Provision Care 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. At our last assessment we rated this key question Requires Improvement. At this assessment the rating has changed to Good. This meant people were safe and protected from avoidable harm.

At our last assessment the service was in breach of legal regulation in relation to safe administration of medicines and ensuring people’s risks were managed safely. The service was also in breach of regulation of recruiting staff safely. At this assessment, we found enough improvements had been made and the provider was no longer in breach of these regulations.

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 and processes were in place to learn from incidents, to prevent reoccurrence and promote safety. One person told us, “If anything goes wrong things are acted upon quickly. They are sorted and don’t happen again.”

Staff told us there was a positive culture and openness to investigating concerns. Care workers told us team meetings, supervisions and spot checks by management were undertaken where any accidents and incidents were discussed. One staff member said, “Incidents are taken seriously, and these are always discussed and reflected upon. Everyone is updated and if any changes are made to people’s care these are updated on the electronic system, so all staff know.”

An out of officed hours procedure was in place for staff so managers could always be contacted for support. Staff confirmed this was in place and they utilised it when necessary.

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. One person told us, “I am involved with lots of services. Provision Care monitor me well and there is good togetherness between them [services].”

People’s care records accurately reflected their needs and provided sufficient guidance to staff to support them safely. Prior to people receiving care their needs assessed face to face by the provider to ensure they could be met safely. Information was gathered from, people, their relatives, and any healthcare agencies where relevant.

People received care and support from a consistent staff team who knew them well which supported good continuity of care. One staff member said, “I support [name] all the and they have other carers through the week who are the same too. We know the people we support well.

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 told us the service was safe, and they felt safe with the staff. One person said, “I do feel safe. I wouldn’t have anyone in the house who didn’t look after me properly.” Staff told us they had received safeguarding training and knew the safeguarding policy and procedure. Staff understood their responsibilities and spoke confidently about keeping people safe from abuse and avoidable harm. They all told us they felt confident the provider would act on concerns raised. One staff member told us, “The process is to escalate to manager any safeguarding concern I have for people. If they didn’t respond properly or ignored my concerns, I would report them to the local authority and you [CQC].”

The registered manager knew their responsibilities of reporting safeguarding matters to external agencies and working openly and collaboratively with them throughout during any investigation.

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.

The provider worked well with people and their relatives to understand, assess and manage any known or identified risks to their health and well-being. Staff provided care to meet people’s needs in a safe and supportive way enabling them to live their lives as safely and independently as possible.

At our previous assessment risk assessments did not identify or mitigate risk to ensure safe care. At this assessment notable improvements to risk assessments were noted. This meant risks to people were now fully identified and the accompanying assessments were thorough and detailed to mitigate risk to provide continuous safe care.

Staff confirmed they were provided with accurate and reflective care plans and risk assessments for peoples that supported them to deliver safe care. One staff member said, “We have access to people’s care records. I find they are a true reflection of people’s current position. They are updated when things change. I am currently supporting someone whose mobility fluctuates quite a lot. When I report these changes our tasks are changed and the care records are updated. This information is shared straight away across the team so all of us support the person in the same way.”

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

Possible risks related to people’s home environment were assessed and recorded in people’s care records to ensure the safety of people and staff were considered. These included smoke and carbon monoxide detectors, security of the home and potential trip hazards to compliment delivery of safe care by staff. One person told us, “Staff always make sure my house is secure. They lock doors. They regularly check alarms in the house including my emergency help line I have installed.”

Staff confirmed they routinely risk assessed any change in environmental risk so these could be assessed and shared with other staff. One staff member told us, “Assessments of people’s homes are done. We monitor risks all the time to ensure we are all safe and report and escalate any concerns we find.”

An out of office hours procedure was in place for staff so managers could always be contacted for support. Staff confirmed this was in place and they utilised it when necessary.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development and were appropriately trained. They worked together well to provide safe care that met people’s individual needs.

At our previous assessment staff were not always recruited safely. At this assessment we found they were. The providers recruitment policy was now followed. Appropriate checks had now been carried out for all staff before employment was offered so that as far as possible, only suitable staff with the right skills and experience were employed.

People told us staff arrived on time and stayed for the length of time agreed and carried out everything they should do. One person told us, “They [staff] always come. They are rarely late and don’t rush off. I do remember a long time ago a day when this did happen. I told the manager who apologised, and it has never happened again.”

The provider used an effective scheduling system to plan and monitor care visits. This recorded carers actual start and visit times to ensure they were adhered to, and people received their care as planned. The system promoted continuity of care by monitoring staff deployment.

Staff were suitably trained and experienced to deliver safe care. A range of eLearning and face to face training was undertaken by all staff. Training matrices confirmed staff training was in date. Staff told us they felt appropriately trained. They were complimentary of the training package offered by the provider. One told us, “I have completed the care certificate and lots of mandatory computer and classroom training. I feel there is enough training provided, and I apply my training in my work confidently.

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. The providers infection prevention and control policy was followed.

Staff had undertaken infection prevention and control training. Staff and people told us they wore Personal Protective Equipment (PPE) such as gloves, aprons or shoe covers. One staff member told us, “I have responsibility for ensuring we have enough supplies. We don’t run out of it. We also keep records of when each member of staff collects stock.” We reviewed the associated documentation in relation to this procedure and found these records were in place.

The provider had made improvements to medicines safety following our previous assessment. Medicines and treatments were now safe and met people’s needs, capacities and preferences. Staff had been trained and had their competencies reviewed in the safe delivery of medicines to ensure safe practices were always followed. In particular ‘when required’ medicines and the administration of topical creams were now supported by effective processes and documentation to ensure these were safely managed.

We reviewed 2 people’s medicines records and found body maps were now in place for where creams should be applied to by carers. Additionally, one person told us, “The staff look after my medicines and prompt and administer them when they are needed. They have also had extra training on medicines as well to look after my specific health conditions.”

Staff confirmed our findings. Two staff members told us their training was in date, and they received refresher training, competency and spot checks of how they managed the safe administration of medicines. Our review of associated records confirmed this.