South West Care Group LTD T/A Goodoaks Homecare East Dorset

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.

Although staff told us they understood how to report safety concerns, they did not always show good awareness of their responsibility to raise issues and record incidents. We identified two recent incidents that had not been reported in line with the provider’s policy. Although the provider’s quality assurance processes would have identified these gaps, we raised the issue with them, and they took immediate action to address it.

When incidents were reported to the management, they were scrutinised and reviewed to identify themes, trends. Appropriate actions were taken to prevent recurrence, thereby helping to keep people safe. Staff confirmed safety events and the actions taken were shared during team meetings, supervisions and messages on the providers electronic communication portal to support learning.
 

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 completed an initial needs assessment before people started using the service. Staff involved people and their relatives to develop their own care plan. A relative told us, “Our [family member’s] requirements were discussed in detail, and I was sent the care plan for comment before the care started. I've asked for several changes since, and they've all been accommodated very readily.”
A summary ‘grab sheet’ was available if the person went into hospital or moved to another service. The provider told us each person had a few copies of these documents at home, printed out and available for them when needed.
 

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.

The provider established effective safeguarding systems with clear policies and procedures in place. Staff told us they knew how to raise concerns and had completed safeguarding training specific to their role. People consistently reported they felt safe around staff and had been aware of who to contact if they had any concerns. One relative told us, “I phoned the office, explained the situation and was listened to very sympathetically. The matter was dealt with appropriately.”
Staff told us they felt confident management would listen and act if they raised concerns. One staff member told us, “All safeguarding concerns are taken very seriously and acted upon quickly and appropriately.” Another said, “I feel extremely confident that any issues regarding concerns about a client would be dealt with quickly and effectively.”
 

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 identified, assessed and kept under review. However, we found 1 person did not have a risk assessment completed in relation to inappropriate behaviours . This meant staff were not given guidance on how to safely manage these behaviours to ensure their own safety. This was discussed with the manager during the inspection, and they took immediate action to implement. Care plans reflected people’s individual needs and preferences . People and their relatives felt involved in managing risks, and risk assessments were person-centred, proportionate and reviewed regularly. People and relatives, including legal representatives, confirmed they were, when appropriate, involved in creating and reviewing people’s care plans. Comments included, “Yes. We have been in discussion about increasing [family member’s] care” and “I've asked for several changes since and they've all been accommodated very readily.”

The provider used a dedicated electronic communication platform to ensure staff were kept up to date with any changes or new information.

Staff understood their responsibilities and escalated concerns appropriately when a person’s well-being was at risk. A staff member told us, “Staff are risk assessing at every visit and reporting to the office with any concerns or changes through [electronic communication platform], phoning the office or on-call phone. Any concerns that arise are acted upon quickly and efficiently by office staff and care staff. Risk assessments are reviewed and updated by office staff on a regular basis”.
 

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 service provided support in people’s own homes, they were not responsible for the upkeep of these premises. However, risk assessments were in place to ensure the environments in people’s homes were safe to protect people and staff from harm. For example, there were effective arrangements in place to manage risks associated with fire or slips, trips and falls.
When people’s needs changed, the provider contacted professionals, such as occupational therapists, to request an assessment.
 

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 levels were safe and effective. Staff received regular supervision, spot checks and competency assessments to assess their knowledge. Staff training was up to date, with a mixture of online training and practical sessions tailored to staff needs. The provider had also organised an additional training session provided by a private community physiotherapist (PT)and occupational therapist (OT) on 'an enabling approach to care'. This supported staff to develop a more reablement-focused approach to the care they provided.

Staff felt supported and valued. New staff members completed an induction when they joined the service to equip them for their role. We received positive feedback from the relatives about staff. One relative told us, “Staff have been well trained.” Another said, “I feel that the staff are trained sufficiently except that the new staff require some support from me.”

Recruitment records showed staff were recruited safely. Other checks included an enhanced Disclosure and Barring Service (DBS) checks for adults. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. References from previous employments had been sought.
 

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.

The provider had an infection control policy. The training matrix showed staff had completed infection prevention control training. Staff practice was observed during regular spot checks. People and their relatives told us that their homes were left clean by the carers.
Staff were provided with and used Personal Protective Equipment (PPE) such as disposable gloves and aprons, which met recommended national guidance and were appropriate for the care they were delivering and the level of infection risk.
 

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.

Care plans included detailed information about each person’s medicines, ensuring staff had clear guidance on administration and monitoring. However, we found 1 person did not have clear documentation from staff on positioning, removing and rotation of transdermal patches when they were changed. We raised this with the provider during inspection, and they took immediate action to address this. We found no evidence this had a negative impact on people.

Protocols for medicines prescribed on an as-required (PRN) basis were in place and documented for pain relief. Weekly medicine audits were conducted by the manager, which would identify any issues promptly. The services electronic medication system would also notify management if there was anything raised by a staff member at the visit.

Staff received medicines training appropriate to their role and were observed in a practical assessment during induction training to ensure safe practice. Recommendations were made to the provider to complete competency assessments during care visits to ensure continued safe practice. The provider acknowledged this during our inspection and took immediate action to address this.

Records were monitored so any concerns could be identified and addressed promptly. Where errors occurred, these were reviewed and actions taken to support learning and reduce the risk of recurrence.