Master 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

The service was safe. It identified, recorded, mitigated, and managed risks and worked in an open and transparent manner. It used reflective practice to drive improvement when things went wrong or shortfalls were identified. People received safe care at a time previously agreed with them and staff stayed for the agreed amount of time. They received their medicines safely and processes were in place to help protect people from the risks associated with infectious diseases. People told us they felt safe receiving the service and systems were in place to identify, record and report any safeguarding concerns. Staff had been safely recruited and trained to perform their roles effectively and competently.

This service scored 0 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us safe care was delivered that met people’s needs and that staff were trained to deliver this; they told us the service took action to ensure this. For example, the service supported people to access healthcare as required. Staff told us the service was open and transparent and that accidents and incidents were discussed with them to drive improvements and mitigate reoccurrence. One staff member told us, ‘Management encourages open communication and staff members are assured that reporting incidents will not lead to blame but rather to constructive feedback and learning opportunities. The open culture helps in identifying systemic issues and addressing them promptly.’ The service had processes in place to address safety events such as accidents and incidents. We saw that these were thoroughly recorded, investigated, and responded to appropriately. For example, incidents and accidents were referred to other stakeholders as required to aid learning and ensure people were kept safe.

The service specialised in delivering care to people at the end of their lives meaning they worked closely with other health professionals to ensure people received safe and consistent care when transferring from one service to another. We saw that the service had consistently delivered this. People told us the service liaised with other professionals as required to ensure people received the care they needed; health professionals confirmed this. One relative told us how quickly and efficiently the care was arranged and delivered from when their family member left hospital. We saw that the service had made referrals to other professionals as required when safety events, such as falls, occurred. This helped to ensure people received consistently safe care. Health professionals who provided feedback on the service reported their recommendations were followed by the service resulting in positive outcomes for the people who used it.

The people who used the service, and their relatives, told us they felt safe whilst being supported by staff. They told us staff were accomplished in their roles and had the skills and expertise to meet their needs. People told us they were treated with respect and compassion by the service and its staff. One relative told us, ‘Staff talk to [family member] with dignity, respect, kindness and care.’ Staff had been trained in safeguarding and told us they had access to all associated policies and procedures. They were able to tell us how to report safeguarding concerns both inside their organisation and externally. One staff member said, ‘The comprehensive understanding I have [of safeguarding procedures] and the access to resources ensures I can act confidently and responsibly to protect those I support.’ Systems were in place to help protect people from the risk of harm or improper treatment. For example, the service had an appropriate safeguarding policy in place that adhered to the local authority’s procedures and a log of all concerns was kept. The safeguarding log recorded what actions had been taken in response to concerns and we saw these to be appropriate. Safeguarding concerns had been referred to the appropriate stakeholders, investigated as required and used to inform practice.

The risks to people had been identified, recorded, mitigated, and managed and people received safe care from staff who understood risks and how to manage and mitigate them. The people who used the service, and their relatives, raised no concerns in relation to safety and management of risk. They told us staff were competent in managing risk and using the equipment people needed to support them in their daily lives. One relative said, ‘[Family member] feels very comfortable with the carers. They have all had training in how to use the equipment and moving and handling techniques. All the staff know [family member] well.’ Staff demonstrated they understood people’s needs well, including in relation to the management of individual risks. One staff member explained the positive impact their training had on one person who had a particular health condition that placed them at risk of injury. The staff member said, ‘The training has significantly enhanced the quality of support provided. I can now better manage complex care needs, identify, and address health issues promptly and deliver personalised care tailored to each client’s preferences and routines.’ The health professionals who provided feedback on the service agreed that staff had the skills to meet people’s needs. Whilst the risks to people had been identified and managed well in practice, we did identify some shortfalls in written risk assessments. We found some contradictory information contained in care plans and whilst risks had been identified and recorded, the associated risk assessments required further detail. This was discussed with the registered manager who acknowledged and accepted this. The registered manager told us they would review risk assessments and seek to make improvements.

The service supported people to live well and safe in their own homes by supporting them with daily tasks. People told us staff not only supported them with personal care tasks but also those associated with keeping their environment clean and safe. Staff also raised no concerns about safety and environmental risk management; they told us people received safe and effective care. The environmental risks to the people who used the service, and their staff, had been identified, mitigated, and managed. For example, people’s homes had been risk assessed to include risk factors such as pets, fire management, storage, parking, and security measures. Utility cut off points had also been identified and recorded in the event of an emergency and the service checked people had working smoke and carbon monoxide alarms in situ to help protect people from harm. Where staff used equipment to support people to mobilise, the service checked these had been inspected by a competent person under the Lifting Operations and Lifting Equipment Regulations 1998 (LOLER); this helped to ensure the piece of equipment was safe to use. A business continuity plan was also in place to consider and address any safety events such as adverse weather for example.

People benefitted from receiving care and support from staff who had been safely recruited, inducted, trained, and supported to provide individualised and effective care. We saw there were enough staff to meet people’s needs and that they provided care at the time agreed and for the allocated amount of time. People who used the service, and their relatives, told us staff arrived on time and were equipped with the skills to meet people’s needs; they told us they consistently saw the same group of staff. One relative told us, ‘We have a stable team of about 6 carers and they all have a nice chat with [family member]. They have a handover period for 5 or 10 minutes and there is a nice line of communication. It is good. The carers are all very nice.’ Another relative said, ‘Staff are well trained.’ Staff spoke positively about the induction, training and support they received. They told us they felt valued and listened to in an open and supportive culture and that staff morale was good. One staff member said, ‘My induction and shadow shifts were thorough, equipping me with the necessary skills and knowledge. I receive ongoing training and support, which enhances my confidence and ability to provide quality care. I feel encouraged to learn and develop, with opportunities for qualification and professional growth.’ The professionals who provided feedback agreed staff had the appropriate skills and training to effectively and appropriately meet people’s needs. The service had robust systems in place to ensure staff were safely recruited and had the skills to perform their roles. The registered manager had a system in place to monitor staff and the support and training they had received. This included in relation to inductions, probationary periods, supervisions, and appraisals. Systems were also in place to monitor and assess staff competency and these included regular spot checks and competency assessments.

The systems the service had in place helped to protect people from the risks associated with infectious diseases. For example, people and their relatives told us staff used personal protective equipment (PPE) as required and washed their hands as per best practice guidance. One relative told us, ‘The supervisor bought a box of all the PPE the staff need. They wear gloves and aprons and wash their hands in between tasks.’ We did not discuss infection prevention and control (IPC) with staff as we found no concerns in relation to this and people told us staff followed best practice guidance. However, we saw that staff had received dedicated training in IPC and that this was also covered as part of their induction. The service also had an IPC policy in place that was compliant with good practice guidance. The service’s business continuity plan also considered and addressed the risks associated with infectious disease outbreaks and pandemics.

Where staff administered medicines to people, we saw that this had been completed safely and as prescribed. Through discissions, people confirmed they received their medicines safely with no concerns. One relative said, ‘Staff administer medicines fine. [Family member] has a blister pack with all the medication in and they give it to them twice a day.’ Staff had received training in administering and managing medicines and had their competency to do so assessed on a regular basis. People’s needs in relation to medicines had been risk assessed and care plans developed. Medicines administration record (MAR) charts showed that people had received their medicines as prescribed and protocols were in place for staff to follow for medicines that had been prescribed on an ‘as required’ basis. The service had an appropriate medicines policy in place and the service regularly audited people’s medicines to ensure they were being administered as prescribed and in line with best practice. Where concerns had been identified in relation to medicines management and administration, the service had referred these to other stakeholders as required.