Integral Focus Support and Care Services

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 registered manager told us to date there had not been any significant accidents or incidents, safeguarding allegations or complaints received. We found no evidence to contradict this. The service had a policy for staff to follow should things go wrong, and we saw there was an incident form template to use should staff need to. The registered manager demonstrated a good understanding of how to respond to any such incident. Relevant policies were in place setting out guidance about how to respond if necessary.

Staff understood how to report incidents, accidents and concerns and were confident these would be reviewed and acted upon.

Staff had access to the information they needed to provide safe and effective care. The registered manager completed regular spot checks and observations to monitor staff practice and ensure staff remained competent and confident in their roles. These checks also helped to ensure risks were being managed appropriately and enabled the service to identify and respond to any changes in people’s needs.

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.

Systems were in place to capture information as part of the pre-assessment process to determine if the service could support people safely. This included speaking with the referring agency, the person and their relatives where possible.

We saw that pre-assessment had been completed and used to record key information about people’s support and care needs to determine the support required. This information was then used to create care plans based on people’s preferences and choices on the support they required. The registered manager told us, where possible, people had the same staff to ensure relationships were built so people received 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. People, and their relatives, told us they felt safe. A relative said, “Yes, [person] is safe. They [carer] take [person] outside for activities and comes home safe and happy.”

A safeguarding policy was in place that detailed the types of abuse and how to escalate concerns if staff suspected or saw abuse to ensure people were protected. A safeguarding care plan was in place with risk assessments that detailed people’s background and on how to keep people safe.

Staff knew about safeguarding processes and had received training in this area. Staff told us that they received safeguarding training. A staff member told us, “I have completed training on safeguarding, moving and handling and medicine. Safeguarding means protecting people to ensure their safety, free from abuse and neglect. What I will do is call the registered manager and make sure people are safe.”

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.

Risk assessments were clear, detailed and specific to people’s individual needs, circumstances and behaviours. Staff reviewed and updated them regularly, including following incidents, to minimise the risk of recurrence. Relatives reported that staff had built a good rapport with people, which supported the delivery of safe and person-centred care and support. Staff explained how they developed an understanding of people’s behaviours and what was important to them, enabling them to recognise potential triggers, tailor their approach and reduce risks.

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 risk assessments in relation to the person’s home environment to indicate if there were any possible risks and how to reduce them. Environmental risk assessments included checks on any equipment used, cleaning products used and other possible risks.

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.

At our last inspection in 2022, we found that the provider had not ensured a robust staff recruitment system was in place. At this assessment, we found that improvements had been made. The provider had obtained satisfactory and reliable references for 2 staff members. Recruitment checks were completed to ensure staff were suitable, experienced and competent to carry out their roles safely.

There were robust and safe recruitment practices to make sure that all staff were suitably experienced, competent and able to carry out their role. Disclosure and Barring Service (DBS) checks were carried out. These provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

Overall, staff attended to people on time. They notified people or their relatives if they were running late. Relatives told us staff completed all the required tasks and demonstrated competence in their roles. There had been no reported missed care visits.

Staff had access to a range of training courses relevant to people’s individual needs, including Oliver McGowan training on learning disability and autism. Staff also received ongoing support through regular supervision and appraisals.

Staff also received spot checks to check if they were competent in their roles. Welfare checks were carried out on people to get feedback on people’s views on staff approach and delivery of care, which formed part of staff supervisions. A staff member told us, “I get regular supervision and spot checks to make sure I am doing well in my role.”

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 confirmed they had completed training in infection prevention and control and demonstrated a good understanding of the measures to manage and prevent the spread of infection.The provider had a policy on infection prevention and control to provide guidance to staff in this area. Staff were provided with personal protective equipment [PPE].

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.

Most people were independent with their medicines or were supported by their families. Staff however sometimes helped with prompting, reminders and occasionally with administration. Staff had been trained in medicine administration and had regular knowledge checks.

Medicines were recorded using an electronic medication administration record (EMAR) system, which enabled medication records to be integrated into each person's daily log on the digital care planning system. The service had contingency arrangements in place in the event of a technology failure. This was evidenced by printed copies of medication records that were stored both in people's homes and at the office.

Staff told us they had received the appropriate training and were confident in administering medicines to people, when required. The provider had effective medicine management systems. For example, staff had received training in medicines administration and there were relevant up to date policies in place.