Nurse Plus UK - Exeter

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.

Systems enabled open and transparent sharing of information about concerns, accidents and incidents. This included systems to learn from any information of concern and ensure this learning was incorporated into service development. Any actions were able to be shared quickly with staff to ensure people received the appropriate support.

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 care co-ordinators undertook full assessments prior to people using the service. This enabled them to gather all the required information to provide a smooth transition when moving between services. This included supporting a safe transition from hospital to their own home and ensuring any required equipment was in place.

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. Staff had received training on safeguarding adults and were knowledgeable about how to recognise and report signs of possible abuse. People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. We checked whether the service was working within the principles of the Mental Capacity Act and how they manage Deprivation of Liberty within the service. Systems were in place to share concerns promptly with the management team and the local authority safeguarding team should this be required.

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 understood risks to people’s safety and how to support people to manage those risks. Care records contained clear information about risks to people’s safety and welfare, and staff worked with people to maintain their independence whilst keeping them safe. We saw records, for example, of how staff waited in the car as one person became distressed if not prepared for them to enter. This ensured appropriate care could be given in a calm way. People had risk assessments showing staff how to respond when a person became frustrated and in relation to skin pressure care management.

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

The care co-ordinators assessed people’s home environment for any risks to the person or care staff. Action was taken as necessary to ensure a safe environment was provided, for example, reducing trips hazards as much as possible. Staff worked with the community occupational therapist to ensure staff were well trained on how to use any equipment people required to maintain their safety.

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.

The manager ensured there were adequate staff employed to meet people’s needs and ensure continuity in care workers. Safe recruitment practices were in place to ensure suitable staff were employed. New staff completed a full induction process as well as completion of their mandatory training and competency checks to ensure they had the knowledge and skills to undertake their duties. Staff undertook regular refresher training to ensure their knowledge stayed up to date with best practice guidance.Staff all told us they had enough training. One relative said, “Yes, they all know what to do and we have two carers so one always knows how to do the morning routine.”

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 received infection prevention and control (IPC) training and an IPC policy was in place. Staff had access to personal protection equipment (PPE) and maintained good hand hygiene to keep them and people protected from the risk and spread of infection.

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.

Safe medicines management processes were in place. The manager assessed people’s ability to manage their own medicines. If people required support, staff were knowledgeable about how to do this safely and accurate records were maintained of medicines administered. We discussed if people were receiving respite care it was helpful for homely remedies to be included for staff administration, rather than the relative giving it as this did not allow them time for respite. This was put in place immediately for one person who had said this would be helpful for them to have a break.