Karrek Community

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

The provider ensured all accidents or incidents that occurred were fully investigated and any areas of learning or improvement identified. Where issues were identified in relation to individual staff actions, additional support and refresher training was provided. Where staff performance failed to improve, disciplinary procedures were used appropriately.

Planned care visits were infrequently missed. Each missed visit was fully investigated to prevent recurrence and written apologies given to people detailing the circumstances of each missed visit.

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.

Summary information about people’s specific needs and preferences was available to be shared with health service colleagues in the event a hospital admission became necessary. When care was transferred to other providers, the service shared information openly to ensure people’s specific needs were recognised and understood.

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.

People consistentlyreported and demonstrated through their actions that they felt safe with their support staff. We observed people were comfortable requesting support and reassurance from staff. People told us, “I feel really safe with them”, “I feel safe with carers”, “Their duty of care is really good. I feel safe with them” and “I have one consistent carer, and I know all the ones who come. I feel very secure with the care and how it is arranged”.

Involved heath care professionals were confident the service provided safe care. They told us, “The provider shows a proactive approach in adapting care to changing circumstances, ensuring that people feel safe, respected, and valued”.

Staff had a good understanding of local safeguarding procedures and were confident any safety issues they raised would be investigated and resolved. Staff said, “If I raised a safeguarding, it would be acted upon, 100%.”

Where people lacked the mental capacity to make specific decisions, and their care plans were potentially restrictive, these issues had been reported to the local authority for authorisation via the Court of Protection. Where orders were made, any related conditions were understood and had been complied with.

There were processes to ensure people were protected from financial abuse,where the service provided support with shopping tasks, records and receipts were maintained for all purchases made.

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.

Staff were confident people were safe, risks had been identified and during home visits we observed risks were mitigated effectively.

Some people could sometimes act in a way which might expose themselves, staff or the public to risk. Care plans included clear guidance for staff on how to support people if they became upset or anxious. Restrictive practices were authorised to ensure people’s safety and staff were clear these techniques should only be used in exceptional circumstances, when other options had failed and significant risk of harm was present. Records showed these techniques and been infrequently and appropriately used. We observed staff using distraction and other techniques as described in care plans, with care and compassion, to help people effectively manage their anxiety. Professionals told us, “From what I have seen, I have no concern about overuse of restraint”.

Specific risks associated with people’s support needs had been identified and mitigated. We observed staff acted on guidance provided to ensure people’s safety. People told us they felt comfortable and safe while being supported to mobilise.

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

Managers had supported people to engage with housing providers when things went wrong to ensure prompt remedial action was taken,

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 confident their staff would arrive on time and care records supported this. People told us, “Time keeping is very good and they let me know beforehand if there is a need to change the time they will come”, “Time keeping is very good. When one carer had a car breakdown, they soon got someone else out to me” and I’ve always been told beforehand if someone was to be late but I can rely on them being there at 7am on the dot”.

Records showed people were normally supported by small teams of staff who supported them regularly. People and their relatives valued this consistency in support and told us, “I have regular carers, time keeping is brilliant. They let themselves in but always knock”, “There is a team of carers on a rota, I know them all” and “I have very consistent carers and time keeping is very good. The carers let me know who will be coming for the next visit, which is good to know”.

Staff were recruited safely and necessary pre-employment checks had been completed. Staff described how people they now supported had been involved in their recruitment processes.

Staff new to the care sector were supported to complete the care certificate as part of their training and induction shifts were completed before staff provided support independently. Staff told us they received regular training updates and were confident they had the skills necessary to meet people needs.

Supervision was provided regularly and team meetings held to provide opportunities for information sharing, reflection and learning. Staff comments included, “I am up to date with my training”, “We do training regularly, occasionally online, sometimes in person. I had First Aid training this month. There is some training to do most months” and “We had a staff meeting 3 weeks ago”.

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 had access to good stocks of Personal Protective Equipment (PPE) and received training in the management of infection control risks. During our home visits staff managed infection control risk effectively and PPE was used correctly.

People recognised staff took action to help them manage infection control risks and we noted during home visits that rooms were clean, and people well dressed. People’s comments included, “They are very particular about using PPE, I like it that they change gloves between doing different tasks”, “I’m very happy with how they maintain hygiene, they use gloves and aprons and clean up after themselves” and “They uphold high standards of cleanliness.”

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.

People told us, “They help me take my medication” and “I’m visually impaired and they continually check for my safety. They give me medicines on every visit, as I could not manage them. As with all my care, they tell me everything they are doing and they have explained how they record things in their app”.

Staff understood how to manage people’s medications safely and had access to clear guidance on when specific medicines should be used. One staff member described the process of giving medication, telling us, “Medication is always given with two care workers. All PPE on, gloves, and aprons. We check the Medicine Administration Record (MAR), get the medicine, explain what we are going to administer, give it, check it’s been taken, then sign the MAR and remove PPE.”

Some people were at risk of experiencing seizures and had been prescribed rescue medications. Staff had clear guidance on the circumstances in which this medication should be used. They told us, “We have had training [on rescue medications] and I have had to give it. We have a going out bag that has the medication and everything else we might need”. During visits we checked these bags and confirmed rescue medications were available where required.

MAR charts were accurately completed and demonstrated people had received their medicines as prescribed. Where errors occurred, these were reported promptly to the office, guidance sought from health professionals where necessary and staff actions investigated to identify any areas of improvement or learning.