New Leaf Care Limited

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.

People and staff were encouraged and supported to raise concerns and people felt confident they could do this and would be treated with understanding, and would not be blamed, or treated negatively. A relative told us, “I would ring the manager, but I have never had to.” A person said, “I would tell my son, and he would deal with it.”

Risks were not overlooked or ignored. A health care professional who regularly worked in partnership with the registered manager told us, “[Registered manager name] makes contact via e-mail or telephone with any relevant updates or incidents. [Registered manager name] is open and honest and has matched her staff to the person they support. This good planning has meant overall the support offer has been successful. There have been some ‘teething problems’ which [registered manager name] was always open and honest about. There were honest conversations with the individual’s relatives about what needs to be put in place to ensure success moving forward.”

The registered manager reviewed any accidents and incidents and looked for themes or trends from incidents and agreed appropriate actions. We saw there had been no serious incidents or injuries since our last inspection. People’s risk assessments identified the action staff needed to take to keep people safe, and what to do in response to any incidents.

Any lessons learned from safety incidents or complaints were shared during staff meetings and in staff supervision meetings.

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 registered manager ensured initial assessments were completed when people first began to use the service. Relatives told us they were involved in assessment discussions, one relative told us, “The initial meeting included [person], the manager, me and the continuing care nurse. Everyone who was involved and needed to give information.” The registered manager worked in partnership with other professionals to support people to access healthcare when they needed it.

Care plans included relevant health and personal information to help inform care provision. People's needs and choices were clearly documented. People told us they had family present who were involved in discussing people’s care needs when initially referred to the service and on occasion other professionals were also involved in their care. A person told us, "Social Services arranged the care package via the hospital. When I got home it was all set up. I discussed my needs with the social worker, and I agreed with the plan.”

The registered manager ensured arrangements were in place to support people who were transitioning in to, or out of the service. Care and support was planned and organised with people, together with partners to ensure continuity. People’s views and those of partners and staff were listened to and considered. The registered manager considered compatibility and whether the service could meet people’s needs, when first referred. A health care professional commented about a person they were involved with and told us, “New Leaf provide support alongside a day opportunity and informal care provided by family. There are a number of logistics to manage as the [person] has periods of respite with New Leaf while still accessing the day centre. New Leaf communicates with family and the day centre to ensure these logistics are managed. There is also a comprehensive handover system in place.”

Two relatives we spoke with told us they had tried other care agencies and had been referred to the current service by the continuing care nurse or had independently changed service. One relative said, “I have tried other companies, but they were not satisfactory, so the continuing care nurse got in touch with this one; brilliant.”

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 had systems in place which meant people’s human rights were upheld, and they were protected from discrimination. The registered manager ensured staff had access to up-to-date safeguarding policies and procedures. We saw the registered manager raised the topic of safeguarding in staff meetings to reiterate the safeguarding policy and remind all staff of the importance of being attentive and maintaining safety for people, whether within the community or in their homes, and themselves.

The provider maintained a deprivation of liberty policy in the community. This referred to situations where a person in a community setting, such as their own home is subject to restrictions on their freedom that amount to a deprivation of their liberty and is usually authorised by the court of protection.At the time of the inspection, no-one was subject to any such restrictions.

Staff received safeguarding training which was relevant and at a suitable level for their role, and most staff were up to date with safeguarding adults mandatory training. There was a commitment to taking immediate action to keep people safe from abuse and neglect. This included working with partners in a collaborative way. Records showed people were appropriately supported when they felt unsafe or raised a concern, and the registered manager had taken timely action to resolve any concerns raised; any individual staff concerns were also discussed in their supervision meeting with the registered manager.

Staff were encouraged to raise concerns and felt confident to do so. Staff had a good understanding of safeguarding and how to take appropriate action. Staff were able to outline indicators of abuse and the required actions if a safeguarding concern was identified.

People and most relatives did not raise any concerns about feeling unsafe and told us they were treated well and with respect. Everyone felt comfortable to raise any concerns with the registered manager. A relative said, “[Person] is perfectly safe with carers and is treated well. I monitor that.” A person told us, “Staff treat me well; I get on very well with them. I can talk to them and have a good rapport with them. I would speak to the manager if I was worried.”

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 were assessed, and people and staff understood them. Risk assessments about care were person-centred, proportionate, and regularly reviewed with the person, where possible. We saw evidence of risk assessments for a wide range of areas, including the environment, medication, mobility, skin care, continence and catheter care. Each assessment had possible outcomes identified and the risk reduction measures needed and contained a good level of instruction and guidance for staff to follow.

Most people felt risks were managed well and staff were competent in supporting them. A relative told us, “[Person] is at risk of choking and falling and forgets [they] can’t walk. Staff are watching [person] all the time; they are aware of the swallowing problem and [person] has thickener for drinks.” A person said, “The girls [staff] help me use the Zimmer frame to transfer. I couldn’t use it without them.”

The provider had policies for restrictive practice including restraint and physical interventions and for challenging behaviour. The registered manager told us no person was subject to any restrictive practice. Staff had time to read people’s information in full, to help them understand how best to support them to stay safe. The registered manager carried out regular spot checks of staff practice to ensure risks were being managed well and staff were following good practice guidance.

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 registered manager explained how and when environmental risk assessments were completed; they told us before any care package started, they would go out to do an initial visit to people in their own home, to talk about the care and support people would like. As part of this process, they walked around the person’s home to complete an environmental risk assessment; our review of records confirmed this. There were no concerns raised by people and relatives around the safety of their environments.

The registered manager ensured people had individualised care plans regarding the environment which indicated any risks and how such risks could be mitigated or lessened. Areas assessed included the external pathways, fire precautions, flooring, furniture, sockets, appliances, lighting, stairs, any adaptations, the presence of gloves and aprons for staff, access to cut-off points for utility supplies and access to the property.

People had the equipment they needed, and rooms in people’s homes were adjusted to fit in with any equipment such as wheelchairs, hospital beds or hoists. Any equipment staff used to support people was maintained and serviced by the supplying organisation. A relative told us how the manager on an initial meeting with a family member, had pointed out a window which was a risk to the person living with dementia. Another relative said, “Carers [staff] are trained to use the hoist; they explain what they are going to do and talk [person] through it when they hoist [them]. [Person] is blind so it’s so important [they] know what’s happening, and now [person] is used to it because of their [staff] reassurance.”

Risks in or around people’s homes, including the use of any equipment had been assessed, to help keep both people and staff safe.

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.

There was a clear staffing structure in place and people had clearly defined roles. There was a consistent staff team in place. Good systems were in place to induct and train staff and to ensure staff received regular supervision support and regular spot checks to provide further management oversight. One staff member told us, “In the beginning I had an induction period, shadowing other staff and training. We always go with other staff at first until we get to know the person and what they want. We get spot checks on what we are doing all the time, and the registered manager is always monitoring us and how we are doing, and how we are supporting people.”

Staff were recruited safely with appropriate checks in place to assess the candidate's suitability to work with vulnerable adults. This included obtaining references, evidence of right to work and DBS checks. Disclosure and Barring Service (DBS) checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. Staff had opportunities to learn, and any poor performance was managed appropriately.

Staff had completed the relevant and necessary training for their roles. People felt staff knew what they were doing and knew how to use any necessary equipment. One person told us, “Staff time keeping is pretty good and have regular girls. I get a phone call if they [staff] are running late.” A relative said, “There is a core of regular girls [staff] and people [person] has got to know. If late, I always get a call and a genuine reason such as car breakdown or traffic hold ups.”

A health care professional who regularly worked in partnership with the registered manager told us, “I have not observed the staff with [person], however [person’s] Mum has nothing but praise for the staff team. She has been let down by several providers in the past, but she now comments how person-centred and flexible the staff team are. She feels [person] is well supported and safe.”

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.

There was an effective approach to assessing and managing the risk of infection, which was in line with current relevant national guidance. People were protected as much as possible from the risk of infection because people’s homes and equipment were kept clean and hygienic.

The cleanliness of people’s homes was monitored to ensure standards were maintained and staff use of personal protective equipment (PPE) was observed by the registered manager as part of staff spot check visits. The provider felt adherence to strict guidelines on infection control was of paramount importance in ensuring the safety of both people and staff.

There was an up-to-date policy on the control of infection, (IPC) which staff could refer to if needed. Staff were trained in IPC and had access to PPE. Most people and relatives had no concerns over staff use of PPE and people said staff wore gloves, aprons and masks. However, 1 relative was concerned some staff did not always change their gloves in between completing different tasks; we found the registered manager had addressed the concerns with these staff and action had been taken to improve their practice. Staff told us there was enough readily available PPE for their use and were encouraged to test for Covid-19 if they suspected they had any symptoms.

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 involved with assessments and reviews about the level of support they needed to manage their medicines safely and to make sure their preferences were included; this was clearly documented in their care plan. People received their medicines on time and could self-administer their own medicines if they wished. People and relatives did not raise any concerns about medicines. One relative said, “Staff are fully aware of [person’s] medical and physical needs and are competent. [Person] is diabetic so they [staff] always tell me if they think [person’s] blood sugar levels are low.”

Staff had received training in the safe administration of medicines. Managers completed staff competency assessments, and medicines audits to help ensure policies were followed in practice; our review of records confirmed this, which was also verified by staff.