Pembroke Care (Reading) Domiciliary Services

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 requires improvement. At this assessment the rating has changed to 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. Lessons were learnt to continually identify and embed good practice.

The provider had systems for recording and reviewing accidents, incidents, and concerns. The care manager reviewed incidents and actions taken. People and relatives knew who to contact if they had any issues or did not feel safe. They said they would contact the care manager for support. Staff were clear how to report safety issues. Lessons learnt were shared through staff meetings, handovers and training. The provider had also provided additional training to staff in areas such as dementia and dysphagia to strengthen practice and reduce risk.

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. This included coordinating care during transitions, such as hospital admissions and discharges. Before care began, the provider completed an assessment to confirm they could meet the person’s needs safely. Staff said they received sufficient information to support people safely, and the care manager described how they worked collaboratively with the person, relatives and external professionals where needed. Feedback from professionals was positive we were told the provider was responsive to advice, open to learning and effective in sharing relevant information.

The provider worked with people and healthcare partners to understand what being safe meant to them and how best to achieve this. Staff focused on supporting people to live fulfilling lives while protecting their rights to live safely and free from abuse, discrimination, bullying, harassment, avoidable harm and neglect. Safeguarding concerns were shared appropriately with relevant agencies when required.

Staff demonstrated a good understanding of safeguarding, including the different types of abuse people may experience. They were familiar with the service's safeguarding policy and procedures and told us they would not hesitate to raise concerns internally and externally if necessary.

Staff had received safeguarding training and were confident in recognising and responding to potential safeguarding concerns. They told us they would report concerns to the care manager. The care manager understood their responsibilities for investigating concerns and making referrals to relevant agencies, including the local authority, when appropriate. People told us they felt safe receiving support and knew who to contact if they had any concerns about their care or wellbeing.

The provider worked with people to understand and manage risks in a holistic way. Staff provided care that was safe and supportive, while enabling people to maintain their independence and continue doing the things that mattered to them. Risks were assessed with people, and measures were put in place to reduce identified risks while promoting choice and independence. Each person had individual risk assessments covering key aspects of their care and support needs. Appropriate arrangements were in place to ensure equipment and the environment supported the delivery of safe care.

The provider identified and managed potential risks within people's home environments to help ensure care was delivered safely. They took appropriate action to ensure equipment and technology used to support people remained safe and suitable for their needs.

Environmental risk assessments were completed to identify potential risks to people receiving care and to staff providing support in their homes. Where risks were identified, measures were put in place to reduce the likelihood of harm and promote safe care practices.

The provider carried out checks on equipment used to support people's safety and wellbeing. For example, staff monitored the effectiveness of equipment, including a pendant alarm and sensor mat used by a person living with visual impairment, to ensure it remained fit for purpose and supported the person's safety. Records showed environmental risks and equipment needs were reviewed as part of ongoing care planning.

The provider ensured there were enough suitably qualified, skilled and experienced staff to meet people's needs safely. Staff received appropriate support, supervision and opportunities for development to help them carry out their roles effectively.

Records confirmed staff completed a structured induction and received regular supervision and appraisal to support their performance and professional development. Staff told us they had regular one-to-one meetings with their line manager and access to training to keep their skills and knowledge up to date.

People were supported by staff who had been recruited safely. Recruitment records showed the provider carried out appropriate pre-employment checks, including criminal records checks, verification of employment history and obtaining references before staff commenced work.

The provider assessed and managed the risk of infection and had arrangements in place to reduce the risk of infection spreading. Staff understood their responsibilities for infection prevention and control and knew how to report any concerns.

People were supported by staff who had received training in infection prevention and control.

We reviewed the provider's infection prevention and control policy and found it was up to date and reflected current guidance. Records and feedback demonstrated the provider had systems in place to support safe infection prevention and control practices, for example, hand hygiene audits were completed.

The person receiving domiciliary care at the time of inspection did not require support with medicines. As a result, there were limited opportunities to assess medicines management in practice within the homecare service. However, the provider was able to demonstrate appropriate medicines management arrangements through staff training records, medicines audits and medication administration records reviewed from the wider service. These gave assurances staff had the knowledge, skills and oversight required to support people safely with medicines should this be required. The evidence reviewed provided assurances medicines governance arrangements were in place to support the safe management of medicines.