Ambar Care Ltd

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 inspection 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 service 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. The registered manager shared learning with staff from incidents, accidents, complaints and safeguarding so that the service could continually improve and develop positive outcomes for people. Information was shared with staff through supervisions, an electronic messaging system, safety briefings and staff team meetings.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was monitored and managed. They helped to ensure continuity of care, including when people moved between different services.
Since the last inspection, the service had introduced a new initial assessment process to ensure key information about people's needs, risks and preferences was gathered before support commenced. This was intended to provide staff with clear information to support the delivery of safe and person-centred care from the outset. However, the service had not supported any new people since its introduction and therefore the effectiveness of the process could not yet be fully demonstrated in practice. Information continued to be shared with staff through established communication systems, including an electronic system, to promote continuity of care and ensure staff were kept informed of people's needs.
 

The service 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 service shared concerns quickly and appropriately.

Staff understood how to recognise the signs of abuse and could describe the actions they would take to safeguard people including informing other agencies if they were concerned about action being taken. A staff member told us, “I would report to my manager, and I would escalate to local authority if I needed to.” Records confirmed staff had completed safeguarding training and received regular updates to help ensure they remained knowledgeable about their responsibilities in protecting people from abuse and harm.
 

The service 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. Risks to people had been assessed and risk assessments had been put in place to help mitigate these. Risks included areas such as supporting people with physical healthcare needs, use of mobility equipment and with personal care. Staff knew the risks to people well and told us they were kept up to date if there had been any changes to risk assessments.
There was also clear guidance in place for staff to support people with specific health needs such as, diabetes. This included actions to take in the event of out-of-range high or low blood glucose levels, enabling staff to recognise changes in people’s conditions and respond appropriately to ensure safe and effective care.

Staff told us they always read the care plan, read the daily notes and had regular discussions with the registered manager to see if there had been any changes to the care package.
 

People received personal care and support in their own homes. The service detected and controlled potential risks in the environment. They made sure equipment, facilities and technology supported the delivery of safe care. The registered manager told us, ''We involve families and health professionals when formulating and reviewing the care plans and work closely with them on a regular basis.'' Risk assessments had been completed to provide staff with guidance on how to keep people safe and minimise risks. For example, there was a risk assessment in place describing risks relating to people's home environment.

The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. Staff worked together well to provide safe care that met people’s individual needs. The registered manager had processes in place to ensure all staff received an extensive induction and staff we spoke with confirmed this. Appropriate checks were in place before staff started work, including obtaining full employment histories, references and a Disclosure and Barring Service (DBS) check. DBS checks provide information about convictions and cautions held on the Police National Computer and help employers make safer recruitment decisions.
The registered manager completed staff file audits which ensured that all employee records were regularly reviewed, up to date and contained all the necessary information. All staff files had been checked, and gaps in information identified had been addressed.
Feedback we received from people and relatives was mostly positive. They told us staff were caring, hardworking and skilled in meeting people’s individual needs. Relatives said staff were patient, took time to support people and developed positive relationships with them. Relatives also confirmed that new staff shadowed experienced colleagues before providing care independently.
However, some people and relatives reported inconsistencies in visit times and in communication when staff were delayed or changed. The registered manager acknowledged this feedback and was taking action to improve punctuality and ensure people were informed promptly of delays or staffing changes.
 

The service 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 undertaken infection prevention and control training and were provided with personal protective equipment (PPE) which could be collected from the office.
A member of staff told us, “I wear PPE when required, such as gloves and aprons during personal care and masks if needed.” A relative told us, “All staff wear PPE, and I feel very safe when they are here.” However, another relative told us, “Some staff were not wearing gloves. I spoke to [registered manager] because I am very vulnerable. Staff were putting used gloves in the household waste bin, which the waste collectors would not take, and [relative] had to remove them. I have a clinical waste bag available.” The registered manager confirmed this concern had since been resolved.
 

The service 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. Staff did not support people with medicines until they had completed the required training, and medicine competency assessments were completed. People had care plans and risk assessments in place which detailed what medicines they were prescribed and how they liked to be supported. The registered manager carried out regular audits and where discrepancies were noted these were investigated to identify the cause and any learning needed.