Quality Support Solutions 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.

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. Relatives confirmed they were informed when their family member had any accidents or were feeling unwell. One relative informed us, “The carers are always quick to tell me about anything of importance such as accidents, falls or concerns over [family members] health condition. It reassures me a lot knowing that I will be contacted quickly if any concerns arise.”

Staff understood how to record and report safety concerns so that appropriate action could be taken to support people. One staff member told us, “I can go to my manager at any time with any concerns or if I’m worried about a person’s safety. They always take time to listen and deal with things quickly.” Staff told us they had the right training to do their job and felt supported by the management team and were clear about their responsibilities. Staff knew how to speak up and could describe how to do this and the actions that would be taken.

Systems were in place to support prompt reporting and investigation of safety concerns, should these occur. The service had policies and procedures in place which required learning from investigations to be used to support staff to continually improve their practice and provide safe care to people.

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. People’s safety was managed well when they first started using the service. Information was obtained about people’s individual needs and risks to their safety and used to ensure people received safe and appropriate care and support as soon as they started using the service.

The provider made sure people, and others involved in their care, were supported to be part of their assessments and planning, to aid a smooth and safe transition when they started to use the service.

Systems were in place to help staff identify and report safeguarding concerns to the relevant persons and agencies.

The provider understood their duty and responsibility to work in line with relevant policies and procedures for safeguarding people. This included passing accurate information to the relevant organisation in a timely way to ensure safe care continued between all those involved, including in the event of an emergency.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff protected people’s right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. People told us they felt safe. One person said, “I feel very safe with the carers, and I know they go out of their way to make sure I’m safe when I am here on my own. They make sure there is no clutter on the floor, so I don’t trip up and they always leave me with drinks and snacks and make sure my phone is within reach in case I need help.” A relative commented, “For the first time I feel I can take a holiday knowing my [family member] is safe and well cared for.”

Staff had received safeguarding training and knew who they could report concerns to internally and externally. One staff member told us, “I would report any safeguarding issue to the office. There is always someone to talk to. I could also report my concerns to the safeguarding team. We all have contact details of who we can report concerns to.”

The service had policies and procedures which covered how to safeguard vulnerable people from abuse and how to ‘whistle blow’ if necessary. We saw safeguarding training was considered essential by the provider and all staff completed this and regular refresher courses. The training records and discussions with staff confirmed this. The registered manager maintained a safeguarding log, to ensure they had effective managerial oversight of any safeguarding concerns. Records showed the provider reported safeguarding incidents as required to the relevant agencies.

Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Risks associated with people’s care, support and the environment had been identified, assessed and plans put in place to reduce risks. One person told us they had poor mobility and described the steps staff took to keep them safe. They explained, “The carers always walk beside me just to be on the safe side. They make sure my shoes or slippers are on properly and they always make sure there is nothing on the floor that I might trip over. They do their very best to protect me from falling.”

Staff were aware of people’s risk assessments and felt they could confidently support people safely. One staff member told us, “We have risk assessments in place for different things, depending on the person. It might be around their mobility or falls or maybe they are at risk of dehydration. They guide us on how to keep people safe. One person I look after is at risk of falling so we have a falls risk assessment in place. This instructs us to make sure their home is free from clutter, so they don’t trip over any objects and to always make sure footwear is in good condition and always worn when walking.”

Risks were reviewed and updated if people’s needs changed. Environmental risks were identified for all properties staff visited. Risk assessments always addressed people's diverse needs. For example, people's specific needs around dementia or specific health conditions were assessed. In all instances, these had been reviewed regularly to make sure they remained up to date and reflected changes to people's circumstances.

The provider detected and controlled potential risks in the environment. They made sure equipment, facilities and technology supported the delivery of safe care. People and relatives told us staff supported them safely in their homes and treated their homes with respect. One person said, “The carers always treat my home as though it was their own. They keep it clean, and tidy and safe for me to walk about.”

Staff told us they had guidance and risk assessments to follow about working in people’s homes and using equipment to support people. An assessment of people’s home environment was always completed before a care package was provided and these were shared with the staff team, so any identified risks were known and mitigated.

Processes were in place to monitor the environment, and any equipment used to support people. Staff reported any concerns, and these were used to update and inform risk assessments where necessary.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. We received positive feedback about staffing. Comments included, “The carers are very reliable and always arrive punctually. The office always lets me know if they are going to be a bit late.” And “I see the same carers and we have got to know each other very well. They have become very dear friends.” And “We have the same carers which is what I asked for, because [family member] has dementia so it’s important they see the same faces and that staff get to know them.” One person told us they would like to have a rota, so they knew which staff were coming. They commented, “The care is very good, but the main problem is we don’t know who is coming or when.” We raised this concern with the registered manager to address.

Staff expressed satisfaction regarding staffing levels, and 1 staff member said, “I think our staffing levels are very good, including at weekends. I never feel rushed and often have the time to sit and have a cuppa and a chat with people.”

The provider followed a robust procedure when recruiting staff to work at the service, to ensure people were protected from staff that may not be fit to support them. An assessment of people’s needs was completed before a care package was agreed. This meant the provider was able to assess how much support a person needed and how many staff were required to provide that support safely. The assessment also identified the skill mix of staff needed to provide people’s care. Staff rotas showed that sufficient numbers of staff were deployed to meet people’s needs.

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.People and relatives told us staff always washed their hands and wore PPE when carrying out personal care. One relative told us, “The carers are very good and always wash their hands and wear their gloves and aprons. Their practices are very good.”
 

Staff confirmed they had completed Infection Control training and had access to Personal Protective Equipment (PPE).

Measures were in place to control and prevent the spread of infection. Staff completed training in relation to the control of infection, and they had sufficient personal protective equipment (PPE). The provider had an infection control policy in place that was up to date and accessible to staff. Regular audits were completed to ensure compliance with infection control protocols.

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 needed support with their medicines. However, when they did this was given as prescribed by a trained and competent staff team. One person told us, “The carers help me with my medicines. I take a lot of medicines and often forget what to take. The carers always tell me what they are for and make sure I take them when I should. I’m so glad they are well trained and know what to do.”

Staff received relevant training and understood the processes to follow to support people with their medicines, including accurate recording of medicines administered. Staff competencies were regularly checked, and a staff member told us, “I have regular observations for medication administration to make sure I’m safe and I have regular training. I also have accessto our medication policy and procedures if I need to look something up.”

Audits of medicine administration were completed to enable any errors to be identified and investigations and actions to take place to help reduce the risk of recurrence. These included checks of staff’s practice to ensure they remained competent and safe to administer and manage medicines. Staff recorded when medicines were administered, or, if medicines were not required or refused on the medicines administration record (MAR) charts. Care plans had information recorded about the level of support needed by people to take their medicines safely.