One to One Community Care

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.

The service was previously in breach of legal regulation in relation the ways people’s medicines were managed and the quality of risk assessments. Improvements had been made in these areas and the service was no longer in breach.
 

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. Processes had been implemented at the service to analyse incidents should they occur. Regular auditing, governance and requests for feedback took place to support continual service improvement.

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. Care plans contained accurate information about people, and these were available to health and social care partners should they be required. Managers at the service demonstrated an understanding of how and when to contact and work with partner agencies for advice and support.

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 ensured staff accessed safeguarding adults training and understood how to identify and respond to safeguarding concerns. Care plans contained sufficient detail for staff to care for people safely. No recent incidents or safeguarding concerns had occurred, however records demonstrated processes were in place to manage incidents should they arise. People told us they felt safe with the care they received. A person told us, “Yes I do feel very safe, it is nice to have them [carers] in the house.”

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. Care plans were completed with people and their relatives to ensure they were able to share their views on what was important to them. Risk assessments were in place to support the mitigation of known risks. Care plans were reviewed regularly. A relative told us, “My relative had a care review recently, I was involved in this.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Environmental risk assessments were in place within people’s care plans to ensure both the safety of people and staff. Staff received training to support their use of equipment in people’s homes, for example moving and handling training.

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. The provider had implemented new systems to ensure recruitment was completed in line with current guidelines. Where historical recruitment records had not been retained, for example copies of interview records, risk assessments were in place. All staff had up to date checks in place from the Disclosure and Barring Service (DBS) and regular spot checks of staff working practices took place. People and their relatives told us that staff knew them well and spoke positively about their conduct. A relative told us, “I would be happy to have them for myself.”

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 had access to adequate stocks of personal protective equipment (PPE) and spot checks of staff practice ensured this was being used appropriately. Staff received training in infection prevention and control to mitigate associated risks.

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. The provider had made improvements to their systems and processes in relation to medicines management. Medicines administration records were in place for prescribed medicines, and these records were organised and completed in line with current guidelines. Where people had ‘when required’ medicines the provider ensured protocols were in place to support staff to know how and when to administer these appropriately. Managers undertook regular audits of medicines administration records and spot checks of staff practice in relation to medicines administration.