Community Care Advice Centre

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.

This is the first assessment for this service. This key question has been rated Requires Improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

This service scored 59 (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.

Systems were in place to learn from lessons following accidents and incidents.

An incident and accident policy was in place that detailed the process of managing incidents. The registered manager told us that there had been no incidents while people received care but should incidents occur this would be analysed with action taken and lessons learnt to minimise the risk of reoccurrence.

The provider did not always manage or monitor people’s safety.

Robust systems were not in place to capture information as part of the pre-assessment process to determine if the service can support people safely when being discharged from hospital.

Records showed a pre-assessment had been completed prior to supporting people to determine if the service can provide safe care and support and risks had been identified as part of the pre-assessment process. However, the information on risks and support needs were not detailed and therefore had not been effectively used to create risk assessments and personalised care plans to ensure people received safe and personalised care at all times. This meant robust systems were not in place to capture information at pre-assessment stage to provide safe and personalised care to people.

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.

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.

People and relatives told us that people felt safe when supported by staff, reflecting a positive perception of the service's commitment to safety and wellbeing. A person told us, “They were all very, very nice [carers], I was very, very fortunate. They made sure that I was safe and they made me feel comfortable in my own home.” A relative commented, “Yes, my husband is certainly safe with the carers.”

Staff knew about safeguarding processes and had received training in this area. A staff member told us, “I am up to date with safeguarding training. Abuse can be number of things like financial, sexual and physical. If I see abuse, I will report to management and safeguarding team and social workers.”

The provider did not always work well with people to understand and manage risks.

Risks to people were identified and included on care plans such as on falls and skin complications. However, risk assessments were not in place to ensure identified risks were mitigated.

Records showed some people were at risk of falls and skin complications. However, risk assessments had not been completed in these areas to ensure people received safe care at all times.

Some people had specific health conditions like hypertension and history of stroke, these areas had not been risk assessed to ensure safe care was delivered at all times.

We fed this back to registered manager who told us that risk assessments would be completed.

Failure to have robust risk assessments in place meant there was a risk people may be exposed to avoidable harm.

The provider did not always detect and control potential risks in the care environment.

Robust systems were not in place to ensure assessment of the environment had been completed at all times.

Risk assessments had not been completed on people’s home environment at all times. Records showed that environmental assessments had been completed for some people. For one person, information included details on risks or hazards within the environment to ensure care and support could be provided to people in a safe way and risks to staff and people were minimised such as reducing the risk of falls. However, the same level of assessment had not been completed for other people, which meant potential risks within the environment may not have been identified when supporting people.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. However, the provider did not always work together well to provide safe care that met people’s individual needs in a timely manner.

The service used a digital system to monitor staff timekeeping. The system gave the service oversight of staff timekeeping. A person told us, “They came the time I expected them to come and always stayed as long as needed. I never had any missed calls.” A relative told us, “We never had a missed call and they came within an hour of what we were told at the assessment at the start of having them. They always stayed as long as required and did all that was needed to be done.”

We reviewed call logs for a period of time to check if people received care in a timely manner and if staff stayed the duration of the call. We found some calls were late by over 45 minutes. Data also showed that some staff did not stay the duration of the call to ensure people received the care they needed. The registered manager told us as it is a reablement service this may be due to people not needing staff support as they became more independent but will ensure this was recorded on call logs.

Staff had completed key training such as on safeguarding, moving and handling, learning disabilities and basic life support. A person told us, “They all seemed to be well trained and knew what they had to do for me.” A relative commented, “I definitely feel that they do a good job.” Another relative commented, “They were all well trained and knew what they were doing. They were all very good carers.” A staff member told us, “I have completed training, which is very helpful.” Another staff member commented, “Yes, when I started, I did induction and shadowed experienced carers. They also give us spot checks on the job to check how we are doing.”

Regular supervisions had been carried out to ensure staff were supported. Staff confirmed they received regular supervisions and support from the registered manager. A staff member told us, “I have supervision once a month. [Registered manager] is supportive and approachable.”

Relevant pre-employment checks, such as criminal records checks, right to work in the UK, references and proof of the staff’s identity had been carried out. This helped ensure people using the service were not cared for by anyone barred from working with vulnerable people.

The provider had an effective approach to assessing and managing the risk of infection, which is in line with current relevant national guidance.

Systems were in place to prevent infection. Staff were able to tell us the process of ensuring people were protected from infection such as good hygiene protocols and wearing personal protective equipment and that they had been trained in infection control. A staff member told us, “I have been trained on IPC and have access to PPE when I go out to support people.”

People and relatives told us that staff followed good infection control processes. A relative told us, “They do wear PPE.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

The service did not support people with medicines. Care plans included the level of support people required with medicines. There was a medicines policy in place and staff had been trained on medicines management should people require support with medicines.