Dementia Care & Support at Home Limited

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.

Staff understood the importance of learning lessons from safety events and taking action to embed good practice. This included staff checking people’s peoples care plan and risk assessments prior to each care call visit.

Critical information was shared with staff timely and followed up via team meetings and individual one-to-one meetings. This helped to avoid miscommunication.

There had been learning following the findings of the previous CQC inspection. Efforts had been made to make the necessary improvements needed. The registered manager was open to our feedback and demonstrated a willingness to continue to improve.

Staff worked with people and with health and social care 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.

Information of care needs assessed by the local authority prior to people joining the service was used to inform people’s care plans and risk assessments. This also informed staff of external support input from health professionals such as district nurses, speech and language therapy team, or dieticians. A social care professional told us, “They will work with us to try and solve any problems identified within care packages. They are helpful and understanding during reviews and take feedback or criticism well.

Systems and process to safeguard people from abuse were operated effectively. A social care professional told us, “I have found the care staff quick to report concerns or issues to their management. Staff have always engaged well with our statutory procedures, such as safeguarding meetings or enquiries, reviews and assessments of need.”

Staff had training and could evidence to us their understanding of the Mental Capacity Act 2005 (MCA) and how they supported people's right to make choices.

People told us they felt safe using the service. Comments included, “I feel my loved one is in safe hands, we have 4 calls a day and the same team of carers, so my loved one knows who they are” and “I feel safe around the carers I know most of the staff and I get a lot of support ,4 calls a day” and “I have 2 carers 4 times a day, I feel safe when the carers move me they explain what they are doing I totally trust them.”

The service 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.

New and emerging risks were responded to promptly. Systems and processes for managing accidents, incidents and untoward events were managed effectively.

People confirmed they felt involved in the planning of their needs in relation to risks and keeping safe. The registered manager told us how risk assessments were designed in collaboration with people. Comments from people included, “I have a copy of the care plan, and I find the ‘Nurse buddy app’ useful as I can see what my loved one has had to eat and the timings of the calls.

Home environment risk assessments were completed when people first started using the service and were reviewed regularly. This helped to keep people and staff safe from risks associated with slips, trip and falls and fire safety around the home.

Records were also held of any specialist equipment in place to support the delivery of safe care. Information included who was responsible for the servicing of the equipment and when.

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.

We analysed care call monitoring data for the month prior to our inspection. Where there were timekeeping anomalies, such as late care calls or short care calls, the reasons were explained by the registered manager. Most people were happy with staff’s attendance at their care call visits. Comments from people included, “The timings [of the care calls] were agreed when I started with Dementia Care so I knew what to expect” and “I had an issue a few weeks ago when they were late but they did telephone me”

Pre-employment checks were completed to ensure staff were safe to work with the people they were supporting. Staff had an interview, and their Disclosure and Barring Service (DBS) was checked and previous employment references sought. DBS checks provide information including details about convictions and cautions held on the police national computer.

The service 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 Personal Protective Equipment (PPE) at the point of care. Records showed that staff were trained in infection prevention and control. Comments from people included, “The carer turns up at the times expected and they always wear PPE when doing personal care.”

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 changeshappened.

Improvements had been made and sustained in this area since the last inspection.

Staff were trained and were assessed as competent to administer medicines safely. Processes were in place to ensure the supply of medicines arrived on time.

Supporting information to assist staff in administering medicines clearly showed who was responsible for the ordering, collecting and storing medicines and whether any family members would be involved in the administration of medicines.

Medicine administration record (MAR) charts were on the whole able to demonstrate people received their medicines as prescribed. Time specific medicines were being administered at the correct time. People’s allergies were clearly recorded on the MAR charts

The administration records were able to demonstrate external medicines such as creams were being applied as prescribed.

Supporting information to assist staff in administering medicines that had been prescribed on a when required basis were in place. The information reviewed was person centred and was detailed enough to ensure these medicines could be administered safely.

A comprehensive audit was carried out across the service on a monthly basis, the audits were ensuring people were receiving their medicines as prescribed.