Onecare-uk 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 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 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.

A system was in place to report, record and monitor incidents and to help support people safely. Accident and incident records detailed the action taken following an accident or incident but there was a lack of detail around lessons learnt. We raised this with the registered manager who said that they would amend the form to include this and in future this would be documented.

Management discussed accidents and incidents with staff during meetings to help ensure staff were familiar with their responsibilities and the action to take in such an event. The provider had recently introduced and implemented PATCH meetings (Person-centred care, Accountability, Teamwork, Compassion and High Standards). These meetings were designed to help people stay safe, clean, respected, independent and listened to. Learning outcomes were shared with all staff to help ensure everyone benefited from this and the risk of it reoccurring was minimised.

Staff were able to raise concerns outside of the management team to help prevent the development of a closed culture.

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.

People’s needs were assessed before they started using the service to help ensure the service was able to meet them. People and their relatives were involved in the assessment process so that their views and wishes were when planning their care and support.

Staff at the service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. People had individual communication and needs passports which were reviewed when there was a change in need.

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.

Procedures were in place to help safeguard people from abuse and improper treatment. Staff were able to recognise signs and symptoms of abuse and received training to help ensure they were up to date with best practice guidance. Staff said if they identified any concerns they would not hesitate to report them.

People told us they were confident they were safe in the presence of care staff and were well looked after. They told us they trusted the staff that supported them. When asked if they felt safe, a person said, “Everything is great here. I feel safe. I feel settled here.” Relatives said their family members received care and support in a safe way. A relative said, “[My family member] is safe, safety is paramount.” Another relative said, “My [family member] feels safe and [they] would let me know if [they] were worried.”

The provider mostly 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.

Most risks to people were identified and managed to help keep people safe. Risk assessments covered various areas such as the environment, diabetes and moving and handling. They included detail about the level of risk but there was a lack of information about control measures in place. For example, a person had a history of a stroke but did not have a personalised risk assessment in place for this. Another person was at risk of falls and the risk assessment in place did not include detail about how to reduce the risk of falls. We raised this with the registered manager who was receptive to our feedback and took immediate action which included reviewing and updating risk assessments accordingly to ensure they had relevant information to help keep people safe.

Staff completed training in areas of potential risk such as first aid, moving and handling and health and safety.

The provider identified and controlled potential risks in the care environment. They helped to ensure equipment, facilities and technology supported the delivery of safe care.

Staff supported people to maintain a clean, tidy, and hazard-free home environment. All supported living addresses we visited were welcoming, clean and of a good standard. The registered manager explained that they worked with various housing associations and had a positive working relationship with them. The registered manager told us, “[The housing associations] are very responsive. I want to ensure there is an environment for people that I would like to live in. It is important.”

We made observations regarding some of the premises’ we visited as part of this assessment. For example, there was limited access for people using a wheelchair in part of a service, lack of hand drying facilities and part of a lounge was used as an office corner. We raised these issues with the registered manager who was responsive and took immediate action where appropriate. The registered manager confirmed that they would raise some of the issues with the housing association and monitor this to help ensure actions were completed in a timely manner.

Staff carried out environmental safety checks, including routine inspections of fire safety equipment and fire drills, to help ensure both people and staff understood the procedures to following the event of a fire. People had a personal evacuation plan in place in the event of a fire or emergency to ensure staff knew how to support people out of the building safely.

The registered manager confirmed that they supported people to maintain their tenancies, including identifying and reporting relevant issues to the housing provider.

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.

Staff were trained to deliver their support roles by a combination of online and in person training. Training records were up to date and a clear effective process was in place to ensure mandatory training was complete. Relatives we spoke with felt that staff were sufficiently skilled to deliver care to their family members. A relative told us, “I think the staff are well trained.” Another relative said, “Staff are well trained and have good values.”

Staff had been trained in Positive Behaviour Support. They were able to respond to people’s individual needs appropriately. Staff we spoke to told us they received training and updates to enable them to carry out their roles safely. Staff received consistent supervision sessions which enabled management to monitor and discuss care staff’s role, performance and development.

Pre-employment checks were completed to ensure staff were safe to work with the people they were supporting. Staff had an interview, and their Disclosure and Barring Service (DBS) was checked and previous employment references sought. DBS checks provide information including details about convictions and cautions held on the police national computer. Newly recruited staff received an induction into the service, and opportunities for shadowing of care calls were available.

The provider assessed and managed the risk of infection. Staff detected and controlled the risk of it spreading and were aware of the procedures to follow if any concerns had to be shared.

Staff followed infection control processes, including washing their hands, keeping people’s home’s clean and wearing personal protective equipment (PPE) where appropriate. This was confirmed by people and relatives we spoke with. A relative told us, “[My family member’s] home is clean and safe for [their] needs.” Another relative said, “My [family member’s]home is very clean and safe.” Another relative told us, “[Staff] are always well turned out and wash their hands or wear gloves.”

Staff had completed training about infection prevention and control. Staff said they had enough PPE.

The provider mostly 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.

Medicines administration records (MARs) were completed by staff. We looked at a sample of these and found they were mostly completed fully indicating medicines were administered as prescribed.

Where people were prescribed medicines on a when required basis (PRN), protocols were not always in place. Therefore, there was a lack of detailed instructions for staff on when to administer these medicines. We raised this with the registered manager who advised that they would review this and ensure detailed protocols were in place as appropriate. At the time of this assessment, the registered manager confirmed that they were in the process of implementing appropriate protocols and ensuring staff completed refresher training to ensure they administered PRN medicines safely.

People's medicine support needs were clearly documented in their care plans. People and relatives told us that medicines were administered safely. A relative told us, “[My family member] has a lot of medical issues, and they support [them] with medication safely and reorder it when needed.” Another relative told us, “Staff give [my family member] their medication morning and evening and it’s all safely done and recorded.”

The provider worked in line with STOMP, which is national best practice guidance on Stopping the Over-Medication of People with a learning disability and or autistic people. There were systems to make sure people’s distressed behaviour was not inappropriately controlled by medicine

Staff were trained in the safe administration of medicines.