True Nest Care Limited

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. 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.

Systems were in place to learn lessons from incidents, complaints and safeguarding concerns so they could be analysed for patterns and trends. The outcomes were used to prevent re-occurrence and promote safety.

Staff told us their professional learning was continuously updated and best practice and updates on people’s changing needs were effectively communicated to support them in meeting people’s changing needs.

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 registered manager took a proactive approach to sharing healthcare concerns, which kept people safe and allowed for quick responses whenever their needs changed. Staff worked closely with health professionals; including GPs, district nurses, and occupational therapists following their expert guidance to meet people's needs correctly. When necessary, staff also communicated with these professionals on behalf of relatives to make sure everyone clearly understood the person's health requirements and delivered the right care.

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 safe and at ease with the staff. They felt staff knew how to look after them in a personalized way. One person told us, “It’s all working fine. I feel safe and comfortable with no issues. They [staff] know what they’re doing.” A relative added, “[Family member] is safe and well-treated by the staff.”

Staff completed safeguarding training and could describe specific safeguarding scenarios, including how to report concerns both internally and to external bodies. A staff member explained that, depending on the situation, concerns would be escalated to the Local Authority Safeguarding Team, the Care Quality Commission (CQC), healthcare professionals, or the police in emergencies.

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 and their relatives expressed confidence that personal risks were managed safely. A relative noted, “There is a care plan in place and it's followed accordingly,” while an individual shared, “I am supported with having a shower safely; they [staff] make sure I don’t slip or fall.”

Risk assessments were person-centred and tailored to individual needs. For individuals with mobility issues, specific risk assessments provided staff with clear guidance to effectively mitigate fall risks and deliver safe care.

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

People’s records contained an environmental risk assessment that looked at the safety of both the individuals and staff inside the person’s property, showing exactly how to manage those risks. When we highlighted specific areas where the registered manager could develop further, they were receptive to our feedback.

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 and relatives were satisfied regarding the consistency, punctuality, and duration of scheduled visits. One person told us, “It is early days, but so far so good, I have the same carer come every day; on time and reliable, does what is required.”

Staff feedback indicated that the scheduling system was effective, although operational changes occasionally impacted workloads. One staff member noted, “Generally, the rota works well. Travel time is usually considered, although on some occasions changes to the rota can make the schedule busier than expected.”

The provider maintained sufficient staffing levels to ensure safe care delivery. Staff competence and performance were sustained through structured training, routine supervisions, annual appraisals, and competency assessments. A staff member commented, “The training has helped me provide safe and effective care. I would welcome additional refresher training and further development in areas such as mental health awareness and managing behaviours that challenge.”

Safe recruitment practices were in place, with the registered manager verifying that satisfactory Disclosure and Barring Service (DBS) checks were completed prior to staff undertaking lone-working duties.

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.

Effective systems to help prevent and control infection were in place. Staff had received relevant infection control and food hygiene training and had access to resources and equipment to help them reduce the risk of infections spreading. People told us staff followed good hygiene practices and used personal protective equipment (PPE) when needed.

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.

No individuals required medication support during the inspection, but safe administration systems were in place, and staff training was fully up to date.