Cera - Derbyshire

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 as 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.

People were encouraged and supported to raise safety concerns with the provider. The registered manager and staff understood the importance of reporting safety concerns and learning lessons when things went wrong.

Systems were in place to support staff to report and record safety concerns and events when they arose. The registered manager investigated safety concerns and events and used the learning from these to support staff to continually improve their practice, reduce risk and keep people safe.

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 had an appropriate process for new referrals, obtaining a copy of the person’s initial assessment, and then carrying out their own assessment of need, before deciding whether they would be able to provide support. There was an electronic care record system in place, which care staff had access to via handheld devices. This helped ensure people’s care was provided in a planned, responsive and organised way.

People were listened to by the provider’s staff when their initial care plans were being created. This helped ensure people were supported to receive continuity of care when they started receiving care from this service.

The provider had standardised policies and procedures in place to ensure the way they supported people reflected best practice in terms of safety and effective ways of working.

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 told us they felt safe when staff they knew interacted with them. Staff used respectful language when describing people and their care needs. The provider had a comprehensive safeguarding policy and procedure in place, which included consideration of sexual safety and online safety. Staff received regular safeguarding training.

People also had access to others outside of the service with whom they could raise concerns about their safety if necessary. For example, social workers, other visiting health care professionals, and family members.

The provider carried out investigations into any incidents which occurred while providing a service to people. They also co-operated with safeguarding enquiries carried out by the Local Authority. The provider’s investigation findings were used by the registered manager to identify any lessons learned and actions to be taken to ensure people were protected from abuse.

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.

The provider reviewed any incidents for recurrent trends or triggers. Information about changes in people’s care needs was shared with the staff so support arrangements could be changed to reduce recurrences. People, and their relatives where appropriate, were involved in deciding how their individual risks would be managed and mitigated.

People’s individual risks were regularly assessed, and positive risk taking was used as a means of enabling people to maintain as much independence as possible. For example, a person told us, “Yes, they do encourage me to stay independent. I’m [age] years old, and my knees and shoulder give me trouble. But they are patient with me.”

People’s care plans detailed how to support their care and health needs. Staff knew the people they supported well and were aware of the symptoms and cues which might indicate they were becoming unwell or distressed. A staff member told us, “From my experience of working at Cera-Derbyshire, I believe the service provides good quality care to service users. Staff treat people with dignity and respect, and we always try to follow care plans carefully to meet individual needs.”

People’s individual risks were identified and assessed in their care plans. Care plans were regularly assessed and amended when people’s needs changed or when they changed how they wanted to receive care from staff.

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

People were cared for in their own homes. The provider had environmental safety assessments in place to identify any potential risks in the person’s home which may have an impact on the person or their care staff. Any potential environmental concerns were discussed with the person receiving care, as the provider was mindful it was the person’s own home.

The registered manager made sure there were enough qualified, skilled and experienced care staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Some people told us they did not always know in advance which staff member would be arriving to support them. The provider did not use agency staff as they felt people needed the consistency of care from their own directly employed staff. However, there were sometimes short notice changes to staff rosters due to sickness etc. Some staff told us this sometimes caused them individual difficulties, and some people also told us this meant they didn’t know which staff member would be supporting them.

The registered manager told us they were implementing a new process which would enable staff, who were supporting a person, to tell them which care staff member would be visiting them next. They also told us people, and their relatives, had recently started being offered access to the Cera-Derbyshire software system so they could see for themselves which staff member would be visiting them. The registered manager also told us some people preferred to receive paper copies of their support rota, and this was arranged each week, but it was difficult to keep those paper copies up to date when staff rotas changed at short notice.

The provider had robust and safe recruitment practices in place to make sure all staff were suitably experienced, competent and able to carry out their role.The registered manager had an effective programme of appropriate staff training in place, and staff told us they received the training they needed to support people safely.

Staff received specific training to ensure they could meet the needs of people with complex care and health needs. This included training related to health conditions, and care needs, as well as learning disability awareness training.

The provider encouraged staff to develop their skills and knowledge. For example, a staff member told us, “Yes, National Vocational Qualifications (NVQs) and additional training are offered at 1 to 1 meetings with the managers”.

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.

There was an effective approach to assessing and managing the risk of infection, which was in line with current relevant national guidance. The provider had an infection prevention and control (IPC) policy and procedure in place, which staff had access to.

The provider’s IPC policy and procedures set out the clear roles and responsibilities around infection prevention and control. The provider ensured their staff had access to the necessary personal protective equipment (PPE) to support effective hygiene and infection prevention. Staff told us PPE was always available for them to use.

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 were involved in decisions about their medicines, and their medicines were appropriately prescribed, supplied, stored, and administered in line with the relevant legislation. The provider made sure people’s individual care plans specified exactly what support each person needed from care staff in respect of their prescribed medicines.

The provider had appropriate arrangements in place for the safe management, use and oversight of controlled drugs in people’s own homes. People had up-to-date information about their medicines available in their care plans and the provider’s medicine records. Although in many cases people’s medicines were managed by the person themselves, or their family members, the provider worked with people to ensure they had the necessary prescribed medicines available to them.

The provider carried out regular medicines audits to identify any errors in recording, or the timing of prescribed medicines being given to people. When any errors were found they were investigated and dealt with appropriately by the registered manager and senior care staff.