- Homecare service
You & Me Supported Living Limited
Report from 26 July 2024 assessment
Contents
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
We assessed a total of 7 quality statements from this key question. People were safeguarded from abuse and avoidable harm. Staff told us they were well supported by the management team and felt confident to raise any concerns, and concerns were acted on. People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible and in their best interests. Risk assessments were not always in place or contained missing guidance. However, staff knew people and their risks well, and we found no evidence of any harm. Staff followed infection control procedures, safe staffing levels, and robust recruitment procedures were in place. There were no competency assessments in place for the administering of medicines and carrying out first aid. The provider told us they would take immediate action to ensure these assessments were in place.
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.
Learning culture
People told us staff listened to them to ensure they received care and support in the way they preferred.
Management told us they prioritised the involvement of the people they supported in their own care management plans. This approach ensured services were tailored to individual needs, preferences, and circumstances. Staff received feedback around concerns raised and felt listed to.
We received positive feedback from partners and saw where the provider had taken action following advice from professionals.
The registered manager ensured lessons were learned from incidents and accidents. Incidents and accidents were reported, appropriately recorded and responded to. There was good analysis of incidents to ensure lessons were learnt.
Safe systems, pathways and transitions
We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.
Safeguarding
People who used the service told us they felt safe. One person said “I feel safe, I would speak to staff [named staff member] if I was worried.”
Staff told us and records confirmed staff had received safeguarding training. Staff we spoke to knew how to identify potential signs of abuse and to report concerns appropriately. A member of staff said, “I feel confident raising concerns and they will be managed” and “If I didn’t want to raise it with the safeguarding lead, I would report my concerns to the Local Authority or the Care Quality Commission.”
Staff interacted with warmth and kindness towards people and knew people well. We observed no safeguarding concerns on our visits, or in any of our interactions with staff.
There were processes in place to safeguard people from abuse and harm. A safeguarding policy was in place, it detailed the types of abuse and how to escalate concerns if staff suspected or see abuse to ensure people were protected. There was a safeguarding lead in place and staff knew who to contact. Records showed the provider had reported safeguarding concerns to the relevant authorities and where applicable had cooperated with investigations and conducted lessons learnt.
Involving people to manage risks
People had been involved with their care planning and had experienced greater independence through being supported to understand and reduce risks. Risk taking was positive and balanced with people's right to choose and they were supported by staff who understood any risks associated with their care.
Staff were knowledgeable about people’s needs and how to support them, taking account of their individual preferences and what was important to them.
We observed and heard from staff how they work with people to plan the best ways to manage risks they might encounter.
Care plans and risk assessments were reviewed regularly. However, we identified not all risks had been identified and documented adequately within peoples care planning. The registered manager reacted immediately to improve these risk assessments and we were assured staff had a strong understanding of how to mitigate people’s individual risks.
Safe environments
People did not raise any concerns about how staff supported them to remain safe in their home environment. People were involved in choosing the décor for their homes and had a sense of pride in their homes.
The registered manager told us regular meetings were held with people to discuss any concerns or suggestions they had with their environment,, and documentation evidenced this. People were supported and encouraged to take responsibility for keeping their homes clean and tidy.
People took pride in showing us how well they kept their homes, and how they had personalised them. They helped maintain and enjoyed communal spaces. The atmosphere was welcoming.
Policies and procedures helped ensure people were not put at undue risk through poorly maintained surroundings. Environmental safety checks were in place, ensuring any risks to staff in people’s homes were identified. Environmental risk assessments were undertaken and the provider listened to the needs to people and what they may require.
Safe and effective staffing
People told us they liked their regular staff and were happy with the support they received. People were supported to keep in touch with staff working in different areas, and regularly met with staff and people using the service from other locations. People’s comments included “Staff are nice, they have enough training, they are trained very well and do a top job” and “Staff are very kind and very lovely.” People using the service told us they felt safe with the care provided and would know who to contact if they had if they had any issues.
Staff told us there was enough staff to support people, they felt supported by the management team and received appropriate training for their role. However, we also heard staff would like in person first aid training. Staff teams were put together based on people’s needs and changes were made to staffing teams to support staff and people using the service where appropriate.
There were enough staff to support people using the service when we visited.
All training for the service was completed online. The service did not implement in person first aid training or carry out competency assessments to ensure staff were safe to provide first aid. The provider acknowledged this and told us they would look into ensuring staff received this training. There were on call systems in place and staff worked flexibly when unexpected scenarios occurred. Staff were recruited safely, with all the necessary pre-employment checks carried out. This included 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. References were also sought from previous employers.
Infection prevention and control
People raised no concerns around infection prevention and control.
The registered manager ensured there were supplies of appropriate PPE and related equipment available for staff. Staff supported people to maintain their own homes.
People's homes were well maintained and the provider ensured specific infection control risks were well managed.
The provider had IPC policies and processes in place.
Medicines optimisation
People told us they take their own medicines and staff prompt them when needed and knew what their medicines were for. People’s choices and wishes around their medicines management were sought and recorded in their care plans.
The service had recently started administering one persons medication. Staff had received training around medication and felt confident administering medicines due to their training and previous experience. However, there were no medicine competency assessments in place to ensure staff were safe to carry out medication administration. The registered manager put medication competency assessments in place immediately following feedback.
We did not observe anybody taking medicines.
Medication audits were in place and actions were communicated to managers. However, these audits had not identified there were no PRN [when required] medicine protocols in place for staff to follow. Staff we spoke to were aware of when to administer PRN medicines. The registered manager told us they would put these protocols in place. We found daily notes were not always clear about the support people received with medicines due to the way the system allows recording. This was something the registered manager had identified and was in the process of addressing.