Altogether Care - Care At Home Limited Poole

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 newly registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

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 service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. People were involved in their care, this included working together when accidents happened. Staff told us they supported learning across the service, and the providers locations. Records confirmed work was undertaken to identify themes and trends to prevent or reduce reoccurrence.

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. People and their relatives told us they felt staff at the service communicated effectively with external professionals, such as the GP. Partnership relationships were established and operating well, feedback collected during the assessment was positive. There were safe systems in place to ensure essential information was shared with the necessary health and social care professionals. The providers electronic care planning system produced a summary of people’s needs and requirements, this meant a safe transition between services, such as, for admission to hospital.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They 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. Staff knew how to ensure people were protected from harm and abuse. They told us how they would raise concerns both within the service and externally. Staff were confident the manager would follow up any concerns and make the necessary referrals to the local authority as required. A member of staff said, “They listen to every carer and respect our decisions when we raise our concerns.” Staff understood how to ensure people’s rights were fully respected and had received training in safeguarding adults during their induction with regular reminders and updates. Records showed all referrals had been made as appropriate.

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. People told us staff worked to keep them safe and understood their needs. An example was where a person was at risk due to their mobility, staff supported the person correctly using equipment. People told us they felt involved. Staff knew people well and told us they had enough information regarding people’s individual risks. People’s risks were assessed before they started to use the service and updated as needed. Risk assessments were created and maintained within the provider electronic care planning system. A staff member told us, “There are risk assessments in the care plans which highlight specific risks to clients and can be found in the home files as well as online in the app. Having them on the app means we can see them before we arrive at a new client’s home, so we are aware of what we need to be looking for before entering. There are also detailed tasks to help assist with reducing the risks presented.”

The service 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 and considerations were in place for people’s care and support. Staff had received training on using equipment correctly, for example, equipment used to help people move around their home. Assessments were comprehensive and included actions staff need to take to support people to safely evacuate their property in an emergency.

The service 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. People told us they were happy with the staff who visited them. Staff were complimentary about their colleagues and told us they worked well as a team. The service had a thorough induction and shadowing programme, together with ongoing support. Training was in accordance with good practice guidelines for staff who worked with people to meet their care needs. Recruitment processes were in place; staff were recruited safely. Procedures were in place to ensure the required checks were completed prior to staff commencing their employment. This included enhanced Disclosure and Barring Service (DBS) checks for adults. DBS checks provide information including details about convictions and cautions held on the police national computer. The information helps employers make safer recruitment decisions. Support was ongoing and there was a schedule of supervisions and spot checks, records showed the conversations were two-way and detailed. Staff felt appreciated and supported by the manager and the service.

The service 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 the correct personal protective equipment (PPE) as needed and supplies were available to them. Policies and procedures were robust regarding preventing the spread of infection. Assessments regarding PPE usage considered safety, necessity and personal preference. Records showed staff had received training and ongoing monitoring for infection prevention and control. A member of staff said, “We are provided with all of the PPE we require and are able to come and collect PPE when we need it.”

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened. People received their medicines as prescribed. There were safe procedures in place for ordering and administration of medicines where it was part of the care plan. People were confident they received their medicines on time and records reflected this. Visits were spaced to ensure safe administration, such as allowing adequate gaps between doses. Medicines records were held on an electronic system, this meant they were updated as changes were made. Alerts from the system told the manager if a medicine was late, or not given, this was then actioned to support compliance with medicines. Staff received training, both theory and practical together with competency checks to ensure safe practices. The service communicated with the GP and pharmacy to ensure people had the right medicines at the right time. There was a detailed medicines policy and procedure in place.