Tru Caring

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 remained 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. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. The registered manager had effective systems in place to record, report and investigate incidents. Records of incidents reflected a comprehensive level of investigation to ensure all actions and learning supported ongoing improvement. Staff had a good understanding of their responsibilities in reporting incidents. However, some staff told us they would benefit from increased opportunities to meet as a team to share updates, good practice and promote learning. The registered manager told us how opportunities to meet were limited since moving to a significantly smaller office space. They confirmed they would explore ways to increase engagement with staff.

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. The provider ensured that care was arranged around people’s changing needs. This included providing support to facilitate and attend healthcare appointments.

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. People told us they received safe care. They said that staff were reliable, professional and trustworthy. Staff had a good understanding of safeguarding procedures and their responsibilities around keeping people safe. Records of completed safeguarding investigations reflected that the registered manager understood their responsibilities and worked collaboratively with people and partners when safeguarding concerns arose.

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. The provider had effectively managed risks specific to providing care in domiciliary settings. This included, electronic call monitoring, which notified senior staff when planned care tasks had not been completed by staff. The provider had systems to manage out of office hours support, a non entry policy and business continuity plans. This helped ensure the service would run safely in the event of an emergency situation, promoting safety and continuity in people’s care. Risks related to people’s care were assessed and monitored. People’s care plans detailed steps for staff to follow to help keep people safe. Staff had received training in line with people needs, which helped to ensure they had the skills and training to effectively manage and reduce risks.

The provider detected and controlled potential risks in the care environment. They made sure equipment and technology supported the delivery of safe care. The provider completed environmental risk assessments of people’s homes to help ensure there was a safe environment for staff to deliver care. Where risks had been identified, the provider worked with people and partner organisations to help improve safety. For example, where domestic fire risks were identified, staff signposted people to the local fire and rescue service to seek advice around improving safety. The provider used technology to support the safe and effective delivery of care. This included the use of electronic systems to monitor care tasks and medicines administration. This helped the registered manager maintain remote oversight of the care carried out by staff.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. People told us that staff were consistent, reliable and that care visits were scheduled and completed at agreed times. They said they were happy with their staff, as they were competent in their role. There were effective systems in place to ensure suitably matched staff were allocated to people’s care visits, considering staff’s skills and people’s preferences. Staff received training relevant, ongoing support and development in their role. This included, supervision, spot checks, competency assessments and training updates. The provider carried out the appropriate recruitment checks when employing new staff. This helped to ensure suitable staff were employed to carry out their role.

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 told us that staff promoted good infection control and hygiene practices. They said that staff wore appropriate personal protective equipment (PPE) and carried out effective hand hygiene procedures. The provider had appropriate infection prevention control policies and procedures in place. Staff had access to adequate supplies of PPE and that they had completed training in infection control.

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 told us they received effective support from staff around administering their medicines. People’s care detailed the level of support they required from staff to manage their medicines. The provider worked with people to pro-actively reduce risks related to medicine. For example, the provider had encouraged some people to arrange for their medicines to be blister packed by the dispensing pharmacy. This helped reduce risks related to shared medicines support (between staff, families and other providers), including administration errors and managing changes in prescriptions.