Assist Care Group - Surrey

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 good. At this assessment the rating has remained 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.

Systems were in place to ensure accidents and incidents were reported, investigated and action taken to minimise risks going forward. Staff were clear on their responsibility to report incidents and concerns. The in-house trainer told us, “The company has a robust procedure for recording incidents or accidents in which I train all the care staff to understand and demonstrate in training. Staff are trained to first contact their immediate supervisor, then complete the relevant forms (which are available on their phones) these are then sent directly to the office where the coordinator or the manager deals with them immediately and on a daily basis.” Records were reviewed by the management team to ensure all required actions were in place and any themes or trends could be identified. This helped to identify and mitigate on-going risks to people’s safety.

The provider had a clear complaints procedure in place, which had been provided to all people using the service, to ensure that any complaints would be investigated appropriately.

Case studies of people's journeys through the service were discussed during team meetings to highlight good practice and promote learning amongst staff and managers.

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.

Staff worked with people and those close to them to establish their plan of care and individual transition plans, prior to people moving between services. For example, the provider had been awarded a contract with a local hospital and had developed emergency protocols to support timely and effective hospital discharges. Their collaborative approach with social workers and community teams helped to reduce delays and support safety. This helped to minimise risks and support continuity of care as far as practically possible.

Safety and continuity of care was a priority throughout people’s care journey. For example, staff had attended urgently to begin new care packages when another care provider stopped trading with limited notice. They had worked to develop safe systems of care during complex times, prioritising people’s wellbeing.

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.

People were protected from abuse and avoidable harm. The provider had safeguarding and whistleblowing procedures which supported staff to raise concerns. Records, such as a safeguarding log showed safeguarding concerns were reported to appropriate agencies when required. Staff told us they understood how to escalate concerns and felt able to speak up about poor practice. Feedback from relatives and professionals indicated people were safe and that concerns were acted upon appropriately.

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.

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.

Managers and staff knew what to do if they had concerns about the well-being of any of the people using the service. Staff received role-specific safeguarding training and were equipped to identify individuals at risk and followed the providers safeguarding policies and procedures to identify, address and report safeguarding concerns. An in-house trainer told us, “The company takes safeguarding very seriously and I have a robust training programme in-house to support the staff. They are all very vigilant and confident about raising concerns of abuse and will immediately report it to the office by telephone and send in a follow up report.” A member of staff told us, “I feel comfortable bringing up safeguarding issues, and I think there should never be a culture that discourages employees from doing so. Any issue should be properly documented, taken seriously, and escalated using the proper safeguarding protocols.”

People told us they felt safe and were confident with the care they received. One person said, “I feel safe with my [carer]. I have [them] 3 days per week, and I have had [them] for a long time.”

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 completed environmental risk assessments within people’s homes, which supported the safe delivery of care. These assessments formed part of the overall care planning process and helped ensure that equipment and environments were appropriate for people’s needs. Equipment used to deliver care, and treatment was suitable and used properly. This helped staff provide care safely in people’s homes.

Staff had completed relevant training to support them in maintaining safe working environments, including health and safety, fire safety and food hygiene.

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 provider monitored care delivery, including care‑visit monitoring on a regular basis. Some people told us their care visits were late and not conducted at the expected time. We spoke with the manager and saw the systems they had in place to identify discrepancies in care visits on a real time basis. The manager described the ongoing challenges relating traffic or calls being extended due to adverse circumstances or ill health, which impacted on staff’s ability to deliver the next scheduled care visit. Leaders demonstrated they were continually scrutinising and developing systems to minimise impact to people and ensure care delivery was, as far as practically possible, delivered in a timely manner.

Staff were recruited safely to the service. This included requesting and receiving references from previous employers, right-to-work documentation and Disclosure and Barring Service (DBS) checks. DBS checks are carried out to confirm whether prospective new staff had a criminal record or were barred from working with people at the time.

The service took into consideration people’s needs and preferences when staff were recruited, and what personal and professional qualities staff could bring to their work. Staff had opportunities to provide feedback on the service during staff supervisions and appraisals.

Staff received an induction which gave them the skills and knowledge to deliver support in line with the providers expected standards of care. Staff were given opportunities to shadow experienced staff to ensure they understood their role and complexities of the service.

Staffing levels were determined through dependency assessments and person-centred care plans and reviewed on a routine and ongoing basis. Staff received regular opportunities to share and gather feedback at team meetings and individual supervision sessions. Routine and proactive checks were in place throughout the service’s operational hours, and a designated Responsible Person was on shift from 07:00 to 22:00, seven days a week. This provided staff with access to active leadership, support and real-time oversight throughout the period in which care was delivered.

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.

Some people and their relatives told us they had experienced some concerns regarding safe staff practices in relation to infection prevention and control. The concerns related to staff not wearing PPE appropriately or following best practice guidance. We raised this with the manager who provided assurances around how these individual circumstances had been managed, and the steps they had put in place to minimise any further concerns. For example, additional training and support had been provided to the staff involved, along with an ongoing review of the infection control policy and enhanced monitoring and oversight of infection control across the service.

Staff received training in infection prevention and control and had access to personal protective equipment (PPE). A member of staff said, “PPE is used in accordance with the task being performed and the individual's evaluated needs. This can include extra PPE when necessary, in accordance with infection-control guidelines, as well as gloves and aprons when there is a chance of coming into contact with bodily fluids or while performing personal care.”

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 medicines management systems in place, including regular audits and competency assessments to ensure staff remained safe and confident when administering medicines. People were involved in decisions about their medicines, with their level of support clearly recorded and reviewed when needed.

Staff received appropriate training in medicines administration and had their competencies checked regularly. The in-house trainer told us, “Medication training is a top priority for the company, and I have a robust medication training programme which all new staff members go through at induction.”

The service used clear and effective recording systems. Records were complete, with any gaps accounted for. Records included key information such as allergies and administration guidance. These systems supported safe practice and understanding of individual risks. Learning from incidents was used to improve practice and reduce the risk of errors.