Derbyshire Care Services HQ

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 requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 69 (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.

One person told us, “I have a good rapport with the care agency. Any problems I phone up. It is dealt with and sorted.” A relative said, “The agency uses electronic records. I can see everything they’ve done.” Staff told us they were able to raise any issues with their managers. One told us, “I have raised safety concerns myself and I’ve had a really quick response. [The system we use] makes it easy to raise concerns and see actions as well. It’s really quick and you can call them in the office and get support.” Leaders maintained an oversight of issues raised, worked openly to resolve issues and took opportunities to learn and make improvements to people’s care outcomes.

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.

A relative told us, “[Person] had an assessment from the care agency and a care plan from the hospital. There was also a meet and greet to ensure awareness of care needs.” A person said, “I was in hospital a while ago and they did pass on all the necessary information about me to the hospital.” Staff told us how they supported people to safely transition between services. For example, one staff member said, “Medicines are nice and clear and if people come back from hospital we can upload any medicine changes.”

Records showed staff worked closely with healthcare professionals who had oversight of their variable medicine doses, for example when people were on anticoagulant medicines. Staff contacted other relevant health and social care professionals if people’s needs changed or they felt additional support could help people further.

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.

Some staff were not always clear on how the Mental Capacity Act offered people protection when they were not able to make decisions themselves, and this had not always been made clear in people’s care plans. However, leaders were aware of this and took action during our inspection to improve these details in people’s care plans.

People felt they received safe care, some of their comments included, “I have had the carers for a few months, and it feels like a safe and good service,” and “I feel safe, and they are all absolutely marvellous to me. They are so polite.” Staff had been trained in safeguarding and understood how to identify signs of potential abuse and how to report these.

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.

One person told us, “Yes, if there are any risks I think they are managed well. There’s never a problem but if there was, I’m sure they would deal with it.” People felt staff helped them stay safe in emergencies. One person told us, “Recently I was very ill, and it was the carers and office staff that made sure I got medical attention. I had to go to hospital and the liaison by the care service before and after was excellent.”

Staff communicated effectively with people so they could be involved in discussions about their care. For example, staff told us they made sure people’s hearing aids were working. Other staff had experience of using communication systems that used pictures and signs to aid communication. Leaders told us some of the staff team were fluent in languages other than English, and this helped support people when English was not their first language.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

People felt staff worked safely in their homes. One person said, “Carers work safely. No trip hazards. No towels on the floor. Risks are well managed.” A relative added, “Staff have been good at assessing the home and all staff seem to know how to support their use of a zimmer frame.”

Risk assessments were in place for staff to follow to help promote safe working. For example, assessments had been completed to help identify and reduce any risk in people’s homes and from any equipment they used. Risks from fire were considered and people’s care plans and risk assessments showed where staff had worked with other professionals to help reduce these risks.

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 appreciated it when the same members of staff supported them. One person told us, “I’m very pleased with the care service. We’ve stuck to the same staff. They know what to do. They’ve been coming for two and a half years.” Leaders understood having regular care staff was important to people and wherever possible they aimed to provide this.

People were happy staff arrived on time and did not rush them. One person said, “They normally turn up on time but if there has been an incident they might be a bit late but always apologise. They stay for the whole visit. They sometimes ring ahead if they are going to be late.”

Prospective staff were assessed and checks completed on their suitability to work in care. Once appointed staff received training relevant to people’s care needs and on-going support, including checks on their competency and performance. One staff member told us, “I find the practical training very useful.” These actions helped to ensure staff were suitable in their job roles.

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.

People told us they were happy with how staff acted to prevent and control infection. One relative told us, “I’m happy with the standard of personal care. I see gloves, aprons and handwashing. My [family member] is nicely presented.” Staff had completed training in infection prevention and control as well as food hygiene. Staff understood when they should wear personal protective equipment and when this needed to be changed.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. However, some improvements were required to ensure medicines taken ‘as and when needed’, and the transcription process for the prescriber’s medicine instructions, were managed in line with good practice. Policy and procedures needed to reflect the actions staff were required to take to management medicines safely. Actions were taken by leaders to respond to this feedback during the inspection. They told us they would continue to monitor to ensure these improvements became embedded and were sustained.

People told us when staff helped them with their medicines this was done to their satisfaction. One relative told us, “The chemist orders the medicines, but the carers dispense them from the blister pack and give [family member] a drink to take with the medicines. There are no problems with the medicines.”