Gravesend Care 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 good. At this assessment the rating has changed to 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.

The provider had a proactive culture of safety based on openness and honesty. Staff listened to concerns about safety. One person was at risk of falling and they were supported following the fall in accordance with their preferences and capacity.

People and staff were encouraged and supported to raise concerns. People and staff told us they felt confident that they would be treated with compassion and understanding, and would not be blamed, or treated negatively if they did so.

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 care and support was planned with them and the views of people who use services, partners and staff are listened to and taken into account. People and their relatives told us they were involved with the care and support plans.

The provider worked with other healthcare professionals to ensure people received joined up care. Where people were supported by external health professionals, such as occupational therapists, staff were made aware of any changes to ensure these were implemented.

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.

Safeguarding processes were in place, and staff understood their responsibility in relation to safeguarding. When a potential safeguarding incidents occurred, the relevant authorities were notified.

People and their relatives told us they felt safe. One person told us, ‘I am really happy here’. Relatives also told us, ‘I think [person] is defiantly safe, safer than the last placement’.

The provider did not work well with people to understand and manage risks. Staff did not provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

The provider had not ensured risks relating to epilepsy were well managed. One person was diagnosed with epilepsy, which was controlled with prescribed medicines. There was no support plan or guidance in place to ensure staff could support the person safely. Staff had also not received training on how to support people with epilepsy. People were at risk of not being supported safely with their epilepsy.

One person was diagnosed with hyperthyroidism and there was no guidance or support plan in place. There was no information on the risks to that person to ensure staff could support them safely.

The provider had not ensured risks relating to manual handling were well managed. One person used a device to support them if they fell. Guidance on how to use the device was not clear and suggested staff ‘refer to a YouTube’ video, however there was no link to this video. Whilst most staff had completed their manual handling training, some bank staff had not, and the provider could not be assured they could use the manual handling device safely.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People were cared for in safe environments that are designed to meet their needs. People lived in their own self-contained flats and had free access to communal areas.

People’s care plans detailed how staff could support them to move freely and safely around their home, for example, keeping it clean from clutter to prevent falls risks.

The provider did not always make sure there were enough qualified, skilled and experienced staff. Staff had not completed training in epilepsy support, and some staff had not completed practical manual handling training. Whilst staff had not completed training in these areas, they told us they felt confident on how to support people, and they could explain what they would do in an emergency situation.

Staff were recruited safely using robust recruitment checks. This included staff being subject to a DBS. DBS stands for the Disclosure and Barring Service. It is a public body that helps employers make safer recruitment decisions by processing criminal record background checks.

People and their relatives told us they were happy with the staff that supported them.

Following the inspection the provider addressed the training concerns we identified.

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.

People were supported by staff to maintain their cleanliness of their home. People’s care plans detailed what household chores they needed support with and what they could do independently. Staff actively encouraged people to be independent with their cleaning. For example, one person told us, ‘I have just started to take the bins out myself and staff have encouraged me to do that.’

Staff told us they had access to enough PPE and completed infection control training to ensure they effectively mitigated the risks of spreading infections.

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 were able to take their medicines independently, but staff verbally prompted people to take their medicines to help ensure they didn’t forget. Staff recorded in the daily notes when they prompted someone and if there were any medicines concerns, this was escalated to senior staff or next of kin.

People told us they were happy with how staff supported them with their medicines, one person told us, ‘They [staff] help remind me to take my medicines as I can sometimes forget.’