Aim24 Care Wokingham

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 requires improvement.

This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed

The service was in breach of legal regulation in relation to people’s safe care and treatment.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff listened to concerns about safety and understood their responsibility to report safety events. The provider reviewed incidents and accidents and ensured that any learning from them was shared with staff. Staff told us they felt confident reporting incidents and accidents and said these were investigated appropriately.

Learning from events was communicated through staff meetings, the care planning software and internal messaging systems. The registered manager reviewed incident and accident logs to identify any themes or emerging risks. There were also regular spot checks of care calls to monitor the quality of care being delivered and to support ongoing learning and improvement.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, where safety was monitored and managed. Although there were few transitions between services, systems were in place to support continuity of care should a person’s needs change. Staff told us they received the information they needed to provide safe care and people’s needs were communicated effectively. However, during the inspection we found some care plans contained incomplete information. This was updated promptly after the issues were highlighted by CQC. The provider liaised with healthcare partners when required to ensure people received appropriate support. Care plans included an emergency information page which staff could access electronically and provide to ambulance staff if required. During the inspection, some people and relatives told us they did not have a care plan folder or copy at home and were unsure how emergency information would be shared in an urgent situation. Following our feedback, the provider issued care plan copies in people's preferred format. This showed that while emergency information was available within the digital care planning system, improvements were needed to ensure people and relatives understood how this information would be accessed in an emergency and that it was consistently available in the home.

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. Safeguarding policies and procedures were in place and staff had undertaken safeguarding training. People were kept safe from avoidable harm because staff knew them well and understood how to protect them from abuse. Staff had training on how to recognise and report abuse, and they knew how to apply it. Safeguarding incidents had been reported and investigated appropriately.

The provider did not always work effectively with people to understand and manage risks. Risks associated with eating and drinking were not managed safely. One person who was at high risk of choking had been assessed by the Speech and Language Therapy (SALT) team. Although their care plan included some general information on how staff should support the person with eating and drinking, it did not contain the specific SALT guidance regarding the required food and drink consistency. This omission had already been highlighted by the local authority and through the provider’s own audit processes, but no action had been taken. This meant staff were not working with all the essential clinical information, increasing the risk of the person receiving food that did not meet their assessed needs.

The provider identified and managed potential risks within the care environment. Environmental risk assessments were completed to help identify and mitigate risks to both people and staff. For example, staff were prompted to check equipment servicing dates before use, ensuring items were safe and fit for purpose. The environment in people’s homes was also assessed to support staff safety, including considerations such as access arrangements and the presence of pets that might pose a risk.

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 supported by staff who had been safely recruited. This included a check for any criminal convictions, gaps in their employment history and uptake of references. Staff told us they received training and ongoing support from the service to carry out their roles safely and records showed that staff had regular one to one meetings, spot checks and yearly appraisals.

The provider assessed and managed the risk of infection effectively. They had systems in place to detect and control potential infection risks and shared any concerns with appropriate agencies in a timely manner. The provider had an up to date infection prevention and control policy, and staff received training to ensure they understood their responsibilities.

Staff told us they had access to a sufficient supply of personal protective equipment (PPE) to carry out their roles safely, and people using the service confirmed that staff wore PPE when delivering personal care. Appropriate PPE was available and used correctly to reduce the risk of infection spreading.

At the time of the inspection, the provider was not administering medicines or supporting people with medicines administration. All people using the service managed their medicines independently, and staff did not handle, store or record any medicines on their behalf.

Although medicines management was not part of the service’s active duties, the provider had previously supported people with medicines, and staff had completed current and relevant training in safe medicines handling and administration. This meant the provider retained the capability to offer medicines support if required. Staff were aware of their responsibility to report any concerns about a person’s health, wellbeing or ability to manage their medicines safely. This helped ensure that any emerging risks related to self administration could be identified and communicated appropriately.