Essex and Suffolk Quality Care 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 requires improvement. At this assessment improvements had been made, and the rating has changed to good. This meant people were safe and protected from avoidable harm.

People were safely supported and risks to their health and wellbeing were well managed. The provider understood their responsibilities to keep people safe from harm and abuse. Medicines were managed safely and staff followed infection control policies and procedures. There were enough staff to meet people’s needs, and they had been trained and supported to understand their role. The provider took appropriate actions and had systems in place for learning when things went wrong and made changes to improve the service.

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 positive culture of safety, based on openness and responsiveness. Staff listened to people’s concerns about safety and reported any issues raised to the registered manager. The registered manager had an overview of all accidents, incidents and complaints which had been responded to or investigated where required. Lessons learned were shared with staff to continually identify and embed good practice. People and relatives told us they could raise any issues they had concerns about and were confident they would be listened to and action taken where needed.

People’s care and support needs were fully assessed by the registered manager prior to the start of their service to ensure their needs could be met. People confirmed they were involved in their plan of care to be provided. One person told us, “Yes, I was involved in the planning of my care, and I stated I preferred female staff which they have given me.”

Processes were in place to support people to use and move to other services as required. We were given an example of one person who did not have any family and needed to attend hospital appointments. The staff liaised with the hospital and arranged the appointment times so that a staff member could attend with them each time.

People and relatives told us they felt safe with the staff who supported them. A person told us, “Oh yes, I do feel safe because the staff are always and supportive to me. A family member said, “My [relative] does feel safe with the staff because of the confidence they have in the support provided.”

Staff had received training in safeguarding people from abuse. Staff understood their responsibilities to report concerns about abuse and whom to report to. They felt confident the registered manager would take the necessary action. Policies and procedures regarding reporting safeguarding concerns had been improved and the registered manager kept an overview of any safeguarding concerns. Where safeguarding concerns had been raised either by the service, partner agencies or via the local authority, appropriate processes were followed to ensure they were investigated with any action taken and outcomes.

People and relatives told us they were involved in the delivery of their care and any potential risks to their safety. Risk assessments were written in a person-centred way, regularly reviewed and updated to ensure they remained reflective of the current needs of the person. A person told us, “I do have risk of falling and this was discussed and recorded. All staff are aware of my poor mobility, and they walk behind me and observe my ability daily.” A family member said, “The needs of my [relative] were very thoroughly discussed with the staff as there are a number of risks with their condition which adds another dimension to the risks. The staff are very observant with their mobility.”

Care plans had been improved and contained guidance for staff in how to manage risks associated with people’s care and support which included personal care, mobility, falls and pressure care. People’s needs around their nutrition and hydration were also now recorded to ensure they kept well. Further work was underway to manage information more effectively on the provider’s new electronic recording and monitoring system. Staff could access and record information quickly using the care planning application on their mobile phones whilst out on their visits. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. The service had a consistent team of permanent staff to support people which meant staff knew people well and were aware of any associated risks relating to their care and support.

During the initial assessment visit to a person at home, the registered manager undertook a risk assessment of the environment to ensure it was safe and accessible. This included the use of any equipment, security of the home, any restrictions or space constraints or risks caused by the room layout. A family member told us “My [relative] has had several falls during the past 3 years and staff do support them with changes in direction and seating, enabling them to take their time safely.”

People and relatives told us that they had regular staff, who mostly turned up on time and had not had any missed visits. Where staff were occasionally late, people understood the reasons why but made comment that they were not always informed of this by the office. A person said, “Staff do arrive on time, stay the right amount of time and do everything I need them to do.” A family member told us, “The staff do arrive on time, do everything in the allotted time. But sometimes there are unforeseen issues that make them arrive late. We are not always informed of this.” We fed this back to the registered manager for their attention.

The provider’s investment in an electronic management system had improved the monitoring of visits to people and managing missed or late calls. The system provided live information about where staff were, when they had arrived and left a care visit and travel time in between. It also alerted the registered manager if a staff member had not signed in to a care visit, so this could be dealt with quickly. The rota arrangements were working well, and staff had no concerns about their hours and working arrangements.

Staff spoke positively about working at the service and did not raise any concerns regarding staffing levels. One staff member told us, “I think there are enough staff to care for people, in fact I could do with more hours.” Another staff member said, “I like that I cover my area and the people I care for. I have the hours that fit round everything. I do extra if needed to be called on. It couldn’t be better.”

The training and supervision for staff had been improved and was robust. Training included topics required from the last assessment such as oral hygiene, basic first aid and pressure care management. Training in moving and handling people was in person with a trainer so staff could experience using equipment. Staff competency to assist people to move safely was observed during spot checks at the person’s home. A staff member told us, “I have recently completed all mandatory training and though these are a refresher of my knowledge, they support me to keep up to date with any changes and give me confidence in providing the best possible care.”

Staff received an induction into working at the service which included online training and shadowing more experienced staff. Supervision was held every 3 months and appraisals annually. Staff told us the registered manager and office staff were supportive and available should they need advice and support. A staff member said “I do have competency tests, supervisions, spot checks and appraisals. My opinion is for me they work, and I appreciate the feedback. I find it helps to improve my skills and maintain my standards.”

Systems had been improved to the recruitment process of care staff. The registered manager was aware of the legal requirements when recruiting staff. Work was underway to incorporate the recruitment files into the monthly auditing system. This was to improve the oversight and management of staff employment, any overseas working conditions and reasonable adjustments for staff. Recruitment processes in place included the completion of appropriate pre-employment checks such as references from previous employers and disclosure and barring service checks (DBS). This helps employers make safe recruitment choices.

People and relatives did not share any concerns in relation to infection prevention and control procedures and all commented that personal protective equipment (PPE) was worn by staff appropriately. Staff had undertaken infection prevention and control training and were provided with PPE which could be collected from the office. A member of staff told us, “You can get PPE easily when you need it, no problems with that at all.” Another said, “I follow PPE guidelines and also if someone wishes me to wear a mask as well then I will do.” The provider had an up-to-date policy in place to support effective infection prevention and control and was following current guidance.

People told us they received their medicines where required and on time. A family member told us, “The staff manage my [relative] medicines and record it on a record sheet and on their phones. There have not been any errors.” A person said, ‘I manage my own medicines, although staff can sometimes prompt me or check that I have taken them. No errors have arisen.”

The medicines administrative system had improved and was monitored and managed effectively. This was now electronic which made it easier, quicker and more effective updating people’s records and monitoring people’s medicines. The use of body maps to inform staff about the application of topical creams had only just been implemented as part of the overall improvements. The registered manager told us about issues going over to the electronic system, such as there not being a tool to record the checks on stock. They had raised it with the company who were looking into this. In the meantime, the staff had tested out a number of ways of stock checking and agreed to return to paper records as the safest approach until this could be resolved.

The provider’s policy had been updated to provide the procedures for the safe administration of people’s medicines. Staff had completed the required training and skill assessments and the checks on their competency and observations of practice were robust. Medicine competency assessments were seen on staff files. People had care plans and risk assessments which detailed what medicines they were prescribed and how they liked to be supported in taking them. The registered manager completed regular audits to ensure the system was safe, which included identifying any changes needed, shortfalls, errors and dealt with them quickly and effectively.