Keiron Starns Care Agency

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 the rating has changed to 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. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The provider completed audits to identify learning, this learning was shared with staff via meetings and supervision. Staff told us the registered manager shared learning with them via varied channels. Comments included “[registered manager] discusses changes with us at supervision and meetings”. This meant the provider could be assured they were supporting a culture of learning and staff had the information they required to drive improvements.

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 communicated with other professionals to enable people’s needs to be updated. Staff we spoke to told us, “We speak with the Local authority if things change for people”.

We were told when a new person is assessed part of this assessment includes inviting them to the service to meet people who live there and staff. These visits are slowly increased and feedback gained from all involved.

The provider had contacted other healthcare professionals to request an assessment, the outcome of this assessment was recorded in the person’s care plan and associated risk assessments completed. This meant people’s care was safe and people had access to information required when moving between services.

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.

During our previous assessment we found shortfalls in staff’s knowledge in relation to safeguarding and the mental Capacity Act. During this assessment we found that improvements had been made. Staff were confident in their knowledge of these areas and were able to clearly explain the principles of the Mental Capacity Act and how to identify and report any safeguarding concerns. Comments included “If the person lacks capacity a best interest decision is made” and “If I was concerned about the safety of a person I would report it to [registered Manager] or if needed the local authority or Care Quality Commission (CQC)”.

The provider had ensured that agreements in relation to the person’s finances had been assessed and the principles of the Mental Capacity Act had been followed and recorded to ensure they were safeguarded against financial abuse. This meant people were protected from the risk of harm.

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.

During the previous assessment shortfalls were found in relation to people’s risks. During this assessment we found the provider had addressed these shortfalls. Risks to people had been identified and mitigated, people who required input from other health care professionals had received this. For example, a person who had been identified as being at risk of choking had been referred to the appropriate healthcare professional to complete an appropriate assessment of this risk, the provider ensured that the outcome of this assessment was recorded and reflected in the associated risk assessments.

The provider had completed a wide range of risk assessments which identified and mitigated risk to people and staff, these were monitored and reviewed. This meant that people’s risks were mitigated.

However, one risk assessment was not individualised, for a person’s choking risk. We found a shared risk assessment and risk mitigation for other people living at the service. This meant the provider could not be assured that risk records were individualised and completed in a person-centred way or that they were in line with right care right support right culture guidance.

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

During the previous assessment we found shortfalls in relation to fire risks. During this assessment we found the provider had taken action to address these shortfalls. For example, risk assessments related to the risk of fire had been reviewed and updated to ensure safety measure were still adequate, all staff had completed practice fire evacuations including a simulation of a nighttime evacuation.

The provider had ensured that regular safety checks and servicing had been completed on equipment such as boilers and smoke detectors.

This meant the provider could be assured that equipment was safe, evacuation plans were effective and staff were familiar with these plans.

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.

Staff had completed training to enable them to perform their roles this included training to support people with a learning disability or autism, The registered manager completed competency assessments with staff in area such as medicines administration and interactions with people to ensure they had the skill and knowledge to support people safely and in line with people’s needs and preferences.

During our previous assessment we found that the provider did not provide supervision and support to staff in line with their policy. During this assessment we found actions had been taken to address this. For example, the registered manager had completed regular supervision with staff. Supervision records contained details of support offered to enhance staff knowledge.

Staff we spoke to told us they received support from the registered manager. Comments included “[registered manager] gives us supervisions and offers support whenever we need it”.

This meant the provider could be assured that staff had the support and knowledge required to perform their role safely.

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.

Staff we spoke to were able to explain how and when they used personal protective equipment (PPE) such as gloves and aprons. Comments included “we have plenty of gloves available”. The registered manager competed competency assessments which included details of how staff followed good practice in relation to PPE.

Food was stored appropriately and people were supported to ensure their home was clean.

We saw staff supporting a person to ensure they had washed their hands prior to eating.

This meant people were protected from the risk of infection.

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.

During our previous assessment we found a shortfall in relation to the management of medicines. During this assessment we found the provider had taken action to address these shortfalls. For example, the provider now completed regular audits of medicines to identify any shortfall and rectify these quickly. The registered manager completed competency assessments with staff to ensure that medicines were managed and administered in line with national guidance.

Staff we spoke to were able to explain how they administered medicines safely and told us they completed daily checks on medicines. Comments included “We check the medicines daily” and “[registered manager] check we are doing it correctly”. People we spoke to told us they were supported well with their medicines. Comments included “Staff help me” and “staff sort my tablets”.

This meant the provider could be assured people were supported safely with their medicines.

However, medicines were still stored and administered in a designated room. There were no records of people’s opinion or choice in relation to where their medicines were stored or taken. This approach was not in line with Right Care Right Support Right Culture guidance and does not promote people to have choice and control over their medicines.