Nissi Home 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 inspection, we rated this key question requires improvement. At this assessment, we found the provider had made improvements and we rated this key question good. 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.

We found staff and leaders understood people’s needs and worked together to prevent incidents from happening. Staff told us they felt able to speak up about concerns relating to people’s care and felt supported by management.

We found the service had systems in place to learn from events. This included learning from incidents according to a comprehensive policy in place and using the provider’s newsletter to share important information and updates with staff such as safeguarding and infection control practice.

The management team took our findings on-board to address the areas needing improvement we identified during the inspection.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

The service worked with people and staff to understand what being safe meant to them and the best way to achieve that. Everyone we spoke with or received feedback from told us they, or their loved one was safe.

One member of staff told us, “Abuse is unacceptable. We are there to care for people. I would need to report to the manager any signs of abuse”.

People were protected from the risk of harm and abuse and safeguarding processes were clear and robust. Another member of staff told us: “I do not have any concerns about people’s safety but if I did, I would tell my manager and they would discuss this with the next of kin and take the next steps”.

The service provided examples when it collaborated with stakeholders to report and investigate safeguarding concerns by taking appropriate action.

We did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.

Risks had been identified and mitigated as a result of risk assessments in people’s environment.

The provider made sure equipment, facilities and technology supported the delivery of safe care. We saw examples when the provider had worked with healthcare professionals to obtain specialist equipment for people, designed to promote their safety and independence, such as pendant alarms.

During our last inspection, we found recruitment checks did not provide enough assurance that the service did everything they were required to do to ensure staff were safely recruited. The provider had made significant improvements this time.

All the recruitment records we saw during this assessment evidenced that robust recruitment processes were being followed to ensure staff were thoroughly checked and supported when starting to work with the provider.

The manager told us there was a focus on staff’s induction training to ensure new staff were equipped with the right tools when beginning to support people. The training was a combination of online and face-to-face classes. We also saw evidence of specialist training being delivered to staff in order to correspond with people’s individual needs prior to admitting them, for example PEG feed training.

People and relatives spoke positively of the staff’s level of skill. A relative of a person who uses the service told us: “[Staff] are well trained, they know what they are doing and we feel safe”. Another relative told us:” The staff I know are well trained. They use a hoist and a sara stedy. I have seen them using the hoist and [my relative] is safe and comfortable.”

Staff members we spoke with told us they received training and continuous support from the service to perform their duties safely.

The provider effectively assessed and managed infection risks, conducting regular audits and taking action to address any identified issues. We saw one example when staff successfully identified and controlled the spread of infection and communicated concerns to the relevant agency promptly.

Infection prevention and control practices were supported by a comprehensive policy, and the provider evidenced adequate PPE material was being provided and used by staff.

In our last inspection, we identified some inconsistencies in people’s medicines records. This time, we found the provider had made improvements, but further improvement was needed.

Staff who administered medication had received relevant training and a comprehensive medicines policy was in place. The care plans included clear lists of people’s medicines including details on dosage, purpose and side effects.

However, in the administration records we reviewed we came across some gaps in the recorded information such as missing staff signatures and missing dates in staff comments about administration. We brought the recording issues to the provider’s attention, and they gave justification for the gaps. Some of these issues had been identified in the monthly audit. We were told staff were working to develop this area.

In one of the care plans we reviewed, we found a PRN protocol for emergency medication was not in place. PRN refers to medication given “as and when needed”. We enquired about this with the provider and they were able to show us the records later. We found that this was mainly an issue for people whose next of kin was responsible for administering medication but this was not always clearly documented in all the care plans we reviewed. The provider rectified this during our assessment process.

We recommend the provider reviews closely the medicines administration records and continues to work with staff to keep improving recording issues.