little control over the environment, however where needed risks were detected and controlled as much as possible. They made sure equipment, facilities and technology supported the delivery of safe care. Care plans detailed additional support some people required to maintain their environment such as topping up utility meters to ensure their environment remained safe and suitable.

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 of staff was done safely and included relevant check such as Disclosure and Barring Service (DBS) checks. DBS checks help providers assess the suitability of individuals for roles, particularly those involving vulnerable. Staff consistently praised the support and training provided by the provider, however a relative commented, there could be more in-depth training in certain areas. One relative said, “Staff are knowledgeable, but it would help them more if they trained on specific mental health conditions and not just in general.” We spoke with the registered manager who was aware of this need and provided evidence and assurance this training and development was booked and planned in the near future to ensure staff were upskilled.

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. Staff were knowledgeable about infection prevention and control (IPC) and received training. People we spoke with did not have any concerns in relation to IPC.

Not everyone received support with medicines but where they did this was clearly documented within care plans with guidance for staff on how people wished to be supported. Risks were identified and guidance provided for staff on how to identify and report these risks. For example, one person was only supported twice weekly. Staff were required to prompt with ordering of repeat prescriptions to ensure the person’s medicine stocks were adequate. Additionally, staff were provided with guidance on how to support the person if medicine doses had been missed repeatedly and any potential side effects. This helped ensure people remained safe with their medicine administration.