Care Quality Services Brighton and Hove

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.

Accidents and incidents were fully investigated and action taken immediately where any areas of learning or improvement were identified. There were robust systems in place to ensure any reported issues were dealt with effectively and quickly. Learning from incidents was at the forefront of managerial oversight, and staff told us they felt supported and never blamed should things go wrong. There was additional provider level support and analysis to identify any learning which could be shared across other local branches.

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 service was quick to respond to requests for assessments as people were referred to them. There were stable processes and systems in place to enable good joined up working and staff had strong working relationships with external professionals. People were involved in decision making and their care plans were regularly updated with any changed to their needs, especially when following a transition from another service such as hospital.

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 and their relatives felt they were safe with staff. They were involved in any decision making around improving their safety. One relative told us, “[Person] feels safe with them all and they are well trained.”

There were efficient safeguarding policies and procedures in place. Staff had received training and demonstrated a good knowledge of what to do should they have any concerns. The branch manager had oversight of any concerns raised and had shared these with the relevant agencies where necessary. Action had been taken in a timely manner to prevent risks to people.Where people were subject to Deprivation of Liberty Safeguards (DOLS), there were robust details of these and any associated conditions in people’s care plans. Staff knew how to support people and followed the guidance provided.

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 assessed and monitored, and action taken to prevent or minimise these. The provider had an electronic application (app) which used innovative technology to support identifying risks. For example, the app would scan daily notes or tasks for certain words to identify whether there was an increased risk, especially around falls. If a risk was identified, additional tasks were automatically added to the staffs call to ensure risks were minimised. This could include increasing someone’s support with fluid intake. This technology supported staff in real time to undertake dynamic risk assessments and provide high quality, safe care to people. This system also enabled staff to report concerns, incidents, and accidents in a timely way, so measures could be put in place immediately to avoid them being repeated. There was regular oversight of the risk by the management team.

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

Risks in relation to people’s home environment were robustly assessed and any measures put in place to minimise these. For example, where people had animals in their property, there was clear guidance for staff in how to navigate these. People told us that staff treated their property with respect and took care of any equipment they used to support them. They did not raise any concerns in relation to cleanliness and spoke positively of the support staff provided with this. One person said, “[Staff] use a hospital bed for me and that is always looked after correctly. I would feel comfortable raising any concerns if I felt mistreated, but I am happy with them.” Staff completed regular environment and equipment checks to ensure these remained safe and hazard free.

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.

Staffing was safe and effective. People told us that staff attended their calls as planned and if there were issues, they would be told. Staff received regular spot checks and supervision to assess their knowledge and ensure their practice was maintained to a good standard. Training was up to date, with both online and practical sessions available to staff. Staff spoke positively about the training they received, telling us that it was useful and relevant to their role. New staff members completed an induction period when they started to equip them for their role. The service used a rota system that ensured adequate staffing, this was effective to meet people’s needs safely. The new manager had a plan in place to improve consistency of staff across calls.

Recruitment records showed staff were recruited safely. This included appropriate checks being made before staff started, for example, Disclosure and Barring Service (DBS) checks and previous employment references. Where a staff member had remained employed by the service for some time, DBS checks were renewed regularly.

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 had undertaken training in infection prevention and control (IPC). People told us that staff wore personal protective equipment (PPE) appropriately, and there was guidance in the care plans of when this was needed. Regular spot checks were also completed by field supervisors to ensure compliance with this. There were policies and procedures in place with regard to IPC and staff demonstrated good knowledge of these. We saw a plentiful supply of PPE available in the office for staff to collect as and when needed.

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.

People were happy with the way staff supported them with medicines. One person told us, “They give me my meds, and it is recorded on their app. It works well. My medication is very important.” Staff understood how to manage people’s medications safely. They had appropriate training and were regularly observed to ensure their practice remained safe. The provider had an up-to-date policy in place with clear guidance for staff. A staff member said, “They do come and check that I’m doing everything right. I like it as I know I’m doing things properly.”

Medicine administration records (MARs) were accurately completed via an electronic application. These were monitored closely by the field supervisors and any errors picked up rapidly. The branch manager also completed regular audits of medicines to maintain oversight. Where errors occurred, appropriate action was taken to address these and improvement practice or facilitate learning.