ICSL East

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 questiongood.At this assessment the rating has remained good.

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 told us that any concerns they raised were listened to and acknowledged. They told us the management team worked with them to resolve the issues raised. They told us they have opportunities to develop their knowledge and skills. The Registered Manager told us about lessons learnt following a prior safety incident where staff had not administered a medicine someone was taking for a month. Staff told us that this information was shared with them so the service could learn and improve.

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 told us they were involved in the care planning process prior to the commencement of care. Staff told us they had access to people’s care plans and risk assessments prior to supporting people, helping the start of care packages to go smoothly. One person said, “…a range of people visited me to assess my needs, so I felt that I was being truly looked after and that all my needs were met.”

The provider did not always work well with people and healthcare partners to understand what being safe meant to them and how to achieve that. They did not always concentrate on improving people’s lives or protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider did not always share concerns quickly and appropriately. In some instances, where people were unable to consent to care themselves, relatives had signed to consent who did not have legal rights to do so. Mental capacity assessments had been completed and showed people were unable to consent, but best interest decisions had not been documented to show that receiving care was in the person’s interests. This was raised with the Registered Manager during the assessment, and they were signposted to guidance on this. Staff told us they received safeguarding training and explained what issues they would escalate to the management team as a safeguarding concern and how they would do this. Staff told us they felt comfortable following this process and felt confident that concerns would be acted upon by the management team. Safeguarding concerns had been shared with the Local Authority and investigations carried out. Where appropriate, these investigations led to lessons learnt and changes and improvements in the service. People told us, “I certainly feel safe around all staff.”

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. All relevant risks to people had been assessed in collaboration with people receiving care and risk assessments were person-centred. People told us they felt staff knew how to keep them safe. One person said, “staff do dynamic risk assessments, and consult family on all requests.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Risk assessments of people’s environments had been completed prior to the start of care. Where people needed equipment to meet their care needs this was regularly checked for safety and to ensure the equipment was serviced and maintained.

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. We saw evidence that staff were recruited safely. Staff’s identity and right to work in the UK had been checked. References had been gathered and checks made with the Disclosure and Barring Service made prior to staff starting work. Staff received appropriate training to meet people’s needs, including specialist training when people had complex needs such as the need for Peristeen transanal irrigation. We saw that care calls were often shorter than scheduled and one person told us that staff were task focused. The Registered Manager told us that this was an issue they had also identified, and they were working with staff to remind them to spend time socialising with people if they had completed tasks with time to spare. Most people told us that they did not feel rushed and they would let staff leave once they had received the support they needed.

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 had infection prevention and control risk assessments in place. Staff told us they had access to personal protective equipment and supplies were kept in people’s houses, with their consent, and restocked when supplies were running low. One person told us, “My carers keep my room in a very orderly fashion, ensuring that all items used are returned to the correct areas provided. Staff always wear gloves and aprons.”

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. We saw that people had risk assessments in place for their medicines. Medicine administration records were completed appropriately. Staff told us that they had training on administering medicines and had their competency checked by the management team prior to administering medicines. One person told us “If carers identify a minor ailment, they give me personal advice as well as inform my [relative] so they can give a second opinion.”