Care Quality Services Shrewsbury

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. This is the first assessment for this service after registering with a new provider. This key question has been rated 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.

There were systems in place to analyse and identify any trends relating to accidents and incidents. Any learning from events was shared with staff and measures were put in place to reduce the risk of the incident happening again. For example, following a medication error medical advice was sought immediately and the staff member received further training and increased checks on their competency. Feedback from stakeholders was positive. One told us, “The provider is very responsive to anything we raise, and they reevaluate their processes following any issues.”
 

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 had their needs assessed before a package of care was agreed to ensure their needs and aspirations could be met. Each person had a personalised plan to ensure they experienced a smooth transition. Risks were identified and managed proactively, and the effectiveness of these processes was monitored to maintain people’s safety. Care and support was planned with people and their representatives and healthcare professionals, to promote continuity and ensure that any transitions were well organised.
 

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 told us they felt safe with the service they received and with the staff who supported them. One person said, “I’m feeling safe when the carers are present and safeguarding is well maintained.” Another person told us, “I’m very satisfied with the care I’m getting, and I feel very safe when the carers are about.” Staff had been trained how to recognise and report any safeguarding concerns, and they were confident action would be taken to keep people safe. A member of staff said, “I feel comfortable raising concerns. Safeguarding is everyone’s responsibility, and I would always report something if I was worried about a person’s safety.” A relative told us, “Safeguarding is taken seriously, for example; the carers don’t feel comfortable moving my relative in certain ways and they will actively seek medical advice before doing anything”. Safeguarding policies were up to date and aligned with local authority procedures. Records showed the provider shared any concerns with appropriate authorities and worked in partnership with them.
 

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 a plan of care was in place to guide staff how to support people in a safe way. These included risks associated with skin integrity, nutrition and hydration, falls and supporting people during periods of distress. People were supported by staff who knew the individual risks and assisted them in the least restrictive way possible whilst minimising the potential for harm. Staff told us they had access to people’s care plans and risk assessments which were easy to follow. They told us any changes to people’s needs were communicated to them through daily handovers and staff meetings. A member of staff told us, “Information held within the care plans covers different risks such as slips, trips and falls, if a client has a step or ramp, electrical items such as those in the kitchen, alarms for smoke and fires and a brief on what to do. I feel as these are well covered in detail, if something new is discovered, it is reported immediately and the office update the care plan and so do a review for safety.”
 

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

People were supported to keep their environment safe. The provider took appropriate steps to identify, assess and manage risks within and around people’s homes. Care plans contained environmental risk assessments which included vital information such as where to shut off gas, electric or water in the event of an emergency and who to contact.
 

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 told us they were informed who would be supporting them however, this could change on occasions due to unforeseen circumstances. People said staff usually arrived on time and stayed for the duration of the arranged call. One person told us, “I feel fine with the carers I get and am very satisfied with the continuity. Punctuality is fine, although I don’t always know what time they are coming but it doesn’t bother me, as I’m going nowhere. I think they stay for the contracted time they should, and I don’t feel they miss any of the duties at the end of each visit.” Another person said, “I have different carers and they are all good at their job. They are very reliable and turn up on time.” A relative told us, “My [relative] is as safe as they possibly could be. The carers change quite regularly but they are all very nice. I couldn’t fault them.”

The provider’s recruitment procedures ensured staff were recruited safely. References and checks with the Disclosure and Barring Service (DBS) were carried out before staff worked with people. DBS checks provide information including details about convictions and cautions held on the Police National Computer. This information helps employers make safer recruitment decisions. Staff received regular training appropriate to their role and there were regular checks on their performance and knowledge to ensure they remained skilled and competent. All new staff received a period of induction which gave them the skills and knowledge and training to meet people’s needs. New staff worked alongside more experienced staff during their induction to enable them to get to know the people they would be supporting. A member of staff said, “I did shadow shifts when I started where I worked with experienced staff and I learned how to communicate and respond to people and got to know them well.”
 

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.

People were protected from the risks associated with the spread of infection because staff had received training and followed the provider’s procedures and best practice. People told us staff wore appropriate personal protective equipment (PPE) such as aprons and gloves when assisting them. One person said, “I think the hygiene standards are good. They [staff] look the part with their name badges and all the protective clothing and changeable gloves.”Staff told us they had access to sufficient supplies of PPE. A member of staff told us, “I have access to appropriate PPE such as gloves and aprons and always use it when required.” There were regular audits and checks in place to ensure staff followed correct procedures.
 

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 who required support with medicines received help from staff who had received training and had their competency assessed to make sure their practice was safe. Staff used electronic devices to record when medicines had been administered or refused. If medicines were not administered, senior staff were alerted which enabled them to take swift action. A relative told us, “The carers are all excellently trained. They are very confident delivering medication, and they make sure it’s kept in a locked drawer”.