LIM Independent Living and Community Care Services Limited

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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

We assessed all of the quality statements within this key question. Our rating for this question has improved to Good. People and staff could confidently raise safety concerns and these were listened to and acted on by the management team. People were protected from the risk of abuse or harm because staff now had a better understanding about their duty to safeguard people and what action to take to make sure people would be protected. People were involved in making decisions about how risks to their safety should be managed. Staff understood how to reduce safety risks to keep people safe from injury or harm whilst maintaining continuity of care. The service had made improvements and staff were now deployed more effectively to ensure people received timely care calls from the same group of staff, which helped to maintain continuity of care. Staff received relevant training to meet people’s needs. They were well supported through supervision to continuously learn and improve their working practice. Recruitment processes had been improved to ensure only suitable staff were employed by the service to support people. Staff followed current practice to ensure infection risks to people were minimised. People received timely support with their medicines and these were administered as prescribed.

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.

People felt confident that any concerns raised would be listened to and acted upon. People had been provided with information about how they could raise safety concerns if they had any.

Staff were aware of the process to follow should they have concerns about a person’s safety. They told us they would record and report any incidents or accidents to the management team so appropriate action could be taken to support the person. The management team encouraged a culture of openness and honesty at the service. The registered manager told us, “I encourage the care workers to speak to me in supervisions. I encourage and train them on the whistleblowing policy. So if they see anyone performing outside of the standards we expect, we encourage them to tell us and to do this without being scared.”

Systems were in place to support prompt reporting and investigation of safety concerns, should these arise. Learning from investigations was used to support staff to continually improve their practice and provide safe, high quality care to people.

People did not raise any concerns with us about transitions and experienced continuity of care.

Staff told us they received information from people and their relatives to help support smooth transitions and continuity of care. The management team understood the importance of people being supported to stay safe and to maintain continuity of care when they first started to use the service or restarting again after a break. The registered manager told us, “We will review people that are coming out of hospital and liaise with the discharge team. I will see the client and if there is any changes I will action them.” The quality manager said, “We will make sure we have a care team for the person that will be small and consistent for the person when they start, to reassure them and help them feel more comfortable.”

Health and social care professionals told us systems had improved to ensure there was good communication and information available when more than one service was involved in caring for a person.

Arrangements were in place to capture information about people, their care needs and risks to their safety to ensure people experienced continuity of care as soon as they started using the service. People, their relatives and partners were involved in this process to enable the provider to have a thorough overview of people’s needs and safety risks and how these needed to be managed.

People told us they felt safe receiving care from staff. One relative said, “I am happy to go out, letting the care workers get on with things knowing my [family member] will be safe.”

Staff now had a good understanding of safeguarding procedures. They were able to identify signs of possible abuse and were aware of the reporting procedures to follow should any concerns be raised. One staff member said, “I would look for any signs of injury or abuse and I check their skin when giving personal care and would report if I see anything unusual.” Staff supported people to feel safe in their care. Staff told us, “I don’t discriminate, I treat everyone equally while consciously respecting their individual needs,” and “I try to foster an inclusive, nonjudgmental environment.”

Systems were in place to help people and staff identify and report safeguarding concerns in a timely way, to the relevant agencies. The registered manager now understood their duty and responsibility to work in line with the service’s policy and procedure for safeguarding people. This included making timely referrals and working proactively with the relevant agencies.

People felt safe with staff and any risks to their safety were well managed. A family member told us, “[Staff] walk with [family member] to ensure he does not fall, they make sure he holds the frame properly.” Another relative said, “The care workers check [family member’s] skin daily for pressure sores. They wash her and apply moisturising cream. That is why her skin is in such good condition. When I was ill this week they took over completely. I have peace of mind that they care for her safely.”

Staff were aware of risks to people’s safety and how they needed to be supported to minimise those risks. Staff ensured they reviewed paperwork and spoke to those involved in people’s care to obtain information about any risks to people’s safety. A staff member told us, “Information is in their care records about any risks to people’s needs. The family member, however, can give you more information and exact information.” Another staff member said, “I read the risk assessment and follow the instructions for the person.”

Systems were now in place to ensure regular assessment, monitoring and review of risk to people’s safety and wellbeing. People’s records contained current information for staff to help them manage risks to people and keep them safe from injury or harm. People and their relatives were involved in making decisions about risks to their safety and wellbeing and how these would be managed.

People told us staff ensured they had working equipment that suited their needs. One person said, “My recliner chair does not work properly. I have reported it to the agency and they are arranging for a new one to be delivered.”

Staff told us they supported people to obtain the equipment they needed to keep them safe and enable more independence. One staff member said, “We have supported [person using the service] to get the equipment she needs, grab rails, and a recliner. We changed her bathroom from a bath to a walk-in shower.” Another staff member told us, “The clients have the equipment to support themselves. We are trained on how to use this equipment to ensure the safety of our clients and the care workers.”

The provider had arrangements in place to assess safety risks to people in their home and had put plans in place for staff to manage these risks, when providing people with care and support.

People felt there were sufficient staff to meet their needs. They were supported by a regular team of care workers to ensure consistency in the care they received. People said improvements had been made and care workers now regularly arrived at the planned time and stayed the required length of time to undertake their duties and meet their needs.

Staff told us their rota was planned so they had sufficient time to travel to people’s homes and stay the necessary time to meet their needs. They told us they had access to good training and completed refresher training to ensure their knowledge stayed up to date. They felt well supported in their role and received regular supervision. The management team made sure staff were now more effectively deployed and given the time they needed to get to care calls. The quality manager told us, “We ensure that staff try and stay within the same geographical area. If they need to travel further we allow travel time and we also pay mileage.” The registered manager said, “For double ups we get the care workers to work and travel together for all the visits.”

Management oversight and monitoring of care calls had improved. The management team used the electronic call monitoring system (ECM) to ensure care calls were made on time to people. Care calls had been planned to allow sufficient travel time for staff between calls. Prompt action was taken when staff were running late for care calls so that people were informed of the delay. Recruitment processes had been improved to ensure only suitable staff were employed by the service to support people. Staff were supported through a programme of training and supervision to continually improve in their role and meet people’s needs. Training was refreshed at regular intervals so that staff stayed up to date with current practice.

People confirmed staff wore appropriate personal protective equipment (PPE) in order to keep people safe from the risk of infection. One person said, “They wear aprons and gloves and uniform.” People told us staff helped them to undertake domestic duties and support them to live in a clean and hygienic environment.

Staff confirmed they had received training in infection prevention and control and knew the processes to follow to minimise the risk and spread of infection. This included wearing appropriate PPE. One staff member said, “Our manager supplies us with all the PPE.” The management team undertook checks to ensure risk of infection to people was minimised. The registered manager told us, “We do spot checks to make sure [staff] are wearing their PPE and we haven’t had any issues that staff are not wearing PPE correctly. We also make sure there is no out of date food in the fridge especially for people we do domestic chores for. I feel comfortable that staff are making and preparing food safely.”

The provider’s infection prevention and control policy was current and reflected national guidance. The management team made sure staff had access to supplies of PPE to support them to minimise infection risks to people. They undertook spot checks on staff’s practice to ensure this was in line with standards and national guidance for minimising infection risks when supporting people.

People that required support with their medicines told us they were happy with how staff were supporting them and they received their medicines as prescribed. One person said, “They hand me my medication and make sure I take it.” A relative told us, “They give [family member] his tablets and put his eye drops in.”

Staff confirmed they had received training in safe medicines management and were aware of what processes to follow to support people with their medicines, including accurate recording of medicines administered. A staff member said, “I help clients with medication management, which includes giving doses, checking for adverse effects, and making sure medications are stored properly in addition to encouraging patients to take their medications.”

Medicines records confirmed people received the medicines prescribed to them. Record keeping had improved and accurate and current records were now maintained by staff. The management team undertook spot checks on staff’s practice to ensure medicines were managed and administered safely to people.