ISSAC

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 inspection, 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 demonstrated a positive learning culture, with staff encouraged to reflect on practice.

Accidents and incidents were recorded, monitored and analysed. There were very few accidents and incidents, which the registered manager attributed to a stable staff team and people having used the service for a sustained period. This supported staff to develop a strong understanding of people’s needs, risks and preferences. Staff meetings and supervisions were also carried out, which provided opportunities to share learning and reinforce good practice.

We discussed introducing a ‘lessons learned’ column to the accidents and incidents log to further strengthen the service’s approach to capturing learning, recognising patterns, and supporting continuous improvement. This was promptly implemented by the registered manager.

Staff worked effectively with partner agencies to support safe systems, pathways and transitions.

The provider carried out pre-assessments before care commenced to help ensure people’s needs could be met safely and appropriately. Staff worked in a coordinated way with health and social care professionals and information was shared promptly when concerns arose. A relative said, “They were recommended to me, they did an assessment of needs before they started. The care plan is reviewed every year and we tweak it as necessary.”

People were supported to live safely and felt protected from abuse and avoidable harm. Staff had completed safeguarding training appropriate to their role. Staff confirmed they had no safeguarding concerns about practice within the service.

People and their relatives told us people were safe. One relative told us, “He is safe with them, there’s no problem. I went away and left them looking after him.”

Safeguarding concerns were analysed to identify themes, trends and opportunities for learning. We discussed making the ‘lessons learned’ section within the safeguarding log clearer and identified that some incidents recorded within the log did not meet safeguarding criteria. The registered manager promptly addressed this and updated their recording processes to improve clarity and consistency.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. When people receive care and treatment in their own homes an application must be made to the Court of Protection for them to authorise people to be deprived of their liberty.

At the time of the assessment, there were no Court of Protection Deprivation of Liberty authorisations in place since people’s care and support arrangements did not amount to a deprivation of their liberty.

Risks to people’s safety were identified, assessed and managed appropriately to reduce the risk of harm. People and, where appropriate, their relatives were involved in decisions about managing risks, supporting a person-centred approach. People and their relatives told us they felt confident in the service’s approach to keeping people safe. A relative said, “I find them good, I feel safe to come away and leave them to care for my relative.”

Staff used personalised risk management strategies that promoted independence while maintaining safety. The registered manager told us a stable staff team and people having used the service for a sustained period supported staff to develop a strong understanding of people’s needs, risks and preferences.

The provider identified and managed potential risks in the care environment. Equipment, facilities and technology were used to support the safe delivery of care and to promote people’s independence.

As a domiciliary care service, the provider is registered to deliver the regulated activity of personal care only. Care was provided in people's own homes, where individuals retained responsibility for their living environment or, where the property was rented, responsibility for the property rested with the landlord. The provider assessed potential risks within these environments and took appropriate action to help reduce the risk of harm when delivering care.

The provider ensured there were enough suitably skilled, experienced and qualified staff to meet people’s needs. Staff received effective support, supervision and opportunities for development, and worked well together to provide safe, person-centred care.

People and their relatives told us staff were well trained and competent in their roles. Staff completed an induction and ongoing training programme, supported by an in-house training provision. This helped ensure care was delivered safely, effectively and in line with best practice. Staff received regular supervision and support to help them carry out their roles safely and maintain good practice.

People and their relatives told us there were enough staff available and that care was delivered by a consistent staff team. A relative said, “We mostly get the same carers, that’s the beauty of ISSAC. They work a rolling week and it’s always the same group.” The registered manager told us consistency of staff supported people to feel comfortable and build positive relationships.

There had been no missed visits, and people told us staff arrived as planned. A relative said, “Their timing is okay and there have been no missed calls. There is good consistency with staff.”

Safe recruitment practices were followed, with appropriate checks completed before staff began working at the service. The provider used an electronic recruitment system which was colour-coded and prevented progression where checks were incomplete, ensuring only fully compliant applications could proceed.

The provider assessed and managed the risk of infection to help prevent the spread of infection and protect people’s health.

Staff had access to appropriate personal protective equipment (PPE), which they collected from the office. People and their relatives told us they were confident staff followed safe and hygienic practices. Staff had completed infection prevention and control training to support them in carrying out their roles safely.

People and their relatives were confident that medicines were managed safely and appropriately. Most family members told us they arranged and ordered medicines, which were then administered by care staff at the agreed times during their visits.

The provider had systems in place to support the safe management of medicines. A designated medicines officer, who had undertaken additional training to become a nursing associate, provided oversight of medicines management. Staff received medicines training, including face-to-face sessions, and competency checks were completed following induction and reviewed regularly to ensure staff remained competent. Staff demonstrated an understanding of their responsibilities and raised any concerns relating to medicines appropriately.

Ongoing monitoring included spot checks of staff practice and regular audits of medicines records. This helped ensure medicines were administered safely and that good practice was maintained.