Fresh Tree Care Services – Surrey Branch

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 service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People were involved in their care, the provider worked with people, their families and staff following an accident or incident to prevent recurrence. Learning and reflection was evident throughout the incident and accident process, with outcomes clearly changing practice and improving safety. Records confirmed reviews were undertaken monthly in accordance with the service policy.

The service 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 and their relatives told us they felt the service communicated effectively with external professionals, such as social workers or GPs. Relationships between the service and external professionals were established and operating well. There were safe systems in place to ensure information was shared with the necessary health and social care professionals. The provider’s electronic care planning system produced a summary of people’s needs and requirements, which meant a safe transition between services, such as, for admission to hospital.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They 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 service shared concerns quickly and appropriately.

People told us they felt safe in the care and support of staff from Fresh Tree Care Services – Surrey Branch. Staff knew how to ensure people were protected from harm and abuse. Staff told us how they would raise concerns both within the service and externally. A member of staff said, “If I had a concern about any of my clients, I will first report to my supervisor or the office team. If necessary, I will escalate to the registered manager. Outside the company, I would contact the local safeguarding authority and social services.” Staff were confident the registered manager would follow up any concerns and make the necessary referrals to the local authority as required. Staff understood how to ensure people were kept safe from avoidable harm and had received training in safeguarding adults during their induction and regular reminders and updates.Clear communication channels ensured information and advice was always shared. A member of staff said,“I follow the safeguarding principles at all times.” Records showed all referrals had been made as necessary and investigations were effective.

The service worked with people to understand and manage risks by thinking holistically. They 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 worked to keep them safe and understood their needs. Relatives agreed the service and staff had given them confidence and reassurance. Staff knew people well and told us they had enough information regarding people’s individual risks. A staff member told us, “I have access to my client’s care plan and risk assessments which contains enough information. For example, one of my clients is at risk of falls, because of this, I ensure the environment is safe and free from hazards, I assist with mobility and use appropriate mobility aids to reduce risk.” People’s risks were assessed before they started to use the service and updated as needed, for example when a person had returned from hospital or following a fall. Risk assessments were accessible to staff on the electronic care planning system.

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

Environmental risk assessments were in place for people’s care and support; they were reviewed and updated as needed. Staff had received training on using equipment correctly, for example, equipment used to help people move around their home. Staff had undergone competency assessments to ensure they were working with correct techniques for supporting people to move safely. Risk assessments were comprehensive and included staff lone working and actions staff should take to ensure people were evacuated safely in an emergency.

The service 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.

There were enough staff to ensure people’s needs were met. The registered manager said it was essential they had staff in place before supporting additional people within the service. There was a thorough induction for staff which included shadowing, competency checks and an ongoing support process. Training was in accordance with good practice guidelines for staff who worked with people to meet their care needs. A member of staff said, “I have the required training to carry out my role effectively, including mandatory training such as safeguarding, moving and handling, dementia and infection control. This training has helped me feel confident in delivering excellent and compassionate care to all my clients.” Safe recruitment processes were in place. Procedures were in place to ensure the required checks were completed prior to staff commencing their employment. This included enhanced Disclosure and Barring Service (DBS) checks for adults. DBS checks provide information including details about convictions and cautions held on the police national computer. The information helps employers make safer recruitment decisions. Staff support was ongoing and there was a schedule of supervisions and spot checks, records showed the conversations were two-way and detailed. Staff told us they were supported by the registered manager.

The service 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 they did not have any concerns about staff working in a hygienic and safe way. Staff had access to the correct personal protective equipment (PPE) as needed and supplies were plentiful. Policies and procedures regarding preventing the spread of infection and avoidable harm were in place. Records showed staff had received training and ongoing monitoring for infection prevention and control and the compliance with PPE use. A member of staff told us, “We are provided with enoughPPE and if we need extra, they will be provided on request immediately.”

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

People received their medicines as prescribed. A person told us, “The carers do my tablets, they are on the ball, I have no worries.” There were safe procedures in place for the management of medicines. Care plans correctly reflected the level of support a person required with their medicines. People were confident they received their medicines on time and records reflected this. Medicines records were held on an electronic system; this meant they were updated as changes were made. Alerts from the system informed the registered manager and office team if a medicine was late, or not given, corrective action was taken. Monthly medicines audits and checks were undertaken to identify non-compliance or concerns. Staff received training, which included competency checks to ensure safe practice. There was guidance in place to ensure ‘as required’ medicines were administered in a consistent way. A medicines policy underpinned practice within the service.