Intrinsic 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

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 72 (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. Lessons were learnt to continually identify and embed good practice. Accident and incident information was shared amongst staff to help improve practice.

Following accidents and incidents debriefs were shared with staff so a structured plan could be developed. Where one person was expressing increased signs of distress staff reviewed this person’s care and staff increased their emotional monitoring, some daily routines were adjusted and de-escalation strategies were re-evaluated.

The registered manager said, “I believe in self-reflection and we do that a lot.” Self-reflection or refresher training was carried out with staff to help support leaning from incidents.

The registered manager made sure there was continuity of care, including when people moved between different services.

When people were transferring from hospital care to receiving care from Intrinsic Care, the registered manager held face-to-face meetings in advance to discuss their needs and personal goals. For example, some people expressed a desire to regain their independence, find employment or voluntary work or move into their own accommodation. The registered manager gave example of where that had been achieved through staff support and their work with external professionals and the commissioning authority.

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 registered manager shared concerns appropriately.

Staff received safeguarding training and put this training into practice. There had been very few safeguarding concerns about people, but where there was, these were raised with the relevant authority and CQC.

Staff knew how to respond to any concerns of potential abuse. A staff member said, “I’d pass any concerns on to [senior staff]. If he was no help, I would call the office.”

Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Staff identified individual risks and provided support that ensured people’s independence and safety.

We found information around some risks to people was not always readily accessible for staff. One person had diabetes and although there was generic information in risks assessments relating to this for this person, there was no specific detail in their nutrition care plan to include, for example, foods they may need to avoid. Although staff did monitor their blood sugar levels daily.

However, other information had been suitably recorded. One person had reduced mobility and it was clearly recorded they needed to be supported to use a walking aid when going out which helped reduce the risk of falls. For people who smoked, staff ensured this took place safely in a designated outdoor space.

The registered manager aimed to ensure people lived in an environment that was regularly checked for its safety. Regular health and safety audits took place and where shortfalls were identified these were raised with the maintenance team. One person required support when having a shower. They had a wet room with a handrail to help keep them safe when receiving their personal care.

The registered manager made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development available to care for people.

People received care from a consistent staff team.

Staff rotas evidence staffing levels were in line with expectations. Care staff worked with people, together with community engagement workers whose role was to organise and support a person with their individual activities. Staff confirmed staff levels were in line with people’s needs.

Staff received suitable induction and training prior to working independently with people. Staff told us, “The office does a briefing, an hour induction to go through all the processes and there is 24-hour support from the office or on call” and, “We had mandatory training prior to working in the property, I had to do care and medication training, safeguarding and IPC and I had to do first aid. We also had de-escalation training.”

Training was specific to people’s needs, for example, staff received diabetes training. A staff member told us, “We are well prepared.”

Staff had the opportunity to meet with their line manager on a 1:1 basis. A staff member said, “[Line manager] does supervisions and when I first started I had one every month and now it’s one every 2 - 3 months. But if there are areas of concern there are informal supervisions. We have to be at our best to provide the best care.”

Staff were recruited through a robust recruitment process. This included them providing a full employment history, evidence of their right to work in the UK and evidence of performance in previous roles. Prior to staff commencing with Intrinsic Care, they underwent a Disclosure Barring Service check. This help ensure they were suitable to work in this type of service.

Staff assessed and managed the risk of infection. People’s accommodation was clean, tidy and well-presented. Staff were provided with personal protective equipment which they could use when supporting people with their personal care, for example.

Staff received infection control training and refresher training was completed. One staff member said, “The refresher training is about every 6 months.”

The registered manager made sure that medicines and treatments were safe and met people’s needs.

People received the medicines prescribed to them and staff used an electronic medicines system which helped reduce the risk of mistakes. Staff encouraged people’s independence when taking their medicines and told us people had specific routines. A staff member said, “We support [person’s name] but she doesn’t really like you touching her meds, she’s specific with what she wants. We hold the Dosette box (multi-compartment medicine box) for her and there has to be a black coffee with it. I have to check the MAR (medicine administration record) chart, you have to complete it specifically or it didn’t happen.”

Only trained staff administered medicines to people. Competency was checked regularly to help ensure staff continued to follow good practices.