Always Caring Bromley Limited

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.

There was a proactive and positive culture of safety, openness and honesty within the service. Staff listened and responded appropriately to concerns about safety and events. Lessons were learnt to continually identify and embed good practice.

People were supported to make decisions and choices and risks were assessed and managed safely. There were systems in place to ensure accident and incidents were reported, recorded and investigated. The registered manager had oversight of incidents and accidents and when things went wrong, considered lessons learnt, ensuring action taken was transparent. Policies and procedures were in place to ensure people’s safety, such as safeguarding and whistleblowing.

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. A person commented, “Very well organised, including handovers and cover arrangements.”

The service worked effectively with health and social care professionals to ensure people received timely care and support when required. This included when being discharged from hospital to their homes. Staff assessed people’s needs and risks and evaluated whether the service could meet them safely.

Records showed effective communication and good working partnerships with health and social care professionals when required. Staff told us they worked closely with people and their families, local authorities and commissioners, GP’s and community nurses to ensure people received appropriate care and treatment.

The provider worked with people and health and social care partners to understand what being safe meant to them and the best way to achieve that. People and their relatives told us they felt safe with the staff who supported them. Comments included, “I feel very safe”, “Extremely reassuring”, and “[Person] is very happy with the staff.”

People were supported by staff who understood the provider’s policies and procedures in relation to safeguarding adults and children. Staff had received training in safeguarding adults and children from abuse. Staff we spoke with had good knowledge of how to recognise the signs of potential abuse and understood the process for reporting concerns and escalating these to external agencies if needed. The registered manager was aware of their responsibilities for reporting safeguarding concerns and records were monitored and maintained to ensure this.

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. A person told us, “I was heavily involved in staffing decisions and was consulted before carers were allocated to [loved one].” A second person told us, “I was involved in risk assessments before [loved one] was discharged home.”

Risks to people were identified, assessed, documented and reviewed on a regular basis to ensure good risk management. Assessments considered areas of risk to people including mobility, mental and physical health, nutrition and hydration, behaviour and communication amongst others. Assessments detailed how staff should best provide support to people to minimise and mitigate risks identified in these areas.

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 carried out risk assessments of people’s home environments to ensure safety for both individuals and staff delivering care. Assessments considered factors such as, fire, electrical and trip hazards, and any equipment used in providing safe care.

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 their support was planned according to their needs, and they felt there were enough staff to meet their needs. A person commented, “There are enough staff to provide [loved ones] care package, with a stable team of carers working in rotation. Consistency is a major strength of the service.” Another person said, “Staffing levels meet our needs. Staff always attend [loved ones] calls and there are no concerns about staffing.” Staff told us people received their care and support at the time they needed it. A staff member commented, “We have enough staff both in the office and on site to make sure people get the care they need. We get enough time to travel between clients and time to spend with people.” The provider used an electronic call monitoring system to allocate staff to support people. Staff logged into the system when they commenced providing care. This ensured people received their care and support when required and alerted office staff if staff were late to a call.

Staff records showed staff completed an induction in line with the Care Certificate and the staff training matrix showed staff completed training in areas that met people’s needs. These included, diversity and equality, Infection control, fire safety, medicine management, epilepsy, depression, first aid, dementia, autism, learning disability, falls awareness and person-centred care amongst many others. Records showed that staff received formal supervision and annual appraisals with the registered manager.

Robust recruitment procedures were in place. Staff recruitment records included proof of identification, application forms with employment histories, employment references and right to work in the UK checks. We saw evidence that Disclosure and Barring Service (DBS) checks had been carried out. DBS checks provide information including details about convictions and cautions held on the police national computer. The information helps employers make safer recruitment decisions.

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.

Staff had completed infection control training and demonstrated a clear understanding of the procedures required to prevent and minimise the risk of infection. The provider had an infection control policy in place. Staff told us they were provided with personal protective equipment (PPE) and a uniform.

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.

Some people managed their own medicines, and some people required support from staff to take their medicines. Where people required support to take their medicines this was recorded in their care records. A person told us, “Staff help with my medication. They receive the prescription and sort all the tablets out. Everything's been okay.” Care plans outlined the level of support individuals required in managing their medicines and identified who was responsible for providing the support.

Training records showed that staff had received appropriate training, and their competency to administer medicines safely had been assessed. Medicine Administration Records (MAR) were completed appropriately and senior staff completed medicines audits to ensure continued safe practice.