Maisy Care at Home 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 service since the location changed. 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.

Staff recorded incidents, accidents and near misses, with clear details of what had happened, including what people were doing in the lead up to the incident, for example an activity and their general mood was documented. This helped staff identify situations which could increase risks to people. Staff took a pro-active approach to prevent situations escalating where possible and minimise distress for people.

The management team reviewed incidents, ensuring actions were taken to reduce the risk of a repeated incident. Staff told us learning from incidents was shared with them and gave them clear information on any changes to the way they needed to support people. Comments from staff included, “Incidents are recorded and always reviewed and followed up by the management. They share findings with us in team meetings.” We saw when things did not go according to plan, learning was taken from it and cascaded to staff.

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.

Relatives told us the provider worked well with health services people were using. People’s health conditions were documented, and staff supported them to access services from a range of professionals including specialist nurses. For example, the registered manager was in contact with district nursing teams and told us they had been proactive in ensuring the right support was made available for people.

People had been supported to develop end of life plans to ensure key information about their needs and how to meet them was shared with medical professionals if needed.

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 and their relatives said they felt people were safe and knew who they could talk to if they had any concerns. One relative told us, “Absolutely, [relative] is 100% safe.”

Staff demonstrated a good understanding of their safeguarding responsibilities and said they completed regular safeguarding training. Staff were confident managers would take appropriate action if they reported safeguarding concerns. Comments included, “I feel confident the manager would know what to do” and “[Manager] understands the needs of the clients”. Staff were also aware how to raise these concerns outside of the organisation if they needed to. Safeguarding was discussed in staff meetings and individual supervision meetings. The manager told us this helped to keep safeguarding on the agenda and gave staff the opportunity to raise any concerns. Leaders had ensured all safeguarding concerns were reported in a timely way to the local authority. We saw the registered manager had a tracker in place to follow up on safeguarding actions.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In home care settings, the Deprivation of Liberty Safeguards (DoLS) do not apply; instead, any restrictions must be considered under the Mental Capacity Act 2005 (MCA), and where a deprivation of liberty is identified, authorisation must be sought through the Court of Protection. We checked whether the service was working within the principles of the MCA. The provider had confirmation of who lacked capacity and had worked with the local authority to ensure people had access to advocates where appropriate.

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.

Staff demonstrated a good understanding of the risks people faced and how to support them safely. Staff told us, and records confirmed, that risk management plans were regularly reviewed and updated to ensure information was accurate. The registered manager told us how plans were followed to ensure people were supported to take positive risks.

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 completed various health and safety checks to make sure people’s homes, and any equipment was safe. Equipment was serviced regularly and staff completed regular checks of the environment to identify any shortfalls.

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 told us they received consistent staff and had built positive relationships with them. People told us late visits were rare. Comments included “Staff aren’t late that often, but when they are I always get a phone call” and “I have the same carer, I am thankful for this.” Leaders informed us they stepped in when there was staff sickness, so visits did not get cancelled. Managers told us they did not use agency staff to cover shortfalls because they did not want people to be supported by unfamiliar staff, who did not know them. This meant that the provider ensured continuity in care for people and ensured people received support from staff they knew well.

The provider completed pre-employment checks for staff before they started work. New staff received an induction, including shadowing experienced staff. Staff told us they received regular training, supervision and an annual appraisal. This helped ensure a competent and safe workforce supported 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.

Staff had access to personal protective equipment and had received training on infection prevention and control good practice. Staff told us they had all the equipment they needed and received suitable training. We saw evidence the registered manager had reported a recent outbreak of covid and had made arrangements for the covering of staff shifts.

The management team completed regular infection prevention and control audits, which included an assessment of how staff put their training into practice.

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.

Medicines were stored safely in people’s homes. Staff received training in medicines management and records demonstrated there were regular checks for their competence in administering medicines safely.

The provider was signed up to STOMP (Stopping over medication of people with a learning disability and autistic people). This is a national initiative to stop over prescribing of psychotropic medicines.

Medicines errors were recorded and escalated in line with the provider’s policies and procedures. Each person had a medicines risk assessment which detailed guidance about how to support people and profiles contained information of any risks and allergies. This was in line with published recommendations of best practice. People had body maps for emollient application and references to the risks of potentially flammable emollients. Medicine Administration Records (MAR) showed all prescribed medicines, including topical creams, were administered as required. This meant people received the correct medicines at the right time, promoting safe care delivery.