Excellent Health Care

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.

Relatives told us that when they had raised an issue with the provider action was taken in a timely manner and improvements were made. The registered manager explained that following an investigation into incidents, accidents, safeguarding and complaints the outcomes were initially shared with the staff who worked with the person involved to make immediate improvements. The actions were then discussed during supervision and a team meeting with the wider staff group so they could implement any changes. Staff confirmed lessons learned had been shared with them. Their comments including, “We learn from having meetings and reading the care plan again”, and “We discuss it with the manager and make sure [the issue] is not repeated.”

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.

People’s care needs were identified to ensure their support needs could be met safely and ensure a safe transition to the service. The provider received information on the person’s care needs in the referral from the local authority. The registered manager told us a senior staff member would undertake the initial care visit. While the senior staff member provided the care, they could identify what was required and how the person wanted the care provided. The provider would work with professionals when required to ensure the required support and equipment was in place to enable staff to meet the person’s needs.

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.

Relatives confirmed their family members were safe when they received care in their own home. A relative said, “[Family member] is safe with the carer, who is careful and does a good job.”

The provider had a process for the reporting and investigation of any concerns relating to the care provided. The registered manager told us they had a safeguarding policy, and they followed the local authority safeguarding process. This was demonstrated in the safeguarding record we reviewed. An audit of safeguarding concerns was carried out to identify any trends indicating improvements were required. Staff told us they had completed safeguarding adults training and were able to explain their role in ensuring people were protected from possible 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.

Relatives told us they felt their family member received care in a safe way and the staff were responsive. A relative said, “Staff make sure [family member] is safe. They’re proactive, which is reassuring for [family member].” The relative explained staff had identified an issue with their family member’s health, and they ensured the person received the medical support required.

The registered manager told us that, if during the initial needs assessment, any risks were identified they would discuss them with the person and their relatives so actions to reduce the risk could be agreed. If additional equipment or support was identified the staff would contact the relevant health or social care professional so they could work together to provide appropriate support. Risk management plans had been developed in relation to people’s health and wellbeing, which provided staff with detailed guidance on how to reduce the identified risks. As part of the care plan there were information sheets provided for staff relating to the person’s specific medical conditional and how these might impact their care and life. Staff completed training to support them to manage risks safely. The training included health and safety and how to support people with their mobility needs.

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

Checks were carried out on the person’s home to ensure appropriate action had been identified to reduce risk. Fire risk assessments were completed to identify any risks, who was responsible for checking the fire alarms and provided guidance for staff on how to evacuate the person in case of an emergency. People’s care plans indicated if they used an emergency call pendant and provided guidance for staff on ensuring this was easily accessible.

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.

Relatives told us their family members were usually visited by the same staff members so there was consistency in their care. A relative said, “We have the same carer for 5 days and the other one for 2 days. My [family member] likes carers they know.” Relatives also confirmed they were contacted if the staff member was running late, and when they arrived, they usually stayed for the agreed time. Staff confirmed they had enough travel time and regularly visited the same people. The provider had appropriate procedures for recruiting staff and ensuring they have the required skills and knowledge for the role. New staff completed an induction, training and had their competency assessed. There were regular supervision and team meetings, with staff feeling supported.

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.

Relatives told us staff wore personal protective equipment (PPE) when they provided care, with a relative commenting, “They wear protective clothing. Masks and gloves and wash hands.” Staff were provided with PPE which they could collect from the office, or it was delivered to people’s homes. The registered manager explained staff completed an annual infection control training course and their competency was assessed. Senior staff undertook spot checks to monitor staff compliance with infection control best practice.

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Medicines risk assessments were completed which identified if the person had any allergies, if any medicines had specific requirements such as needing to be administered at a specific time and any possible side effects. Staff completed regular training on the administration of medicines, and their competency was assessed. Audits were carried out to ensure medicines were administered as prescribed and the records were completed accurately. If any issues were identified from the audit, improvement actions were implemented. Relatives confirmed staff provided the appropriate support with their family member’s medicines.