Norwich

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 69 (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.
Safety incidents were reported, investigated and analysed thoroughly. Staff received training in how to identify and report safety concerns. There was a strong culture of learning from incidents to keep people safe. The management team shared case studies of incidents with staff members through newsletters to promote best practice.
 

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 service worked closely with health professionals to share relevant information and promote good outcomes for people. Where a person was receiving input from a specialist nurse, the service had arranged for staff to meet with them to understand how best to support the person. Meetings with relevant health professionals were held regularly to formally review people receiving care from the services reablement team. One family member told us their relative sometimes needs input from the district nursing team, and that staff “are all very competent” at identifying concerns and communicating with the nursing teams as required.
 

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.
Policies around safeguarding adults and children were in place to guide best practice. Where safeguarding concerns had been identified, the service took action swiftly and worked with the local authority transparently. Staff received training and ongoing competency assessments relating to safeguarding and knew how to raise concerns. A staff member told us, “Incidents are taken seriously” and described how actions taken are prompt and appropriate.
 

The provider mostly 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.
Most people’s care records contained risk assessments and guidance for staff on how to reduce or minimise risks when providing care. The registered manager and staff responsible for creating and reviewing people’s care records described how risk assessments are reviewed and updated regularly, and always in response to incidents.
For people living with diabetes, care records did not always fully explore the risks associated with this. This meant in the event of a medical emergency, staff may not have sufficient guidance to refer to or share with healthcare professionals. We raised this with the service who took action to address this.
 

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.
The service carried out an assessment of people’s homes to identify any risks and suggested ways to reduce these. Staff had access to evacuation plans which were detailed and easy to understand.
People told us their homes were treated with respect and care, and things were not left in the way with the potential to become a trip hazard “What I like about them is they never leave anything lying about”.
The management team had undertaken assessments of people’s homes to ensure risks were identified and mitigated as much as possible, whilst also respecting people’s individual preferences.
 

The provider did not always make sure there were enough qualified, skilled and experienced staff.
At the time of our assessment, the service had experienced a reduced workforce and increased number of people receiving care. This had been acknowledged and identified independently by the service, who were taking responsive steps to address this. Recruitment campaigns, a temporary stop on accepting new care packages and increasing communication with people had minimised disruption.
Some people told us there were not enough staff, and this resulted in visit times running late. However, they did not feel this impacted them too much as office staff had mostly kept them up to date with any changes to their allocated visits. People did not experience missed calls regularly, but told us visit times can change at short notice. A family member told us, “They do notify us if they are late and we only had a missed call a long, long time ago”. When speaking about visit times, a service user told us, “The times can be a bit hit and miss”.
 

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 using the service and their relatives confirmed staff wore personal protective equipment (PPE) to minimise the risk of cross contamination. One family member told us, “They always wash hands first and wear gloves”. Staff undertook training in Infection Prevention and Control. Policies were in place to promote good practice, and staff competency assessments were undertaken as part of staff mandatory training.
 

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.
Medicines administration records viewed showed that people received their medicines as intended by the prescriber. Some minor recording discrepancies were identified, however the service had systems and processes in place to monitor and respond to these as necessary.
Staff were well trained and competent in administering medicines. People told us their medicines were administered safely and on time. Speaking of the support they receive with medicines, one person told us, “My medicines are given to me exactly on time” and another person said, “They give me my medicines absolutely splendidly!”.
Where medicine errors had occurred, action was taken to ensure people were safe, and staff were retrained in line with the providers medicines policy.