Future Home Care Limited Nottinghamshire

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 78 (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 strong proactive and positive culture of safety, based on openness and complete honesty. Staff actively listened to concerns about safety and

thoroughly investigated and reported safety events. Lessons were always learnt to continually identify and embed good practice.

The provider used a digital system to log accidents and incidents, and we saw that the registered manager reviewed these to identify any themes and trends. Any areas of concern, or good practice, were identified and shared with the wider staff team.

Closed cultures were considered and discussed at team meetings to reduce the risk of a closed culture developing in the services. Any service that delivers care can have a closed culture. We define this as ‘a poor culture that can lead to harm, including human rights breaches such as abuse’. In these services, people are more likely to be at risk of deliberate or unintentional harm.

This practice of continued learning and ongoing consideration of closed cultures was embedded and supported ongoing good practice which improved the safety of people living at the services.

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 had a dedicated team who carried out assessments for people referred to the service. They worked in conjunction with the registered manager and ensured that the person’s needs could be met by the service, and compatibility with existing people was carefully considered to ensure people were suitable to live in the same environment and minimise the risk of any conflict.

People were engaged in the process of planning to move between different services as well as relatives and professionals. People’s strengths and skills were considered and embraced to promote confidence and independence.

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.

We saw where restrictive practice was being used, it was legally justified, proportionate, necessary and as a last resort. This was also documented in people’s support plans.

Staff had received appropriate training and had access to policy guidance on safeguarding and demonstrated good knowledge of safeguarding. One staff member described some of the signs they would look for that may indicate a safeguarding issue, “Our [people supported] here being non-verbal we would make note if [they were] acting differently, seem withdrawn or upset or any physical marks. With financial abuse we check their finances every day and make sure no money is missing, we are constantly checking for any signs they [people supported] are not being fully looked after.”

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.

We saw people were supported to do the things that mattered to them including holidays and outings which were risk assessed. For people with limited verbal communication care plans emphasised people’s preferred means of communication to support their understanding and ability to make informed choices by providing information in a way that they understood.

Risks were assessed and mitigation in place which kept people safe whilst promoting them doing things they wished to do.

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

An assessment of the environment was made, and we saw evidence that where people needed equipment to support their safety this was in place.

Where there were risks outside of the provider’s control, for example a poorly maintained environment, we saw staff and leaders escalated this to the relevant agencies and ensured there was support in place to keep people safe.

The provider made sure there were always enough qualified, skilled and experienced staff, who received thorough support, supervision and strong development opportunities. They worked together well to provide safe care that met people’s individual needs.

We reviewed documentation that evidenced staff received regular supervision to support their development. Training was completed, including person specific training, to ensure staff had the right skills to safely support people. The management team assessed staff competency to ensure they could meet individual people’s needs. Staff confirmed they felt supported and were encouraged to undertake training and develop their skills and knowledge. One staff member told us, “I have had the training I need, but if I were to feel I needed anything more my team leader or manager would help me but I’m confident currently.” People and relatives also had confidence in the staff, one family member said, “I’m happy with it, there’s always the right number of staff they’re knowledgeable when I speak to them.”

The provider followed a safe recruitment process. Interviews were values based to ensure staff were well suited to the role. People were actively engaged in the recruitment of staff for their services. We saw documentation that supported staff being matched to people based on people’s likes and preferences.

These processes ensured people were supported safely by appropriately trained staff who were matched to the needs of people to enable them to work towards and achieve their aspirations and potential.

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 services assessed were found to be clean, staff had access to appropriate personal protective equipment, and the provider had a current infection prevention and control policy to guide staff. Staff ensured people were supported with their personal hygiene and clothes were clean.

These measures helped protect people from harm and avoidable infections.

The provider made sure that medicines and treatments were safe and met people’s needs. Staff involved people in planning, including when changes happened.

Care plans did not always effectively explain how people liked to take their medicines, for example, with a glass of water. This was discussed with the service manager who assured that this would be addressed. As staff knew people well this had not presented a risk of harm.

The providers policy and standard operating procedure did not provide clear guidance for staff. This was escalated to the providers policy team by the registered manager at the time of the assessment. Staff had all received appropriate training and competency assessments for administering medicines which mitigated the potential risk.

STOMP was considered and we saw an example of where someone had been supported with the reduction of psychotropic medicines which had significantly improved their quality of life. Stopping over medication of people with a learning disability and autistic people (STOMP) is a national NHS England work programme to stop the inappropriate prescribing of psychotropic medications, an identified priority in the NHS Long Term Plan.