STEPS

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 to continually identify and embed good practice.

The provider ensured all accidents and incidents were fully investigated and areas of learning or improvement identified. Care staff felt they were valued and able to raise concerns and report near misses. They were confident appropriate action would be taken and lessons learned. One staff member told us, “We look back and discuss this in team meetings, training and supervision sessions, what went wrong, what was right. You come across different situations and any sort of incidents the managers will send out an email or put on a training session.”

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed and monitored. They made sure there was always continuity of care, including when people moved between different services.

External professionals told us the service worked effectively with them and was responsive when concerns or changes in people’s needs were identified. Professionals’ comments included, “In my experience, the service provides good quality of care, communicates well with partner agencies, and delivers support in line with what is agreed, often going above and beyond expectations.” and “Where issues or questions have arisen, STEPS’ management team has been willing to work collaboratively with us to resolve them.”

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 consistently reported and demonstrated through their actions that they felt safe with their support staff. We observed people were comfortable requesting support and reassurance from staff. People told us, “I’m quite happy with STEPS because I think they do a good job” and “In my view they have been more than excellent”.

Staff had a good understanding of local safeguarding procedures and were confident any safety issues they raised would be investigated and resolved. Staff said, “If I felt there was a risk, I would speak to the office, and it would be escalated and followed up”.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. We checked whether the service was working within the principals of the Mental Capacity Act. We found that staff supported people in the least restrictive way to ensure people and their families felt in control.

Healthcare professionals were confident the service provided safe care. They told us, “Staff appear well trained and supported” and “The registered manager and myself meet fortnightly to stay on top of any outstanding queries.”

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 were confident people were safe and risks had been assessed and mitigated. Care plans included guidance on how to support people if they became anxious or distressed. Care staff said they would contact the office if they had any concerns around risk.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Care plans included environmental checklists, highlighting potential hazards such as lighting, trip hazards and any other associated risks with the property. The provider did alert the fire service if fire alarms were missing or if they identified concerns around using cooking equipment.

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.

The provider had enough suitably qualified skilled and experienced staff to meet people’s needs safely. Staffing levels were planned so that people received the care they required and visits were delivered as scheduled. People told us staff arrived mostly on time and stayed the full duration of the visits. Peoples’ comments included “They stayed the right amount of time.”

The provider had good induction training, to ensure staff had the skills to meet people needs. Professionals told us how well the staff team were trained, one said, “The staff appear well trained and supported.” The provider held their induction over 5 days, and staff did shadow shifts for as long as needed along with face-to-face training and eLearning.

We saw records of training provided during induction which included on-line training and face to face sessions with outsourced trainers.

Staff were recruited safely and necessary pe-employment checks had been completed. Staff files contained photographic identification and full employment histories.

Care staff told us, “Supervisions are regular and covers how they are managing any problems and their workload, supervisor is lovely always asking if you are coping or any problems.”

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 good stocks of Personal Protective Equipment (PPE), including gloves, aprons, and hand sanitiser. Staff told us PPE was readily available and could be replenished when needed. One staff member told us, “PPE is from the office, or a supervisor will check if we need anything and bring it to you.” We noted during home visits that PPE was used and people told us, “They always wear gloves and aprons when they are giving me personal care.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning when changes happened.

Staff understood how to manage people’s medicines safely and had access to guidance. At the time of the assessment the provider was rolling out digital Medication Administration Records (MARs) and not all staff had access to the digital version. There were paper MARs and these were available in people’s home for care staff to complete. Supervisors regularly checked the paper MARs for any missed medicines or errors.

The digital MAR did not have facilities to record why ‘as required’ medicines were used. For example, if someone was experiencing pain, then pain relief medication would be offered and administered. However, staff were aware of this issue and protocols had been developed around the use of ‘as required’ medication. This ensured information about why these medications were used and on their effectiveness was recorded in the care planning app and / or paper MAR.

Staff told us, “Medication training is done yearly” and “Medication annual competency form is completed with supervisors.” People told us, “They always check that I have taken my medication as sometimes I forget.”