Prime Way 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 good. At this assessment, the rating has remained 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. The provider demonstrated how incidents, accidents and near-miss events were thoroughly investigated. Investigations were used to identify any lessons learned and opportunities for improvement, and the outcomes were shared with all staff to promote learning and reduce the risk of recurrence. The provider had robust systems in place to monitor and oversee accidents and incidents. A tracking system recorded the progress of each investigation, ensuring actions were followed through and completed. The level of risk associated with each incident was assessed and documented appropriately.

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 provider had processes in place to ensure safe systems, pathways and transitions were maintained. This included an initial needs assessment at the start of a service being provided, with assessments carried out by care coordinators. Assessments were carried out in people’s homes or in hospital, to capture the needs of people and to ensure the service could meet them. People were supported to access a range of external health care professionals to improve their well-being, with good communication maintained by the staff.

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.

Overall people and their relatives told us they felt people received safe care and treatment. A person told us, “I feel very safe and well looked after, very much so. This is the best company I have had, and I have had quite a few. I get the same 2-3 carers, and they are all very helpful”. A relative told us, “He feels absolutely safe and well looked after by the carers.”

People using the service were provided with a service user guide when they first joined. This guide included information on how to raise concerns, make a complaint, and how to speak to a member of staff if they required support or advice.

Staff had completed safeguarding training as part of their induction and demonstrated a good understanding of how to recognise signs of abuse and report concerns appropriately. The registered manager and provider reported safeguarding concerns to the local authority in line with local procedures. Records showed safeguarding concerns were investigated and a log of all concerns raised was maintained. Lessons learned from incidents and investigations were shared with staff to promote learning and improve practice.

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’s care records contained individual risk assessments that identified and addressed risks specific to their needs. These included risks associated with mobility, falls, and skin integrity. Where people had specific health conditions, tailored risk assessments were in place, for example in relation to diabetes management and the risk of choking. Standardised assessment tools were used where appropriate to support decision-making and care planning. For example, water low assessments were completed to help identify and monitor risks associated with skin integrity.

Information about changes to people's care needs and identified risks was shared with staff to ensure support could be reviewed and adjusted where necessary, helping to reduce the likelihood of recurrence. During the inspection, we discussed with the provider the need for a specific risk assessment to be implemented in relation to the risk of scalding for one person. This had been identified as an action following a recent investigation. The provider acknowledged this and took steps to ensure the risk was appropriately assessed and managed.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The provider had taken reasonable steps to identify and manage environmental risks. People’s care records contained information to help staff work safely, including details about fire safety, the use of any equipment, utility shut-off points, and the presence of pets. Where environmental concerns had been identified, appropriate action had been taken to reduce risks and promote people’s safety. Systems were in place to monitor the environment regularly, identify potential hazards, and ensure any risks were escalated and addressed in a timely manner.

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's needs were individually assessed, and staffing levels were planned in accordance with these assessments. The provider informed us staff retention was good, and ongoing recruitment was taking place to support the growth of the service and enable the delivery of additional care packages.

The provider used an electronic monitoring system to oversee care visits. Staff were required to sign in and out electronically when arriving at and leaving people's homes. The provider explained continuity of care was a priority and that efforts were made to allocate regular staff members to each person wherever possible. We reviewed electronic monitoring data from the previous four weeks, which showed that visits were carried out within allocated timeframes and there had been no missed calls.

We received mixed feedback from people and their relatives regarding visit times. Comments from people and relatives included, “Unfortunately I have had a couple of missed calls, over 6 months ago and not been told about. I did tell the office”, “The carers always turn up but not on time but it’s understandable, when they have so many people to visit each day”, “We have no issues, they send me a rota and always come on time”, “They are flexible, understanding and always on time. I know who is coming because I get sent a rota.” Although we received this mixed feedback, this related to previous experiences, and evidence demonstrated improvements had since been made. The provider employed a team of care coordinators who monitored visits throughout the day using the electronic system. Visits were reviewed at regular intervals, and where a call had not commenced within the expected timeframe, care coordinators contacted the relevant staff member and ensured people receiving care were kept informed of any delays.

New staff completed a comprehensive induction programme and spent time shadowing experienced colleagues until they felt confident and competent in their role. Robust recruitment processes were in place to ensure staff were recruited safely. This included a range of pre-employment checks and assessments of the applicant’s knowledge, skills, and competencies. All applicants completed an application form and attended an interview, with pre-employment checks carried out before appointment. These included obtaining references and completing Disclosure and Barring Service (DBS) checks.

Staff completed regular training to help them understand people's needs and to ensure they followed current best practice. They also received regular supervision and annual appraisals from managers, which supported their professional development and helped ensure they worked appropriately and in accordance with organisational policies and procedures.

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 provider had an infection control policy in place, which contained guidance for the staff. The staff had also received infection control training.

Staff were provided with information on current health concerns,such asa leaflet about hantavirus and to how to keep them safe. Hantavirus is a group of rodent-borne viruses that can cause severe illnesses. Staff had access to appropriate equipment, including personal protective equipment (PPE), which staff confirmed was readily available. Staff supported people to maintain clean home environments and to understand about the risks of poor infection management. The provider carried out infection, prevention, and control audits, which were comprehensive. This included a dashboard, which monitored PPE use and any actions from the audit were followed up.

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. Staff had received training in medicines management and were assessed as competent before administering medicines independently. The provider used an electronic recording and monitoring system to support the safe management, oversight, and administration of medicines. People's care records contained detailed information about their prescribed medicines, including guidance for staff on the application of prescribed topical treatments such as barrier creams. Medicines administration records (MAR) were completed accurately and demonstrated medicines had been administered as prescribed. The provider carried out regular audits of medicines records to ensure safe practice and compliance with procedures. Where any issues or shortfalls were identified, appropriate action was taken to address them and reduce the risk of recurrence.

Overall people and relatives confirmed the staff safely administered medicines. A person told us, “They help me with the medicines which are packed separately for the morning and evening. I feel they are given safely.”