Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At the last inspection this key question was rated as Requires Improvement. At this inspection this key question has now improved to Good. This meant people were safe and protected from avoidable harm. Systems and processes to safeguard people from the risk of abuse.
Safety and Security
● People felt safe with the staff that supported them. One person told us, “I feel safe and secure with them, and “It’s all done carefully there is no rough handling, they never rush me.”
● Staff understood how to support people safely and were aware of what signs to look for of potential abuse.
● Staff knew the procedure to follow if they suspected abuse which included reporting any concerns to the registered manager. There had been no safeguarding concerns identified at this service. Assessing risk, safety monitoring and management
● Risks to people’s health, safety and well-being were assessed and detailed in people’s individual care plans with the staff actions required to minimise them.
Safety and peoples needs
● Risk assessments were reviewed and amended to ensure they reflected people’s changing needs such as any changes in people’s ability to move around their home which may present a risk of them falling.
● Staff knew about risks associated with people’s care, for example, one staff member told us how they ensured a person had access to a specific piece of equipment. This was important to support their breathing and health. They knew how to use the equipment and when it should be used.
● The registered manager kept in regular contact with all staff to ensure any new risks related to people’s care were communicated and appropriately managed. Staffing and recruitment
Safety in numbers
● Sufficient numbers of staff were employed to safely meet people’s needs. People confirmed staff stayed the full amount of time agreed and they were not rushed. A relative told us, “They have all become regulars, they are generally reliable for time keeping, we’ve had no distress, if they are a bit late, they always let us know, they have never missed a visit.”
● People spoke positively of the staff team that supported them. One person told us, “They are excellent. I think they are friendly, and they are always cheerful and happy, they make you feel that way as well. Their smile helps me have a smile.”
Safety in recruitment
● The provider followed safe recruitment procedures. Pre-employment checks were completed to ensure new staff were suitable and of good character to work with people. Using medicines safely
Safety with medicines
● People who received support with their medicines told us they received them as required. Medicine Administration Records (MAR’s) showed medicines administered to people. Some records were not clearly completed. Good 8 A&M Home Care Services Limited Inspection report 01 April 2020
● Coding and staff initials on the MAR’s had not always been completed correctly which meant it may cause confusion about how the medicine had been managed. The registered manager provided assurance all medicines had been administered correctly.
● Records showing the location of pain relief patch applications had not been completed although staff knew where and how to apply them. The registered manager took action during our visit to devise a draft application record which they have subsequently advised has been implemented.
● Staff completed training on medicine management to ensure they knew how to do this safely. All staff who managed medicines told us they felt confident in supporting people with them. Preventing and controlling infection
Safety with infection control
● Staff had completed infection control training and followed good infection control practice.
● People confirmed staff used personal protective equipment such as gloves and aprons to help prevent the spread of any infection.
● The registered manager confirmed all staff were provided with a good supply of gloves and aprons which they could replenish when needed. Learning lessons when things go wrong
Safety with risk management and control
● Staff told us they would complete a report if a person had been involved in an incident or accident. This was so the registered manager could take any necessary action and any lessons learnt to reduce reoccurrence.
● Risks were monitored by the registered manager and lessons were learnt when the care and support did not result in positive outcomes for people. For example, it had been noted a person showed negative symptoms when lying flat in bed due to a health condition. Staff changed the way they supported the person to prevent any negative impact on the person’s health.