Hand on Heart Care

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• 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 people received was safe and there were suitable numbers of appropriately recruited staff employed to meet their needs. This meant people were supported to live safely. Any risks to people were assessed, monitored, and recorded, by the registered manager and staff as required. Accidents, incidents, and safeguarding concerns were reported, investigated, and recorded appropriately. Staff were trained to administer, prompt and support people to take their medicines, if required. Infection control procedures were followed

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.

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

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.

People’s relatives said they felt very safe using the service and the support received was of the standard required by them. Relatives told us staff who supported people knew how to keep them safe. One relative said, “I do think it is safe.” Another relative added, “The team support ensures the safety in the family home of a very vulnerable person.” Relatives were confident to raise concerns they might have and knew how to do this if they felt there were any safety issues. Where possible, people and those important to them were supported to understand how to raise concerns when they did not feel safe. One relative said, “If there is a problem, I just contact the office and they respond."

Staff, and the registered manager gave positive feedback, that demonstrated people received the standard of care they required. The registered manager supported staff to safeguard people from the risk of abuse, and staff had received relevant, up to date training to achieve this. Staff understood how to recognise abuse, neglect, protect people from its different forms and to report any concerns to the registered manager. A staff member said, “If we have any concerns, we report it to the office immediately.” The registered manager understood their responsibility to refer safeguarding incidents to the relevant external agencies without delay, ensure they were fully investigated and to take appropriate proactive action to minimise the risk of similar incidents reoccurring. They said they encouraged a culture at the service where people, relatives, and staff could raise concerns without fear about what might happen. Staff were aware of their duty to protect people from abuse and how and when to report any concerns they had to managers and staff. The registered manager had a clear understanding of the Deprivation of Liberty Safeguards (DoLS) and that it was only used when it was in the best interest of the person. Staff supported people to understand and manage risk. The registered manager, and staff assessed and reviewed safety risks to people regularly, and made sure people and those important to them, were involved in making decisions about how they wished to be supported to stay safe. Care plans were clear and provided sufficient guidance to staff to keep people safe.

The provider's safeguarding policy and processes were in line with relevant legislation. Records demonstrated safeguarding concerns reported to the registered manager were recorded in detail and reported promptly to the relevant external agencies. The registered manager worked well with these agencies and acted in a timely way to make sure people were safeguarded and protected from further risk. People and those important to them were involved in this process and informed about what action would be taken to keep people safe.

People and their relatives said they received a good standard of care. Any risks to people’s safety were managed well, without unnecessary restrictions. People’s relatives told us staff knew how to support them with known risks and that they were involved in planning the care they received. One relative said, “My mum has had 4 carers [Care staff] since we first started using the service some years ago, and has been looked after by the current 2 for a while. She is very fond of both of them, and they are kind and attentive to her needs."

The feedback from the registered manager and staff demonstrated risks to people were safely managed. Staff received relevant training to help them keep people safe. This included any training regarding equipment used to support people, such as hoists to help people move and transfer safely. Staff understood risks posed to people and explained to us how they would reduce the risk of injury or harm.

People had any risks to them assessed, and care plans were in place to help staff prevent or minimise the identified risks, as far as possible. The risks included supporting people with their mobility, and personal care. This meant staff had up to date information about the action they should take to manage these risks and keep people safe. There were systems in place for staff to report concerns, incidents, and accidents. This enabled the provider to have oversight of and be able to manage risks. The management team completed regular audits and action plans were put in place if new risks were identified.

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

People’s relatives told us there were enough staff to support them. One relative told us, “Not only are enough staff provided to meet [Person using the service] needs but consideration is also given in providing carers [Care staff] that will be compatible with my mum.” Another relative said, “There are enough carers [Care staff] provided and what I really like is they use their initiative."

The registered manager and staff feedback demonstrated there were enough staff to support people with their care and support needs. The registered manager, reviewed staffing levels regularly to make sure there were enough suitably skilled and experienced staff deployed to meet people’s needs. Staff received regular, relevant training to support them in their roles and they said they were well supported by the registered manager to learn and continuously improve their working practices. Staff told us about the training they had received, how it helped them to deliver support and were knowledgeable about the areas they received training in. The registered manager told us the service staffing levels were regularly reviewed to make sure there were always enough staff to meet people’s needs. There were systems in place for the provider to identify and monitor staff training requirements and ensure they remained relevant and up to date.

The staff duty rotas showed there were enough suitably deployed staff to meet people's needs safely. The registered manager ensured that thorough pre-employment recruitment checks were completed prior to employment, to make sure that only staff deemed fit and suitable would be employed to support people using the service. This included checks with the Disclosure and Barring Service (DBS) who provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. Training records demonstrated that staff received relevant courses to support them to meet a range of people’s needs. Training was refreshed at regular intervals so that staff stayed up to date with current practice. A staff member said, “After getting proper training we start work under a senior who gives constructive feedback.” Supervision and appraisal records demonstrated that staff had regular supervision meetings and an annual appraisal of their overall work performance with their line managers to support them in their role and to identify any further training or learning they might need. Staff were well supported by the management team during individual supervision, and appraisals of their overall work performance. They were able to discuss their job roles in order to continuously learn and improve their working practice.

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.

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