Nottz 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 72 (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. The registered manager listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. For example, incidents, accidents and complaints were reviewed and investigated. Learning and required improvements had been completed and shared with the staff in staff meetings to reduce the incidents or complaints from happening again. This reduced the risk of reoccurring incidents to keep people safe.

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. Staff had completed pre care assessments with people and people who knew them well before staff started to provide care. This involved a face to face visit, to obtain information of people’s care needs and how they wanted to be supported. The information was used to form care plans to provide staff with accurate guidance on how to support people. Care plans and risk assessments were in place and detailed individual risks. A relative told us, “We met with Nottz Care, and they did an overview of [family member] needs and took a comprehensive history of her health.” Another relative told us, “When we registered with the care company a comprehensive care plan was completed and [family member] needs were identified.” The provider had completed an emergency record that could be shared with other health services to ensure people received their assessed care when moving between services, such as hospital, to enable smooth transitions.

The provider had systems and processes in place to protect people from harm, neglect or abuse. People and relatives told us they felt safe, their comments included “There are no safety issues or has there ever been any incident that I have felt vulnerable when the carers are with me,” and “[family member] is safe with the carers.” Staff had completed safeguarding training to provide them with the knowledge and skills to identify safeguarding concerns or risks. Staff were able to clearly explain the processes in place to report safeguarding incidents. One staff member told us, “If I suspect or witness any abuse, I will report it immediately to my line manager or supervisor, I will properly document all details into the incidents forms and care notes.” Safeguarding incidents were recorded, investigated and reported to external agencies, such as the local authority safeguarding team and the Care Quality Commission, where required, to ensure people were protected from abuse and neglect. The provider had a detailed safeguarding policy in place to provide all staff clear guidance and processes to follow.

The provider worked with people to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Records demonstrated people were involved in their care planning and risk management plans. Staff were provided with accurate written guidance to follow to ensure people were supported to manage risks the way they wanted to be supported. For example, a person required moving and handling equipment to support them to get in and out of bed and wished to use this on their own when there was no staff support. Staff were provided with a detailed risk management plan on how to leave the equipment in a safe way to meet the persons wishes safely. This protected people from the risk of harm. People and relatives told us risks were managed safely. One relative told us, “[family member] has a high spec mattress on her bed that assists with prevention of pressure sores. The carers check the mattress to ensure the mattress is inflated in accordance with her weight.” Another relative told us, “[family member] has slide sheets on her hospital bed and the carers manage manual handling very efficiently.”

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 registered manager had completed an environmental risk assessment for each person they supported and reviewed this regularly to ensure it was accurate. The provider was working closely with the local fire service to risk assess people’s home environments. If concerns were identified they had referred people to the fire service for a home visit to support people to make their environment safer.

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. People told us staff arrived on time to their care calls. One person said, “They [staff] come on time and stay for the time they are supposed to.” Another person said, “I have 2 calls a day, one for personal care and one at teatime, they [staff] are generally on time, if they [staff] are going to be late, they will contact me.” Records we reviewed demonstrated there were enough staff recruited to support people safely. We received mixed feedback from staff regarding staffing levels. Staff told us, “Staffing levels can be low at times, which puts extra pressure on carers, often due to sickness or staff turnover. However, the manager works hard to ensure all care calls are covered.” “Sometimes I feel like at times some carers are made to work a lot harder as the staffing levels at time is low, this is due to staff not sticking to the job or even unwell staff. However, the manager does make sure that all calls are covered.”

Recruitment processes were followed to ensure only suitable staff were appointed. Checks including, interviews, references and Disclosure and Barring Service (DBS) were completed before staff started working at the service. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. Staff at all levels had opportunities to learn and develop. Staff had been offered further training of an NVQ (National Vocational Qualification) in Health and Social Care as a work-based qualification to expand their skills, knowledge, and competence in the care sector.Staff had one to one supervision regularly to discuss their development opportunities.

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. The provider had a clear policy and procedure in place to manage infection outbreaks. Staff had completed infection prevention and control training. Staff and people told us they wore Personal Protective Equipment (PPE) such as gloves, aprons or shoe covers. One person told us, “PPE is worn at all times, but they [staff] sometimes forget to wear the shoe covers.” Another person said, “They [staff] wear their gloves and aprons.” Spot checks were also completed to ensure staff followed infection prevention control measures in line with Nottz Care policy. People told us staff protected them from infections spreading. One person told us, “I have breathing difficulties and suffer from severe asthma, and the carers understand that I am vulnerable if I catch an infection. They will wear a mask when they come to me if they have been with previous clients who have a cold.”

The provider did not always make sure that medicines and treatments were safe and met people’s needs. The provider did not make sure that records relating to the administration and management of people medicines were accurate and well maintained as recommended by the National Institute for Health and Care Excellence (NICE) guidelines. For example, we found handwritten medicines entries had not been signed by two staff members to confirm the transcribing was correct. This practice increases the risk of errors and places people at risk of receiving their medicines in an unsafe way. We found gaps in people’s medication administration record charts (MAR), with no explanation to demonstrate why the medicine was not administered. Records showed staff had completed training in safe administration and management of medicines. People told us they felt their medicines were managed safely, one person told us, “I take my medicine, but they check and remind me.” Another person told us, “I take my own medicine, but the carers observe and record it when I have taken it.”