13B

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 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.

There was a system for reporting accidents and incidents. These were clearly described with evidence of actions taken and measures that had been implemented to reduce the risks. Information was shared with staff to promote learning across the service.
 

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.

Before people started using the service an assessment was completed to ensure their needs and choices could be met. This included ensuring there were enough staff to support people, and had the relevant training, knowledge and skills.The registered manager understood the importance of ensuring the transition to receiving live-in care needed to be sensitively managed. This included matching staff to people to ensure interests, hobbies and personalities complimented each other. Before people started using the service they were able to meet the staff member who would be supporting them as a live-in carer. This meeting was either in person or virtual and included the person’s family or representative. Staff were provided with a detailed handover about the persons support needs and choices. Care plans were in place to guide staff.Hospital Passports had been developed which could be used when people went into hospital to ensure health staff were aware of people’s needs. Hospital passports are documents about the person and their care and support needs, their health, and other information, such as interests, likes and dislikes.
 

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’s relatives told us they felt their loved one was safe with the care and support provided. There were systems in place to ensure people were protected from the risk of harm, abuse or discrimination. Any safeguarding concerns were reported appropriately to the local authority and CQC.Staff received safeguarding training staff told us how they would raise concerns if they believed people were at risk of harm or abuse. One staff member said, “I would always report to the manager or if nothing happened then social service. You can’t sit by and watch when things happen in your care. You always put people. first.”
 

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.Care plans and risk assessments included details of people’s risks and how these were to be managed safely. They reflected people's individual needs and considered how people could continue doing the things that were important to them. This included where people may make, unwise choices and how to support them safely. Risk assessments included mobility, falls risk, skin integrity and nutrition and risks specific to each individual.Staff knew people really well and understood the risks associated with their care and support. Staff spoke about how they managed people’s individual risks. They understood people’s own level of risk taking and supported them in a safe as way as possible.
 

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.An environmental risk assessment before care and support was provided. As part of the assessment process the registered manager ensured people’s homes were a safe place in which to provide care. This included external access to the home and how staff would gain entry. Checks were made externally and internally for any hazards, such as trip hazards or any animals that staff would need to be aware of.
The registered manager told us where possible changes would be implemented to mitigate risks whilst respecting people’s individual preferences. Safety checks were made to ensure smoke detectors were in place and people were offered the opportunity for a referral for fire safety checks. People’s relatives told us they had found this reassuring.
 

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.There were processes to ensure staff were recruited safely. This included references, employment history, and Disclosure and Barring Service (DBS) checks. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The registered manager told us that if there was a need to use agency staff then they would complete the same checks as if they were employing the staff member directly.

Staff completed training, supervision and competency assessments relevant to their roles. Staff told us that training was tailored to specifically meet the needs of people they were supporting. For example, whilst all staff received moving and handling training, only staff who supported people who required the use of a mechanical hoist, would receive hoist training. When staff started work at the service, they completed a period of induction and commenced their training. Staff received a detailed handover about the person they would be providing live-in care for to ensure they fully understood the person’s needs, choices and how they liked to live their life.

People received live-in support from the same staff member for a number of weeks. When the staff member was on leave the person received support from a staff member who they knew, until their regular staff member returned. The systems in place ensured there were always enough staff who were able to provide the appropriate support. The registered manager told us that in an emergency situation, such as sudden staff sickness, the management team would be able to provide interim cover.
 

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.Staff received infection prevention control training and had access to essential personal protective equipment (PPE). Staff told us there was always plenty of PPE available.Contingency measures that were in place in case of any future outbreaks. There was observation of staff in relation to their individual practice, this included the use of PPE and hand hygiene.
 

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.Systems were in place to ensure medicines were managed safely. Staff received medicine training and were assessed as competent before they supported people with medicines. Staff competency was regularly re-assessed. There was information for staff about why medicines had been prescribed and when and how they should be taken. Medicine administration records were completed when people had taken their medicines. People’s relatives told us they worked with staff to ensure their loved ones received the medicines they required.