Top Option Healthcare 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 requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported incidents. Lessons were learnt to continually identify and embed good practice. The management shared learning with staff from incidents, accidents, complaints and safeguarding so that the service could continually improve and develop positive outcomes for people. Information was shared with staff through a WhatsApp group, supervisions and meetings. A member of staff told us, “The manager keeps us up to date with any changes.”

The service 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. Staff told us they read through the care plans to ensure they had all the information they needed to provide support safely. Relatives told us they were happy with the initial assessment process and the way the support package was put into place. A relative told us, “A full risk assessment was completed when [relative] first started and we talk about changes, these are then put on the care plan so the carers coming know about it.” Another relative told us, “We got Top Option via the hospital at the beginning and the transition was very smooth. We had a long chat during the assessment, and they really understood what support was needed.”

The service 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 service shared concerns quickly and appropriately. The registered manager had raised safeguarding concerns appropriately and had worked with the local authority to investigate these to ensure people were being safeguarded.  Staff understood how to recognise the signs of abuse and could describe the actions they would take to safeguard people including informing other agencies if they were concerned about action being taken. A staff member told us, “I would report to my manager, and I would escalate to Local authority if I needed to”.

The service 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 to people had been assessed and risk assessments had been put in place to help mitigate risks as far as possible. These risks included areas such as supporting people with mobility equipment or with personal care. Staff knew the risks to people well and told us they were kept up to date if there had been any changes to risk assessments. Staff told us they always read the care plan and checked the care planning application they used on their phone to see if there had been any changes to the care package.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. Staff worked together well to provide safe care that met people’s individual needs. The registered manager had processes in place to ensure all staff received an extensive induction and staff we spoke to confirmed this. Appropriate checks were in place before staff started work including providing full work histories, references and a Disclosure and Barring Service (DBS) check. DBS provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. There was enough staff available to provide safe and consistent care to people safely. A relative told us, “We have never had any missed calls. The manager steps in if cover is needed.” Another relative told us, “I am amazed at how good the staff are. I feel they are such a good example to other carers. I really appreciate how they look after [relative].”

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

The service 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 deputy manager told us, "Staff did not support people with medicines until they had completed the required training, and medicine competency assessments were completed." Medicine competency assessments were seen on staff files. People had care plans and risk assessments in place which detailed what medicines they were prescribed and how they liked to be supported. The registered manager completed regular audits. There was a robust system in place to identify any shortfalls and to ensure people received their medicines safely.