Proxy Care Personnel

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 Good. At this assessment the rating has remained 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.

Accidents and incidents were recorded appropriately. This included what had occurred, which authorities had been informed, and what actions were taken to prevent reoccurrence of the situation. The registered manager told us, “I always repeat to the staff it’s not about blaming people; it’s about working together to improve.”

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 registered manager and staff were aware of their responsibility to protect confidential information about the people they supported. They informed us of an incident where a third party had attempted to gather confidential information through multiple phone calls, but that staff’s diligence had ensured this had not occurred. The registered manager told us, “They tried to find a weak link within my team to get the information, but that does not exist in my team.”

People confirmed staff wore ID badges which contained their name and a photograph of them. This allowed people to feel confident that anyone arriving at their home worked for the service.

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 were aware of their responsibility to safeguard people from the risk of harm or abuse. A staff member confirmed to us, “If I notice any physical and obvious signs like bleeding or notice the confidence of the client has changed and they’re not speaking like they normally do, then I will call management or care coordinator.” The registered manager told us, “We ensure safeguarding is our priority. All staff are safeguarding trained and have refresher courses. If something does occur, I want all agencies involved to know, what happened and what we have done to implement safeguarding practices to ensure that it doesn’t happen again.”

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.

Care plans and risk assessments were detailed, containing information about the person’s individual needs. They also contained comprehensive information about people’s medical history; the symptoms people may experience from this and any signs staff should be vigilant of that could indicate a crisis for that person.

The provider was fully aware of all potential risks in the care environment and controlled them well. They made sure equipment, facilities and technology supported the delivery of safe care.

Although staff were not responsible for the overall upkeep and safety of people’s homes, they ensured people were supported in keeping their environment safe. For example, staff had identified that one person did not have a fire alarm in their home. They worked with the person and gained consent to refer them to Surrey Fire and Rescue team for support. This resulted in the fire service fitting a fire alarm in the person’s property, helping mitigate the risk of the person being harmed if there were a fire.

Environmental risk assessments were completed upon the start of the person using the service. This determined if there were factors to be aware of such as any trip hazards and when medical equipment such as hospital beds were last serviced.

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 were able to confirm that on the whole, staff arrived on time and stayed the full length of time. One person told us, “They are always here at a reasonable time and yes, they stay.” The provider had call monitoring systems in place to ensure people received the care they needed. This recorded when staff arrived and logged in at a person’s property, if they were late, and if they stayed the full length of the care call. The management team were able to monitor this in real time and follow up any discrepancies as they arose. The registered manager told us, “The protocol is staff contact the person on call or in the office if there are any issues. If we come across any instances for being late, they would call the carer to find out what is going on. We call the service user if there is going to be a delay because of traffic etc.”

Staff received training in areas of care delivery upon their weeklong induction to the service, as well as regular refresher courses. One staff member confirmed, “I did online and face to face training for 2 weeks as part of my induction. They made it in a way that I could understand it and could easily communicate anything I didn’t understand.” Another told us, “The induction and training was done first and I was happy with the induction. I have recently done CPR (Cardiopulmonary Resuscitation) training, and I learn so many things from the training which is so beneficial and informative. It is continuous.”

Staff were recruited safely into the service. This included gaining references from previous employers and completing a Disclosure and Barring Service (DBS) check. This ensures potential new staff members are of good character to work with vulnerable people.

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 had access to a consistent stock of personal protective equipment (PPE). Staff followed infection prevention control processes to minimise the risk of cross contamination. A staff member told us, “When I get to any client’s place, I do a quick assessment and wear gloves, apron and mask if required. I put it all in a bag and throw it in a bin outside once I’m done.”

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.

Care plans were in place to guide staff on people’s preferences on how they liked to receive their medication. This included if they preferred to take them with water, any side effects of the medication, and if they were able to administer it themselves or not. A staff member told us, “If the care plan mentions it then I support clients with their medicine. Depending on the client, I will either prompt or administer it myself if the care plan says that.”

Protocols were in place for as and when medication (PRN). This informed staff when the medication should be given and the maximum dosage within a 24-hour period. We did identity a small number of protocols that required additional information. The registered manager was extremely responsive and ensured these were updated by the end of our assessment.