Quest Recovery Services 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. The last rating for this key question was good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 81 (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 established a learning culture, where staff shared ideas and learnt from things that went wrong. The staff reported and recorded all accidents, incidents, complaints and adverse events. Records showed these had been investigated and people using the service had been consulted. There was evidence of lessons learnt, for example, changing people’s care plans, providing updated guidance and training for staff and reviewing risk assessments. The registered manager shared learning with staff through regular written updates and team meetings.

People using the service and their relatives felt well informed and involved in making improvements when things went wrong. Staff told us they understood their responsibilities to engage with this process. Their comments included, “Any concerns or incidents are reported and taken seriously. Supervisors immediately investigate these” and “When something goes wrong, we recognise, report, record, review and refer it to make sure there are improvements.”

The registered manager explained, “We need to learn from mistakes and reflect on these. We discuss case studies and use examples for training.”

There were appropriate records to show that accidents, incidents and complaints were analysed to identify any trends.

The provider took a lead role and worked with external professionals to ensure people experienced safe transitions between services. They were proactive in identifying and eliminating risks to people’s safety and wellbeing. For example, the agency started to care for a new person who had been referred by the local authority. Staff found the person was resistant to care and communicated their distress in a physical and verbal way. The staff recognised the person had unmet needs which included poor mental health, nutritional and hydration concerns and were living in an unsafe environment. The agency arranged for urgent interventions from external healthcare professionals to reassess their needs and look at the equipment they may need to live safely. They worked in collaboration with others to provide higher levels of care and to support the person with their mental and physical health. As a result of this work, the person started to accept and welcome care, their home environment was made safe and their health started to improve.

The provider developed accessible information about people’s needs which was shared with other care providers and hospitals to ensure these needs were understood and met by everyone involved in their care. They acted as support and advocates for people who needed this. For example, a person they were caring for became unwell and was admitted to hospital. The person’s family lived a long way away. The staff supported the person during the hospital admission and the registered manager took a lead in ensuring a safe discharge back home. For example, they cleaned and decluttered their home, they shopped for food and made sure there was enough electricity paid for on the meter.

The provider had procedures to help keep people safe and to investigate allegations of abuse. Safeguarding procedures were shared with staff and people using the service. Staff undertook training to understand what to do if they were concerned someone was being abused. They also discussed safeguarding procedures during team and individual meetings with their line manager. Staff were able to describe how they would respond to different abuse scenarios. They demonstrated a good understanding with a member of staff stating, “Safeguarding means protecting people’s rights to live safely and free from abuse.” People using the service and their relatives told us they felt safe. A relative commented, “[Person] is safe and well looked after. I would certainly recommend the staff.”

The provider had records to show how allegations of abuse had been responded to. They had worked closely with the local safeguarding authority and others to help protect people from harm and abuse.

The provider assessed, monitored and managed risks associated with people’s care and treatment. They developed comprehensive assessments which involved the person using the service and their representatives. They promoted positive risk taking and had developed guidance for staff and relatives to understand why this was important and how to support people to take risks.

External professionals told us they thought risks were well managed in a person-centred way. Their comments included, “In my experience, [registered manager] has always been proactive about ensuring the safety and wellbeing of clients” and “[Registered manager] has a hands-on approach which helps prevent things from going wrong by early interventions and requesting additional support, like aids and adaptations. I find the staff are very responsive.”

Risk assessments included links to, and information about, best practice guidance and were designed in a user-friendly way to help give people using the service, relatives and staff as much information as possible. Risk management plans were regularly reviewed to make sure these remained relevant and the least restrictive way of ensuring safety. Plans included clear information about how people communicated and expressed themselves. This helped ensure they received personalised support to communicate their feelings.

Staff undertook training to understand about keeping people safe, supporting them to move and with eating and drinking.

The provider undertook comprehensive assessments of people’s home environments and equipment they used. They were proactive in securing additional support when people needed. For example, they had identified potential fire safety concerns in a person’s home. They made a referral to the local fire brigade who carried out an assessment and made recommendations for improvement. The agency supported the person to meet these recommendations. For another person, the provider purchased fire safety equipment because the person could not afford this themselves. They also made appropriate referrals to ensure the authorities involved in commissioning care were aware of the person’s situation.

In addition to assessing risks, the agency provided information for people, their relatives and staff about safety within the environment. This included a guide to help people manage clutter whilst respecting their wishes and valuing belongings that were important to them.

The provider made sure there were enough staff to meet people’s needs and to keep them safe. The provider did not accept new packages of care unless they had staff available to support people. Staff were matched to people making sure their language needs, personality and interests were considered and met. People told us they were cared for by the same familiar staff who they liked. They told us staff arrived on time. Their comments included, “They are always on time and the same regular care workers”, “[Person] quite likes [staff] and knows them well. They always chat away to [person] and ask [them] before doing anything” and “I always know who is coming. They come to me 3 times a day and they are always on time.”

The provider had systems for safe recruitment and selection of staff. These included checks before and after they started working at the service, a comprehensive induction and regular assessments of their skills and competencies. Staff were able to describe these systems, and we saw evidence of checks in the provider’s records. The staff explained they had regular supervision and appraisals from managers which helped them to understand their roles and responsibilities.

The provider had systems to help prevent and control infection. Staff undertook training about this, and the management team regularly assessed their knowledge, competencies and observed them providing care in line with these procedures. People using the service and their relatives told us staff wore personal protective equipment (PPE), washed their hands and followed good hygiene practices. Staff told us they had access to PPE whenever they needed this.

The provider made sure people received their medicines in a safe way and as prescribed. They worked closely with other healthcare professionals to make sure medicines were reviewed. This ensured people were receiving the right medicines for them. Staff made referrals when they identified people may need a change of medicines. The provider had shared information about STOMP (stopping overmedication of people with a learning disability, autism or both) principles with staff and relatives. This helped ensure those involved in supporting people with a learning disability recognised people had the right to alternative interventions to help manage their needs. This was a tool they could use for discussions with doctors at people’s medicines review meetings.

People using the service and their relatives told us they were happy with the support they received with medicines. Their comments included, “They make sure [person] has [their] medicines, they are very kind and caring with this” and “Staff always make sure [person] takes [their] medication, this is so important, and we are happy this is done properly.”

The provider created detailed medicines care plans and risk assessments. Staff kept records to show when they had supported people with medicines and the managers reviewed and audited these. People who wanted to, and were able, were supported to manage their own medicines independently.