TogetherCare

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 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 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.

Staff demonstrated a positive commitment to maintaining safety by identifying and responding appropriately to changes in people's needs and levels of risk. Care records showed risk assessments and care plans were reviewed and amended when required to help ensure people received safe care and support.

A professional working with the service told us, “The service is proactively addressing issues, demonstrating a strong focus on reflection and a lessons learned approach to continuous improvement”.

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.

Pre-assessment information was completed prior to people using the service and shared with staff to help ensure they understood people's needs. Where additional support was required, referrals were made to relevant health and social care professionals.

The provider worked with the Local Authority to provide urgent care when required. Processes were in place to ensure that in these circumstances, vital information was provided to ensure a safe and effective transition of care.

There were effective arrangements in place for partnership working with external professionals. Stable systems supported joined up working and positive professional relationships, which helped to promote safe care and coordinated decision making. External professionals provided positive feedback about the service’s approach to multidisciplinary working and advocacy for people.

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.

There were effective safeguarding systems in place. The provider had clear policies and procedures, and staff had completed safeguarding training appropriate to their role. Staff demonstrated a good understanding of different types of abuse and knew how to escalate concerns. Staff were aware of the provider’s safeguarding and whistle blowing policies and knew which agencies to contact if they felt the provider was not acting on their concerns. Safeguarding records showed referrals, actions taken and learning identified. Safeguarding concerns were shared with the Local Authority (LA) and CQC, as required.

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.

Risks to people were identified, assessed and kept under review. Care plans and risk assessments reflected people’s individual needs and preferences and supported positive risk taking. Staff worked with people to agree how risks could be managed in a way that respected their routines and abilities.

People told us they felt safe, one person said, “I am very happy with the care service I get. I am definitely safe from any risks”. Another person told us, “The paperwork and risk assessments have been in my property since Together Care started providing my care. I understand these are there for the carers to follow when they are supporting me”.

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

The provider supported people who lived in their own homes. As such, the provider was not responsible for the maintenance of people’s property or possessions. However, they had carried out environmental risk assessments to help ensure the environment was safe for people and for staff to work in. Assessments covered areas such trip hazards, fire evacuations and infection prevention and control. A relative also confirmed this and said, “They check and make sure there are no trip hazards.”

The provider completed recruitment checks before staff commenced employment. However, some improvements were required to the provider’s systems and processes to ensure procedures were completed consistently and in full. Managers responded appropriately and recruitment checklists were reviewed and updated to ensure they aligned with legal requirements, supporting safe and effective staffing arrangements.

Staff received up to-date training through a mix of online learning and practical sessions. Competency assessments were used to confirm staff could carry out their roles safely. Staff told us the training was relevant and supported them in their work. New staff completed an induction programme before working independently.

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.

The provider had processes for the management of infection. Personal protective equipment (PPE) was readily available and used appropriately by staff. Staff received infection prevention and control (IPC) training, and competency checks to support safe practice. People confirmed staff followed good IPC practices in their homes.

People received support with their medicines from trained staff. Care plans contained information about people's medicines and how these should be administered.

Medicine administration records [MARs] were used to record when a medicine had been given. As and when required medication (PRN) protocols were in place, which are medicines not given routinely, but when required, following prescribed guidelines. We did however find that information was not available for staff to determine when medicines of variable doses should be given, for example ‘give 1 or 2 tablets’. We fed this back to the registered manager, and this was implemented before the inspection ended.

Staff received medicines training appropriate to their role and were regularly observed to ensure safe practice. People told us they received medicines as intended, one person told us, “My carers always give me my medication at the right time and in line with what I am prescribed.” Records were monitored to identify if any concerns could be identified and addressed promptly. Where errors occurred, these were reviewed and actions taken to support learning and reduce the risk of recurrence.