Care Assist 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 questiongood. At thisassessmentthe rating hasremainedgood.

This meant people were safe and protected from avoidable harm.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Incidents,complaintsand safeguarding concerns were recognised,reportedand responded to appropriately. Leaders described learning from events through supervision andfollow‑upactions, which supported a developing culture of safety and openness. Staff felt able to raise concerns, and issues were investigated with an emphasis on learning and improvement.

Theproviderdemonstratedpositive aspects of a learning culture, withteamleaders and staff open to feedback to issuesidentifiedduring the inspection. Staff spoke confidently about learning from incidents, complaints and near missesand weresupported through supervision and training.

However, somerelatives said they were not always routinely asked for feedback aboutpeople’scare. While concerns raised were listened to, relatives were not consistently assured that feedback led to visible change. Leaders acknowledged this and described plans to strengthenauditprocessesand improve the use of surveys and relative forums at local and senior levels to better capture feedback anddemonstratehow learning informedservice improvement.

The provider worked with people and healthcare partners toestablishand maintain safe systems of care, in which safety was managed ormonitored. They made sure there was continuity of care, including when people moved between different services.

People’s needs were assessed before they started using the service to ensure theproviderwas able to meet them. This helped to achieve a smooth transition fromonesetting to another. People and their relatives were involved in the assessment process, so their views and wishes weretaken into account. Relatives we spoke with confirmed this with us.

The provider had systems to support safe care and continuity, including personalised risk assessments, personal emergency evacuation plans [PEEPs]. These documents were shared with external professionals to help them understand people’s needs and provide safe care.

The provider had asupported living move inpolicy and procedurewhich had clear informationcovering all relevant areas of the process.

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, avoidableharmand neglect. The provider shared concerns quickly and appropriately.

Procedures were in place to help safeguard people from abuse and improper treatment. Staff were able to recognise signs of abuse and received training to help ensure they were up to date with best practice guidance. Staff said they would report concernswith their team leaders.

When asked if they felt safewhen staff supported them, a person said, “Yes, I feel safe, staff are nice to me.” Relatives told us they were confident their family members were safe in theirhomesand in the presenceofstaff. A relative said, “Iknow[family member] is safe.”Another relative said,“[Family member]is very safe there.”

Appropriate systems were in place to help protect people from abuse and neglect. The provider had relevant policies including safeguarding adults and whistleblowing. The safeguarding policy made clear the providers responsibility for reporting any allegations of abuse to the local authority and Care Quality Commission.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe,supportiveand enabled people to do the things that mattered to them.

People had individual risk assessments relating to their mental health and medical conditions,self-neglect,medicines amongstothers. People received safe care from staff who understood and managed risks effectively. Staff told us they had received training on people’s conditions; they followed people’s individual risk assessments and sought the support from the community mental health team when it was necessary.

Care plans provided information about the person’s diagnosis, hobbies, interests, lifestyle,careand supportrequiredas well as the potential risks to the people. Appropriate risk assessments were completed to mitigate the risks to people using the service.

Staff were aware of the risks to people and the steps they would take to keep them safe from harm.

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 lived in a safe and well-maintained environment. People told us they liked their bedrooms and communal spaces. People appeared relaxed and comfortable. They had the equipment and furniture they needed. Bedrooms reflected people’s personalities.

Staff undertook checks on health and safety. They reported any issues and the provider arranged for these to be addressed. There was an up-to-date fire risk assessment. People and staff knew what to doin the event ofa fire.

The provider worked inpartnershipwith the landlord to ensure any maintenance issues were addressed.

The provider made sure there were enough qualified,skilledand experienced staff, who received effective support,supervisionand development. They worked together well to provide safe care that met people’s individual needs.

Staff were recruited through robust processes,which includedproviding references, a full work history, their fitness for the role and their right to work in the UK.We reviewed a sample of recruitment records,and they confirmed information had been received to satisfy the provider that staff had the necessary skills and experience to support people. 

Systems were in place to ensure staff were suitably trained and skilled forroles. Staffweresupported to take onadditionaltraining to gain a qualification in care or management. Staff had access to a range of face-to-face trainingfacilitatedby external trainersandonlinetraining consideredmandatory by the provider.Refresher trainingwasscheduled to ensure staff remained suitably skilled.New staffwere inducted and allnew staffhad an induction to work throughto support a consistent approach to inductions. Staff were provided with regular supervision and annual appraisals to support staff performance and professional development. 

The provider had effective systems in place tomonitorand have oversight of training to ensure that staff remained suitably skilled and trained for theirroles.

The provider did not always assess or manage the risks of infection effectively. They did not always detect and control the risk of it spreading.

The communal parts of thesupported living settingslooked and smelt clean. However,wefound shortfalls with the management of one aspect of infection protection control (IPC) atone of thesupported livingpremiseswe visited. The registered manager and staff were not following best practice guidelinesfor one person. Some aspects of the person’sensuite bathroomroomwerenot clean.This was also noted bya relative who told us,“Thesmell in theroom was so bad,I had to leave.”Wehave received assurances from the managerthey will address thisinvolving the person to see howbesttosupportthem inthis area.

There were systems to help prevent and control the spread of infection. Staff completed training to understand about good infection control processes. Staff were provided with personal protective equipment (PPE) to use when needed.

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

People received their medicines safely and as prescribed. Staff supported people to access healthcare professionals who reviewed their medicines. People were involved in administering some of their own medicines when this had been assessed as safe.

Trained staff administered medicines in line with the provider’s medicines policy. Staff had completed competency assessments and received regular refresher training. 

There were clear andaccuraterecords relating to medicines, including when these were administered. Medicines were stored appropriately. Staff carried out checks and audits on medicines.

Managersmaintainedoversight of medicines management through regular audits. Systems were in place for ordering repeat prescriptions and liaising with local pharmacies.