Cinox Healthcare – Shaftesbury Office

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 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.

Staff told us they knew how to report safety concerns. One staff member said, ‘I inform the management or senior staff immediately, depending on the incident, I will call ambulance and I will document it in our system’. Another said, ‘When there is an incident, I do an incident report, I also report to the office and the office talk with the family’.

When incidents were reported to the management, they were scrutinised and reviewed to identify themes and trends. Appropriate actions were taken to prevent recurrence, thereby helping to keep people safe. Staff confirmed safety events and the actions taken were shared during team meetings and messages on the providers electronic communication portal to support learning. Comments from staff included, ‘The incident is discussed in our monthly staff meeting where the manager will explain the impact of the incident and caution on how to avoid it’, ‘We do get feedback about incidents and how to do something better’ and ‘We discuss incidents in our team meetings, reflect on what was not done well and how best to handle future situations. The manager uses the feedback toimprove care to safeguard clients.
 

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’s needs and care requirements were detailed within their care plans and risk assessments. Pre-assessment paperwork was always completed involving people, relatives and partners prior to services commencing and these assessments were shared with staff. People’s information was kept up to date through regular reviews. Should staff be concerned about people they would inform service management who would contact relevant healthcare professionals. There was a process in place to share information when people went into hospital.
 

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.

We asked people if they felt safe with support they received from staff and a person said, ‘Yes, I do, its fine I am just comfortable with them.’ A relative said, ‘Yes, 100 percent, because [Loved one] is more than happy with them.’
All staff had participated in safeguarding training and understood their roles and responsibilities. Staff told us they knew how to report safeguarding concerns and felt confident to raise concerns as they would be dealt with appropriately. A staff member said, “Yes, I feel confident in reporting to the manager, and I know the issue will be death with, I can also report to the local authority or CQC.” The service had systems in place to ensure safeguarding concerns were reported to the local authority quickly and 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.

Risks to people had been assessed and steps to mitigate risks taken. These were completed in partnership with people whenever possible to ensure they understood what steps to take to minimise risks and maintain their independence.
Risk assessments did not prevent people from participating in fulfilling lives but enabled people to participate more safely. A range of risk assessments were completed and regularly updated including falls, malnutrition and safety plans for complex care which included crisis escalation plans.
Staff told us they were provided with all the information needed to support people safely. Comments included, ‘Risk assessment are completed for each person and are tailored to their individual needs’ and ‘They are easy to understand, and they hold the information we need to support the client.’
The registered manager told us, ‘When we receive a client, I look at the support plan and see what risks are recorded. I then go and meet them in person to see if these are appropriate. I explain to the client what the risks are here and what they should do to avoid the risk. In educating / talking with the clients about how to mitigate risk but also understand that the clients can have the option to make decisions.’
 

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 service provided support in people’s own homes, they were not responsible for the upkeep of these premises. However, risk assessments were in place to ensure the environments in people’s homes were safe to protect people and staff from harm. For example, there were effective arrangements in place to manage risks associated with fire or slips, trips and falls.
When people’s needs changed, the provider contacted professionals, such as occupational therapists, to request an assessment.
 

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.

Staffing was safe and effective. Staff received regular supervision, spot checks and competency assessments to assess their knowledge. Training was up to date, with a mixture of online training and practical sessions tailored to staff needs.

Recruitment records showed staff were recruited safely. Other checks included an enhanced Disclosure and Barring Service (DBS) checks for adults. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. References from previous employments had been sought. However, the provider did not always follow their own recruitment policy and procedures by ensuring full employment history was obtained. We raised this with the manager during the inspection, and they took immediate action to address.
 

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 effective systems in place to prevent and control infection. Staff followed current infection prevention guidance and used personal protective equipment (PPE) to reduce the risk of cross infection.
Staff confirmed there was always enough supply of PPE. Training records we reviewed showed staff had undertaken training in infection control as part of their induction and mandatory training.
 

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.

People told us they received support with their medicines as requested and this was recorded in their care plan.

Records showed staff had completed medicines related training and had regular competency assessments to support safe management and administration of medicines. Medicines were recorded on an electronic system which provided a live record of administration. This meant changes to people’s medicines were implemented immediately and visible to all relevant staff.

The provider had effective medicine management systems in place and audited medicine administration charts. This supported safe delivery of care.