Bright Opportunities Enabling 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. 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 75 (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.

The provider demonstrated a good learning culture. Managers described significant learning after concerns about restrictive practice, Mental Capacity Act (2005) compliance and governance at the previous CQC inspection in 2022. They reviewed restrictions, assessments, care plans and best-interest decisions, put Deprivation of Liberty Safeguards (DoLs) in place where needed, and sought support from the local authority and social workers. The registered manager told us they had “Skilled themselves on mental capacity.” Risk assessments and care plans were now reviewed every 3 months. Post-incident forms were introduced, and learning incidents were discussed at team meetings. Managers said they had moved from, “Firefighting” to prevention and that, “We just know our clients better now.” The provider was open to feedback and had identified further areas to review. The relative of the person knew who the registered manager was and how to raise concerns if they had. They spoke positively about the support and said they had never needed to complain and had no concerns. This meant the person benefited from a service that continually improved through reflection and learning.

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.
The managers worked with others to solve problems and make improvements. Staff said they could reach health professionals when needed, and they communicated with other agencies to help ensure continuity of care. Regular contact was maintained with the local authority, social workers, GPs, and other professionals.
The provider had good arrangements to support continuity. New staff shadowed experienced colleagues before working independently. A relative of the person said, “For a period of time before they start working with the person they shadow with someone [staff] who knows [name] well.” Staff described systems used to pass information between colleagues including handovers and a communication book. The person had a hospital communication passport and a Herbert Protocol document in place to optimise their health when other professionals needed to be involved in the person's life. The Herbert Protocol is a nationally recognised risk-reduction tool used by police and other emergency services to support the timely location of vulnerable individuals who are reported missing. This meant the person experienced smooth, safe transitions between services, reducing risk and promoting continuity of care.

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.
The provider promoted the person’s rights to live safely and free from abuse, neglect and avoidable restrictions. Managers monitored restrictions, consent and best-interest decisions, and had addressed concerns identified at the previous inspection. Practice reflected a least restrictive approach, helping to protect the person from avoidable harm while supporting their independence and rights.
Staff understood how to recognise, report and escalate concerns, had completed safeguarding training and were confident concerns would be acted on. Managers gave an example where they referred a safeguarding concern to relevant professionals, involved family members and introduced additional safeguards. Learning from the incident led to service improvements and greater family involvement. Staff told us they felt the person was safe and well cared for, and professionals expressed confidence in the safety and quality of care.

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.
Staff had a detailed understanding of the person's risks, anxieties, and distress and its presentations. Staff were skilled in recognising signs that the person may be becoming overwhelmed and used a flexible, person-centred approach to support their wellbeing. They adapted activities in response to the person's verbal and non-verbal communication, encouraging participation in activities when someone showed uncertainty while respecting the person's wishes and changing plans when needed. Staff balanced reassurance with independence. Risk assessments were recorded including for less frequently completed activities, such as attending a safari park. The person’s ‘Living Safely and Taking Risks’ record was particularly detailed and prompted positive risk-taking where possible to support quality of life and independence, such as safely using a kettle and helping with cooking. Staff supported unplanned changes and continuously assessed risks. The person enjoyed having warm baths, so they got a temperature gauge to check the water temperatures, to make sure the bath wasn't too hot. This supportive approach enabled the person to maintain their autonomy, do the things that mattered to them, while receiving the care they needed to keep them safe and well.

The provider identified and controlled risks in the person’s home. They made sure equipment, facilities and technology supported the delivery of safe care.
Environmental checks were proportionate for the homecare setting. Risks associated with the person’s home environments were assessed and managed wherever possible. Managers helped to monitor safety through smoke alarm tests, fire drills, fire extinguisher checks, fire risk assessments and emergency equipment checks. A personal emergency evacuation plan (PEEP) was in place to provide guidance for staff in the event support was needed during an emergency evacuation. This meant the person was protected from avoidable risks and received care in an environment where equipment and support arrangements promoted their safety and wellbeing.

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.
The person received support from staff who were competent and understood their needs. Staff received training appropriate to their roles and demonstrated a good understanding of the needs of the person they supported. For example, staff received training to equip them with the skills to provide safe and compassionate care to people with a learning disability and autistic people. Managers addressed competency gaps, supported qualifications, and funded additional learning where this benefited the person. Staff described thorough induction, shadowing, and showed knowledge of the person’s needs, preferences, risks, and communication. One of the person's relatives said, “Staff are really well trained…they [staff] know exactly what to do with them.”
Staff told us they felt supported within their roles and were able to seek guidance from the registered manager when required. If staff became unwell or unavailable at short notice, there were cover arrangements in place to ensure safe care would resume. Recruitment of staff was done safely. The person’s relative was also included in the recruitment process. This meant the person received timely care and support.
Some recruitment records needed slight improvement because employment histories and gaps were not always explored or recorded in detail. The provider told us they would review this.

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.

Staff supported safe practice in the person’s home. Staff completed training and competency checks, including practical hand hygiene demonstrations. One staff member told us acrylic nails, nail polish and long nails were allowed if gloves were worn. This did not match the provider’s policy, or best practice guidance, and the provider agreed to review the policy with staff. Staff had access to suitable personal protective equipment. Staff knew how to report infection risks or concerns if they had any. Cleaning schedules covered daily cleaning and weekly deep cleaning. Fridge temperatures and water temperatures were monitored. This meant the person was protected from avoidable infection risks and received care in a safe environment.

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 service had good medicines systems, including twice-daily stock checks, electronic medicines administration records, monthly audits, expiry monitoring and competency assessments. Daily stock checks had been introduced following previous learning. Over-the-counter medicines were recorded and monitored; however, records did not make it immediately clear which products were prescribed medicines, and which were homely remedies. The provider told us they would review this. Audits identified and addressed discrepancies promptly. The provider used an electronic medication administration record which had built in safeguards to help prevent mistakes. Staff received medicines training and understood their responsibilities in relation to safe medicines administration. The provider had identified an area they wanted to improve prior to our assessment in relation to best practice with patch medication through their quality improvement checks and research. This meant medicines were managed safely and the person received the support they needed.