Nurtrio

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 72 (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 were knowledgeable and reported incidents, accidents and safeguarding concerns appropriately. The management team ensured investigations of accidents and incidents took place to determine what actions they needed to take to reduce the risk of recurrence.

Staff reported they received regular weekly updates which included any learning identified and changes to individuals’ needs. These updates, alongside daily handovers and team discussions, supported staff to remain informed of people’s care needs.

Staff reported they felt confident raising concerns, knowing the provider would take appropriate action in response.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored.

Staff assessed people’s needs before providing care and used this information to develop care plans and risk assessments. Staff discussed and agreed care plans with people.

Where appropriate, staff involved relatives and healthcare partners in discussions.

One relative told us,“[staff member] came to see us and we had a good chat. I told them everything we needed, and they were very honest about the care package they could deliver.”

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.

Staff completed training in the Mental Capacity Act and demonstrated an understanding of its principles. The provider had policies and procedures in place to guide staff, which supported them to act in accordance with legal requirements.

Staff demonstrated a good understanding of their role in safeguarding people from harm. They told us they received regular training and were clear about the actions they would take if they suspected abuse.

When staff reported safeguarding concerns, the provider took appropriate action by notifying the local safeguarding team and CQC, carrying out investigations, and implementing measures to ensure people remained safe.

People, and their relatives consistently told us they felt safe.

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.

Staff completed person-centred risk assessments specific to people’s individual needs.

People we spoke with told us staff knew them well and communicated effectively with them and their relatives.

Staff told us the electronic app system kept them up to date with any changes to people’s needs. They explained the system required them to confirm they had read and understood updates before being able to complete care tasks, which helped ensure staff consistently recognised and acted on changes.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Staff supported people to maintain a clean, tidy and hazard-free home environment. The registered manager told us equipment was clearly labelled with service and maintenance dates. Managers instructed staff to ensure equipment remained safe prior to use and to report and act on any potential faults.

Records showed staff clearly documented both internal and external risks within people’s care plans, with appropriate risk assessments and mitigation where required.

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 told us they were happy with how staff managed their calls. Regular staff arrived on time and stayed for the full duration of the call.

Staff received training appropriate and relevant to their roles. They completed an induction when they joined the service, followed by additional core training. One staff member told us, “I find the training interesting and it supports you in the job.”

The provider monitored and recorded all training to ensure staff maintained up-to-date knowledge and skills.

Staff received regular supervisions, appraisals and competency checks. Staff told us they found these useful.

The recruitment records we reviewed varied in quality. Some files contained incomplete application forms that did not provide a full employment history or include satisfactory explanations for gaps in employment. We discussed this with the registered manager who informed us they had implemented a new, safer recruitment process earlier in the year. The registered manager provided evidence of improvements, including more robust checks and better oversight of recruitment documentation.

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 prevention and control policy in place and provided staff with appropriate training in this area.

Staff had access to personal protective equipment (PPE), and people told us staff used this appropriately.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

Staff administered medicines using an electronic Medication Administration Records (MAR) system. This enabled staff to receive immediate updates about changes to people’s medicines.

The provider monitored medication administration tasks using a live system, with office staff receiving immediate alerts to enable them to check the reasons for any potential errors or missed doses and take prompt action where required. However, the provider did not carry out regular medicines audits as part of quality monitoring processes. We raised this with the registered manager who acknowledged the concern and confirmed the provider had started to implement an auditing process to strengthen oversight.

Staff completed training, and regular observations of competency took place to make sure staff managed medicines safely.