Care Quality Services North Somerset

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 the service. This key question has been rated good.

This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The registered manager had a positive learning culture that was based on an open and honest approach. Staff had a proactive and positive culture of raising concerns and these were reviewed along with any actions taken if and as needed. Any lessons learnt were shared with staff at team meetings and through weekly updates. The registered manager made referrals to the local authority and health and social care professionals. Notifications were submitted to the Care Quality Commission when required. The provider undertook reviews of the quality of actions taken although we found one incident form had no information confirming the outcome of it. Further information was available within other documentation. We raised this with the registered manager and regional manager so any actions could be taken if needed. This meant people received the best care possible through actions being taken and the provider identifying concerns and embedding good practice.

The registered manager 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 felt staff supported them with their individual needs and wishes. Staff made referrals to health care professionals if needed, such as to the person’s GP or district nurse and they also raised concerns with the office. People felt supported with their care. One person told us, “They help me as needed”.

The registered manager 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.

Staff received training in safeguarding adults, and they knew how to raise concerns and how to identify abuse. Staff felt people received safe care.

The registered manager reviewed safeguarding concerns, and the provider had a quality assurance system that ensured safeguarding concerns were documented along with what actions were taken including referrals and notifications made.

People’s care plans contained important information such as if the person had capacity. Supporting information was detailed in people’s care plans along with when this had been reviewed and if the person had appointed someone to make decisions for them if they were unable to. People felt happy with the care and support they received. They told us it was, “Very good” and “Absolutely brilliant.”

The registered manager worked with people to understand and manage risks by thinking holistically. However, we found during our inspection some improvements were needed to ensure all care plans contained guidance and risk assessments to support people’s individual risks.

For example, we found 2 people’s care planning documentation that could benefit from being improved on. This included where 1 person’s care plan had limited information about their diabetes care should they be unable to manage this themselves. Another person’s care plan had information within their daily routine about how staff were to support them with their mobility and equipment. Although there was no detailed guidance within their care planning documentation on how staff might need to use their equipment to support with their mobility. We raised this with the registered manager so they could review these 2 people’s care planning information and documentation. Other care plans we reviewed had information about the person’s diabetes care and how staff were to support people with their mobility, equipment and any other risk associated with their care and support. Following our assessment, the registered manager confirmed they had provided staff with information on what actions they might need to take if a person with diabetes became unwell.

The registered manager ensured people had any risks identified and equipment provided so they received safe care. They made sure equipment and technology, supported the delivery of safe care.

People’s care plans contained important information such as what equipment the person used, if they wore a pendant alarm and if there was an emergency contact. There was also information within people’s care plans on where the person’s utility supply was.

People were supported by enough staff who were qualified, skilled and experienced. Although people, relatives and staff felt some improvements could be made to the continuity of care staff provided.

For example, some people, their relatives and staff raised feedback with us that the care and support provided could be on occasions inconsistent. As some people raised there was inconsistency in when staff attended their care visits and who attended these. We raised this feedback with the registered manager so they could review this. Some relatives raised positive feedback where they were now able to review any changes made to the person’s scheduled visits. This they felt this was an improvement.

Staff completed training in the safe administration of medicines, moving and handling, first aid, safeguarding adults, mental capacity, and dementia care. Within the provider’s induction, staff also received training in how to support people with their diabetes, catheter and stoma care. Although staff had covered this within their induction no bespoke training had been provided to staff since. Staff received effective support and supervision although staff could benefit from some additional training to ensure they could provide people with care that met their individual needs. We shared this feedback with the registered manager so they could review what ongoing training staff might require.

Staff felt supported by the registered manager and office staff. Staff received supervisions and an appraisal, regular updates and team meetings. Staff completed a set of minimum working standards that were part of the care certificate.

The provider ensured staff had suitable checks completed prior to being employed by the service. This included references and identification checks. Some improvements were needed as part of the inspection process to provide CQC with assurance of completed Disclosure and Barring Service Check (DBS) undertaken. As we found during the inspection the provider was able to confirm when the DBS had been undertaken and the outcome of this. We raised this with them as part of the inspection feedback.

The registered manager assessed and managed the risk of infection. They ensured people were supported by staff who had received training in how to use personal protective equipment (PPE) safely. People told us staff wore PPE and staff had access to equipment such as gloves and aprons.

The registered manager made sure people received their medicines safely from staff who received training. Practical competency checks were completed to ensure staff were administering medicines safely. Care plans confirmed if people needed supporting with their medicines. Risk assessments were in place for the management of people’s medicines and where emollients posed a possible fire risk. Documentation confirmed people had received their medicines and topical creams as prescribed and information was also available to staff on were to apply the topical cream and how often. Where medicines incidents were raised, the registered manager had a positive learning culture of reviewing these incidents providing training and learning to prevent similar incidents from occurring again.