Ornate Healthcare Services

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.

Accidents and incidents were documented and investigated fully to minimise risk and promote learning opportunities. There was an open and transparent culture at the service; staff told us the ways they could report any matters necessary and were confident these would be followed up.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

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 and their relatives consistently told us they felt safe in the presence of staff. One person said, “We’ve been with them for a while and I think they’re generally good. She’s definitely safe.” Another relative told us, “I do feel he’s safe. I have had to increase the care package; there are some little tweaks needed and I leave notes.”

There was an up to date and relevant safeguarding policy in place which staff had access to and demonstrated knowledge of. Staff had received appropriate training and knew how to recognise the signs of abuse. They were confident any safeguarding concerns would be addressed quickly by the registered manager and other office staff.

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.

Risks had been assessed and measures were in place to minimise these where possible. Guidance on how to support people to remain safe was detailed within electronic care records; staff could access these in real time on their mobile phones via an app. For example, one person presented as a high risk of choking and aspiration; staff were instructed not to use a spouted beaker and to make sure the person was sitting upright when eating and drinking. The potential outcomes of being given an inappropriate diet were documented and actions staff should take to mitigate the risk.

People were involved in decisions about their safety and care planning wherever possible. Care plans showed person-centred practice, with descriptions of preferences, routines and what mattered to people. Families and representatives were appropriately involved, for example where people had reduced capacity. Risk assessments were appropriately completed and captured people’s strengths and independence.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

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 received training appropriate to their role and told us about the confidence this provided them with. Training was robust and innovative. A previous office location had been converted to replicate a person’s home and training sessions were held and attended by staff. A whole range of care tasks that might be undertaken during visits in the community were simulated, for example preparation of meals, delivering personal care, administering medication and training on specialist equipment. Managers observed staff for competency and compliance.

Where specialist training was identified this was arranged for staff, often involving external health professionals. The registered manager was keen to access any relevant training on offer for staff to increase staff knowledge and develop their practice.

Staffing levels were suitable to meet each person’s needs and people told us they were mostly kept informed about who would be providing care and support. One person told us, “They [carers] are on time. I get the same people, which I prefer; they’re aware of your needs. I think they’re very good, very helpful. They let me know if they’re going to be late.” Another told us the care team hadn’t been as consistent recently; they had voiced their concerns to the registered manager, who had apologised and taken appropriate action.

Recruitment practices were safe and robust. Staff files contained Disclosure and Barring Service [DBS] checks, verified references, interview notes, proof of identity documents and training records. Gaps in employment had been explored.

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.

Policies were in place to minimise the risk of infection spread and highlighted the importance of disposing of waste appropriately. This included supporting people to undertake domestic tasks independently where possible.

Staff received appropriate training and understood their responsibilities in maintaining high standards of cleanliness in people’s homes. People told us that staff wore personal protective equipment (PPE) when necessary and oversight via regular spot checks by the office team reflected this.

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.

Not everyone receiving personal care needed help with medication as some people were able to self-administer and this independence was encouraged. For the people that did, a recent photograph on the electronic systems helped staff identify them; we were assured people were in receipt of the correct medication. Where people had not consented to having a photograph taken signed documents were in place recording the decision.

Whilst the ordering and collection of medication was not always the responsibility of the service it was discussed and recorded that carers were responsible for monitoring medication stock levels. Action had to be taken if medication was running low or was unavailable; instructions were to contact the manager or dial 111 for emergency supplies, as to leave the client without medication was not an option.

A professional we contacted for feedback considered staff always demonstrated good practice, followed correct procedures, and ensured medication was managed safely and appropriately at all times.