Inner City Care, Sherwood House

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 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. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Investigations were completed where required to determine the cause of an issue and to find a solution. Where needed, meetings were held with staff to discuss areas for improvement and to embed good practice.

There was a clear process in place to report concerns. All staff understood this process. Staff had confidence any issues reported would be acted on by management.

Records showed accidents and incidents were recorded, investigated, and regularly reviewed to help identify any themes or trends that could affect people’s on-going health and safety. This helped to reduce the risk to people’s safety.

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.

People’s care records included detailed information about their on-going health and where appointments with other services were needed. Outcomes of these visits were recorded and care plans amended should people’s needs change. This could also involve an increase or decrease in the number of calls they received each day from staff.

A person who used the service said, “I take my own medicines, but the carers have driven me to the dentist.” A relative said, “I arrange appointments, but they (staff) take (my family member) which is great.”

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.

We noted that the provider kept clear records of any safeguarding concerns and made detailed reports to the appropriate external agency including the local authority safeguarding team and the CQC to support people to live in safety.

During the assessment process we were informed of a safeguarding issue regarding two members of staff and a person who used the service. Swift action was taken by the provider to address this issue, to make the person safe and disciplinary action taken against the two staff members. We are continuing to review this issue in conjunction with the provider.

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. This could involve staff supporting people to maintain good personal hygiene, to prepare a meal or to move around their home safely.

Care plans and risk assessments identified potential risks to people’s safety. Discussions were held with people and relatives (where appropriate), when carrying out initial assessments and review processes. Care plans contained clear risk assessments and considered people’s capacity, choices, and preferences.People and relatives told us they were involved with this process. A person said, “They came out to assess me and we did a review about 6 months ago. I`m happier and healthier as they watch my diet.” A relative said, “They came out and assessed and a review was done. They have improved (family member’s) quality of life. We made big changes and (family member) gets extra help.”

Staff had a good understanding of providing safe and enabling care and where to access information about risk. One staff member described this to us, “The care records have every detail of the service users. This includes likes, dislikes, and the type of care they need.

The provider assisted people to identify potential risks within the home environment and discussed ways to reduce those risks for them and for staff when in their homes.

We saw that care plans and assessments contained information which evidenced that the safety of people’s home environment was considered and measures put in place to support people to live in a safe environment.This also included guidance for staff on how each person would like to be assisted in an emergency such as fire or gas leak.

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’s individual needs were assessed and the appropriate staff assigned to ensure they received the care they needed.

Records showed staff had received the training they needed to carry out their role safely and competently. A decision had been made to increase ‘face to face’ training and move away from on-line / e-learning as the provider felt this was a more effective way of training their staff.

Safe recruitment processes were in place. The provider had requested references and proof of identity documents as well as criminal record checks before staff started work. This helped to ensure people were cared for by appropriate staff.

Staff arrival and departure times at each call were electronically monitored. We asked for three-months records which showed the average arrival and departure times of each call. We found the majority of these calls were completed on time and staff stayed the required length of time. This helped to keep people safe and ensure they received the care the needed.

People and relatives felt staff had the right training to safely meet their other family member’s needs. They also told us staff arrived on time. One person said, “They are in a routine that suits me as I get regular carer`s and they call me if they are running late, which is rare. They come on time for 7 days per week.” A relative said, “Care has been provided for 3 years. The carers are brilliant as they come in and speak the same language to my parents. We get the same two carer`s and they are always on time, always.”

Staff felt well trained, supported to develop their roles and they had enough time to provide the care needed at each call. A staff member said, “I can say that I’m well trained for my role because my company provide me full training in online courses which are updated with time and also give face to face training every month where I learn more about my role.”

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.

We saw that staff had received training regarding infection prevention and control, use of personal protective equipment (PPE) for example gloves, face masks and aprons, and risk assessments detailed when PPE should be used to protect people from the risk of infection. This helped to keep people safe from the risk of the spread of infection.

The provider 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.

The provider made sure that people’s medicines were managed safely. This included supporting people to store them safely within their homes, helping with administration when required and disposing of unused medicines.

Each person had individualised medicine care plans and risk assessments. These informed staff of each person’s needs. This included the times they needed to take their medicines, the dosage and possible side effects.

Where people required ‘time critical medicines’ such as medicines to reduce the symptoms of Parkinson’s disease, calls were planned and prioritised to ensure people received them when needed. This helped to ensure people’s health and safety were maintained through safe and timely medicine administration.

We saw that staff received training and had an assessment of their competency from the management team before they carried out medicines support independently. Staff confirmed this. The provider had a robust medicines policy to guide staff in line with safe practice and organisational processes.

The management team had oversight of medicine administration and conducted regular audits to ensure safe practice.

People and relatives felt staff provided good support with medicines. One person said, “The carer`s never miss my meds.” A relative said, “[My family member] has a blister pack as [they] has dementia, and the carers help with it. We feel very privileged to have them as they never miss them.”