Crestar Healthcare

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 previous assessment the provider was in breach of one legal regulation relating to good governance. At this assessment the provider had addressed the above concerns and is now compliant.

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.

People were protected through established systems and practices designed to ensure their safety. The provider had procedures in place to record accidents and incidents appropriately. Care records demonstrated the involvement of other agencies and documented actions taken to reduce the risk of recurrence.

Staff told us they had received health and safety training, and risk assessments were in place to promote people’s independence whilst ensuring their safety. We observed risk assessments were specific to the individual. Additionally, risk assessments were in place with regards to the person’s home and these provided staff with control measures to ensure people’s safety.

People were cared for and supported by staff who had the skills to ensure their safety. Discussions with staff demonstrated they understood their responsibility to record and report any safety issues with the registered manager. Where necessary the registered manager would review the person’s care plan and risk assessment with the person to ensure their safety going forward.

At the time of this assessment the registered manager was not providing a service for people with a learning disability and autistic people. However, staff told us they had received the relevant training, and the staff training matrix confirmed this.

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.

People told us a needs assessment was carried out prior to them using the service and we saw evidence of these assessments. A relative said, “Someone came out to have a chat with [person’s name] before the visits.” This enabled the provider to develop a care plan with the involvement of the person. This ensured they received a service the way they liked.

Staff told us for all new people, the registered manager provided detailed information regarding their care and support needs. They confirmed care plans were informative, 1 staff member said, “I feel that I already know the person before meeting them because the care plan is so informative.”

People were complimentary about the service they received. Records showed the registered manager worked with other healthcare agencies to ensure people received a joined-up service

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 were assured they were protected from the risk of potential abuse. Staff told us they had received safeguarding training and the training records we reviewed evidenced this. Staff were able to describe different forms of abuse and explain how they would protect people from harm. Discussions with the registered manager and the records we looked at demonstrated clear safeguarding systems were in place. One person told us, “I feel safe with the care provided, they talk to me and always ask me if I am ok.”

Further discussions with the registered manager confirmed their understanding of safeguarding responsibilities, including reporting concerns to the local authority safeguarding team. Records we reviewed provided evidence safeguarding procedures were followed appropriately

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 were involved in managing their risk. The registered manager told us people were involved in developing their risk assessment and people confirmed this.

Staff told us risk assessments were very detailed and if the person’s needs had changed, the registered manager was very swift in reviewing them to ensure the person’s safety.

We observed risk assessments were in place regarding people’s specific health conditions. For example, diabetes, reduced mobility and specialist aids and adaptations in place.

Risk assessments were in place with regards to the person’s home and these provided staff with control measures to ensure people’s safety.

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 were cared for by staff who had been safely recruited. Staff told us recruitment safety checks were completed before they started work and the staff files we looked at evidenced this.

Staff told us they received an induction before commencing visits, which helped them understand their role and responsibilities. One staff member said, “Without the induction, I would not be able to do the job.”

Staff had access to relevant training, and where people had specific health conditions, staff received additional training to ensure they could meet those needs and identify when medical intervention might be required.

People were confident there were sufficient staffing levels to meet their needs. They told us they had not experienced any missed calls, and those requiring two staff members confirmed the appropriate number of staff were always provided to meet their needs safely. People told us they were familiar with all the staff who visited them.

The provider assessed and managed the risk of infection.

People were assured they would be protected from the risk of avoidable infections. People told us staff always wore disposable aprons and gloves when providing personal care. We observed a detailed infection prevention and control (IPC) policy was in place which was accessible to staff. All the staff we spoke with confirmed they had received IPC training and had access to appropriate personal protective equipment (PPE). Risk assessments contained clear guidance on practices to prevent cross-infection, including additional measures for people with weakened immune systems. Staff demonstrated a good understanding of these practices.

Some people told us they required support with meals and staff confirmed they had received food hygiene training, and the records we reviewed provided evidence of this.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

People were prompted to take their prescribed medicines by staff. Care plans contained clear details about the individual’s prescribed medicines, and staff supported people to order their repeat prescriptions to ensure they did not run out.

Staff training records evidenced staff had received medication training. Staff records also showed medicines competency assessments were routinely carried out. This ensured staff had the up-to-date skills to support people with their prescribed medicines.