Nationwide Care Services Ltd (Dudley)

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 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 did not always investigate safety events to identify lessons learnt. Lessons were not always learnt to continually identify and embed good practice.

The oversight and management of safety events was not always effective. Where accidents and incidents had been documented, the provider did not always adequately review these for understanding and learning. For example, records failed to demonstrate the provider had reviewed the causes and circumstances of how some safety events which had resulted in people sustaining injuries might have occurred. This meant opportunities to understand how and why these incidents had occurred, so that individualised and decision-specific control measures could be considered, were missed.

Accidents and incidents were recorded by staff. Where appropriate, these records included the actions taken by staff, which included contact with external healthcare professionals. Some incidents had been reviewed by the provider to support their awareness of these events.

Accidents and incidents were mostly not reviewed within staff meetings. For example, despite a number of incidents occurring within this period, no incidents were reviewed within the staff meeting covering the period January to March 2026. This meant staff did not have the opportunity to share learning to improve the safety of the service.
 

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored.

The provider ensured safe systems of care in relation to the transition process for people before they moved to the service. Leaders told us this process consisted of obtaining information about people’s needs by completing assessments of people with the participation, where possible, of friends and family who know the person well. When we spoke with people and their relatives, we were not made aware of concerns regarding this process.

Systems were in place to ensure care plans contained relevant information about people’s needs.

Effective systems were not always in place to ensure safety events were adequately reviewed for understanding and learning. For example, where people experienced incidents which impacted their health and safety, incident records did not always show that the causes and circumstances of the event had been reviewed. This meant people were at risk of their needs not always being clearly reviewed and used for learning and understood by staff.
 

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that.

People informed us they felt safe when staff supported them. One person told us, "I feel very safe.”

There was a safeguarding policy in place, records showed staff had completed safeguarding training and staff were able to tell us the action they would take if they had concerns. Leaders told us how safeguarding concerns would be reported to the local authority and Care Quality Commission (CQC).

We checked whether the service was working within the principles of the Mental Capacity Act 2005 (MCA). Where people had been assessed as lacking mental capacity to consent to their care arrangements, decision-specific mental capacity assessments and best interest decisions regarding key aspects of people’s care had been carried out to demonstrate decisions taken on people’s behalf were being taken in their best interests.
 

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.

People’s care plans and risk assessments provided information which reflected people’s physical health and safety needs. For example, Staff had guidance when people had specific physical health conditions.

Staff demonstrated a good awareness of people’s needs, such as people’s communication needs, and involved people in understanding and managing their own risks when we spoke with them.

The provider had systems in place to identify and manage risks within people's home environments.

The provider completed environmental risk assessments of people’s home and undertook observational checks of people’s home environments as part of the quality assurance checks they completed of people’s care and staff.

Staff completed health and safety training and demonstrated a good awareness of how to ensure people’s home environments and mobility equipment was maintained to mitigate potential associated risks.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development.

The provider mostly demonstrated a regard for safe recruitment practices and employed staff with the skills, knowledge and experience to meet people's needs. Staff completed an induction, received training relevant to the people they supported and took part in supervisions. Staff told us they shadowed experienced colleagues before working independently.

People and relatives were confident that staff had the skills to provide safe care. One relative said, "They know what to do."

The provider did not consistently obtain and check staff applicants' full employment histories. This meant there were limited assurances around staff suitability to support vulnerable people.

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.

Training records showed and staff confirmed they completed training in infection prevention and control (IPC), and staff told us they had access to personal protective equipment when they needed it. The service had an IPC policy which set out their IPC expectations.

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

Clear systems and processes were in place regarding the storage, administration and documentation of people’s medicines.

Staff completed training in safe medicines management and staff we spoke with demonstrated good awareness of medicines processes and people’s individual medicine needs.

Leaders told us they used an electronic medicine system to monitor medicine practices, and they completed regular checks and audits to ensure safe and appropriate medicines practices.

People and relatives told us they were happy with the medicines support they received from staff.