Evelyn Grace Ltd

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. Systems such as observations of staff practice and audits on various areas of care were used to identify themes and drive improvement. Records were kept where there had been medicine errors, and the registered managers ensured medical advice was sought and arranged additional visits to people to check on them to ensure they were well. Information was always passed to the staff team following any learning event to minimise errors occurring again.

Staff confirmed they could speak up about concerns or issues without fear of being blamed. Staff felt there was a culture of learning from events and that all staff were sent information to ensure everyone was consistent when providing care.
 

The provider worked with people and professionals 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. This included when people were being discharged from hospital or moving to a residential care service. We saw evidence of where the registered managers had clear communication with relatives to ensure people received the right support and home visits when they were needed. This ensured people were not left without the appropriate care and reduced the anxiety people might feel returning to or leaving their home.

Referrals and requests for professional advice were made when people’s needs changed so that people could continue to live safely at home. One professional told us, “Communication has always been constructive and focused on achieving safe and effective outcomes."
 

The provider worked with people and professionals 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 registered managers shared concerns quickly and appropriately.

People and their relatives told us if they had any concerns, they would raise these with the registered managers. Staff told us they had completed safeguarding training and knew to report concerns to the registered managers.

The registered managers confirmed there had been no safeguarding concerns but were aware who to report concerns to externally. One of the registered managers was in the process of completing the Level 3 Safeguarding Support Officer Apprenticeship. A professional, who was overseeing this training, told us, “Overall, [registered manager] values, professionalism and consistent engagement strongly indicate a service culture where staff are supported, learning is encouraged and people receiving care are respected and safeguarded.”
 

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care that fully met people's needs and was safe, supportive and enabled people to do the things that mattered to them. We noted that a relative sometimes assisted one staff member to mobilise a person using the service. The registered manager confirmed this had been agreed with the person using the service, who had capacity to consent to this. The potential risks had been assessed, and the person was not placed at risk of harm.

We were told of a person who was receiving end of life care. To ensure their safety staff carried out an assessment of presenting risks at the start of each visit to determine whether the person was sufficiently alert and and physically able to manage a safe transfer to the chair using a prescribed Mini-Lift. This responsive, real-time decision-making process was agreed by all those in the person’s life to ensure there was a unified, safe and pro-active approach in place to support the person.

This was verified following a positive comment from a professional who trained staff to mobilise people safely. They told us, “Management have proactively sought advice when encountering complex or challenging moving and handling situations, showing a strong awareness of risk and a willingness to seek appropriate guidance.

Care plans detailed how staff should support people in various areas of their lives, for example with equipment to move and position people safely. People and their relatives confirmed they were involved in the completion and reviews of care plans and risk assessments. People and relatives did not raise concerns about safety and gave examples of staff recognising early signs of deterioration and acting promptly. One relative told us, “He (person using the service) gets dehydrated quite often, but the team spot the signs and get him to drink.”
 

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

Environmental risk assessments were in place, and staff were clearly informed of what to consider before visiting people. Staff demonstrated familiarity with people’s homes and safety arrangements. Oversight of the servicing of the equipment in people’s homes relied partly on relatives. The registered manager confirmed they would document when equipment had been checked and serviced by external professionals.

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 were visited on time and were happy with the staff who visited them, everyone we spoke with praised the staff team.

Staff received a detailed induction and completed a wide range of training. The registered managers monitored the completion of this to ensure staff were skilled and had received up to date guidance and information. Each month there was a topic for staff to review and complete training on, such as stroke awareness. The registered managers recognised when staff had the necessary skills to take on more responsibilities and they had promoted a staff member to support them, and their tasks included carrying out observations on staff and completing checks on the service.

The registered managers regularly worked alongside staff. This was a way to get to know people using the service and their relatives but also to observe staff working with people and to be positive role models for the staff team. The registered managers were passionate about checking people were happy with the staff who visited them and we saw they changed staff as and when they needed to following feedback from people or their relatives.

Staff recruitment was value-based as the registered managers employed staff who were committed to providing kind and caring support to people. Staff confirmed they had gone through recruitment checks, shadowed experienced staff and received information about the people they were visiting prior to carrying out the care. This process enabled staff to support people safely and appropriately.

Staff described feeling supported and their work was regularly checked. Comments from staff were positive and included, “The Management team are always at the end of a phone to discuss our needs, and the client’s needs, for advice or even just moral support” and “There are procedures in place to ensure I always feel supported and part of a team."

The provider assessed and managed the risk of infection appropriately. Staff had received infection control and food hygiene training. People and family members told us homes were respected and kept clean and tidy.

Staff described timely access to personal protective equipment (PPE), supporting safer practice. A staff member told us, “If I ever need to stock up on more and request, the wait time is never long and I’m always provided with PPE in good time.” Infection control was monitored through spot checks and audits. We also saw there was an Infection Prevention and Control policy which staff followed.
 

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. There were some inconsistencies in medicines recording. For example, on an occasion staff recorded ‘see notes’ instead of signing the relevant medicines record to confirm the task had been completed. Although the notes confirmed the prescribed drink had been administered, this had not been formally recorded in line with expected practice. The registered manager acknowledged this did not meet required standards and took action to reinforce accurate recording with staff.

We saw how the registered managers advocated on behalf of people where they felt their needs were not being met by professionals. For example, where a person needed a review of their medicines, we saw the registered manager had liaised with the G.P so their medicines would be updated.

Staff stated they were confident in prompting and administering people’s medicines. They were clear on how to safely carry out medicine tasks and confirmed they were observed carrying out this task and received training. If staff had any concerns, they could use the on-call arrangements one staff member told us, “I always make sure to ask the on-call manager for any assistance or clarification.”