All About Care (South West) 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

Safeguarding systems, processes and practices were effective to help ensure people were protected from the risk of abuse and neglect. The service had a balanced and proportionate approach to risk that empowered people and respected the choices they made about their care. Safe recruitment practices helped ensure all staff, were suitably experienced, competent, and able to carry out their role. There were appropriate staffing levels and skill mix to make sure people received consistently safe, good quality care that was person centred. Staff received training that was relevant to their roles and responsibilities. They were supported by the registered manager and colleagues. This included supervision, support to personally develop and to improve services. Medicines were managed safely and staff followed robust infection prevention and control policies to keep people safe.

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.

At our last inspection we found staff had not been provided with adequate training. At this inspection we found improvements had been made. We received feedback from staff and leaders that training was provided to ensure staff could meet people’s individual care needs. For example, when one person required specialist support with a continence aid, staff were provided with 1 to 1 training and were assessed by the trainer as competent before they were able to provide support to the person. Staff told us they felt comfortable to ask for any training they felt they needed.

People and their relatives told us they would speak with staff if they had any concerns. They knew who the managers were and told us they were approachable if they needed to speak with them. Relatives told us they were kept updated about their relative and informed of incidents or matters of concern. One relative said, “Quite honestly, I think the company is fantastic. They are attentive and always in communication with us.”

An induction aligned to the care standards certificate was in place to ensure staff were provided with the right training to ensure they had the right skills to care for people using the service. The Care Certificate is an agreed set of standards that define the knowledge, skills and behaviours expected of specific job roles in the health and social care sectors. It is made up of the 15 minimum standards that should form part of a robust induction programme. A training programme meant mandatory training was routinely refreshed and additional training was provided whenever required to ensure staff could meet the needs of the people using the service.

We reviewed care records and found assessments on people’s required care needs had been completed before staff started providing care to the person. These assessments had formed the basis of ongoing care plans which were regularly reviewed. Documents were in place for visiting emergency healthcare professionals so they could easily see the persons care and medical needs, this meant the appropriate healthcare support could be provided in a timely manner.

Staff told us they were provided with the information they needed to ensure they were able to meet people's care needs.

People told us they were asked for their views in relation to the care and support they required. Staff spoke with people and their relatives to ensure the right care and treatment was in place. This was regularly reviewed. One relative said, “They go out of their way to make sure mum’s opinion is heard” and another relative said, “I’ve been involved in (loved one’s) assessment and care plan the whole way through.”

Healthcare professionals told us they had no concerns with the service and had access to the information they needed to ensure timely care was provided.

People were protected from the risk of abuse. There were systems in place to enable staff to report concerns should they arise. The provider had appropriate safeguarding policies and processes in place. Staff were provided with guidance on different types of abuse and how to raise concerns if these arose. Staff had undertaken training in safeguarding to provide them with guidance on types of abuse and reporting concerns.

People told us they felt safe. One person said, “I can’t fault them on anything. I think they’re all wonderful. I can’t find anything they don’t do properly.”

Staff took every precaution to help keep people safe from unnecessary harm. They were kind and ensured people were happy and felt safe. They encouraged people to make choices to reduce risks and stay safe, whilst respecting people's rights to make their own decisions. Staff knew how to raise concerns if they needed to. They told us they had confidence in the registered manager and the provider told us they would listen and take action if they raised concerns.

Staff knew people well and understood the risks to people. Staff told us they had access to plans which instructed them on how to keep people safe. Staff communicated in a range of ways including calling the office to speak with senior staff, using an encrypted messaging service and through regular meetings to discuss any concerns in relation to risk.

At our last inspection the provider had failed to robustly assess the risks relating to the health, safety and welfare of people. This was a breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Enough improvement had been made at this inspection and the provider was found to no longer be in breach of regulation 12. Since our last inspection improvements had been made to assess the risks to people health, safety and wellbeing. We reviewed care records and found people had been assessed for risks and measures had been put in place to reduce the likelihood of harm. For example, where people were cared for in bed there were risk assessments in place to guide staff to support people to maintain their skin integrity through regular actions such as supporting people to move position. Actions staff took were recorded to enable them to be monitored.

People told us they were confident the service had assessed them for any risks to their health, safety and well-being. One person said, “Yes, they considered risks. For example, so I can safely go downstairs on my own, they spoke to me, and we agreed the carer will stay with me until I’m safely down.”

We reviewed care records and found records that demonstrated initial assessments of the person’s environment had been completed before care commenced.

The provider told us, “We complete an environmental and fire risk assessment before we start providing care. Once they have used our service for a while we complete a post check to ensure the environment remains safe.”

We were told by people and their relatives that assessments had been completed. One relative said, “Before any care started, they visited [loved one’s] home completed an assessment of her home and they noted [loved one] already had equipment in place. They were very clear they were speaking to [loved one] and only referred to me if [loved one] wanted them to.”

Staff had received training appropriate to their job roles. One staff member said, “We have up to date training on a regular basis which is paramount to giving the best service we can to our clients and extra training is always available if needed.” At our last inspection we found staff had not always received regular supervisions and appraisals. At this inspection improvements had been made. The provider showed us how they had implemented effective systems and processes to ensure supervisions were up to date and supported best practice. Staff told us they felt supported. One staff member said, “Yes, I am able to raise any concerns or issues without any fear because I know I have all the support from my management team.”

People told us they did receive a rota confirming the name of the staff who would be attending however, this did often change. One person told us this had caused them anxiety, but they had noticed improvements since they had raised this concern. We also received comments from people who told us, “They come when I’m expecting them. They are very accommodating as well” ,” 9/10 carers I get are regular staff” and, “If they’re going to change my times, they phone me.”

There were robust systems and processes to ensure the staff with the right skills and values were recruited safely into the service. Checks including full employment history, references and a Disclosure and Barring Service (DBS) check had been completed before staff were offered a positon. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

People told us staff wore PPE appropriately, one person told us “They come in and wash their hands and put their gloves and apron on. The mask is on when they come in. All staff do that every time.”

Infection prevention and control procedures were in place and robust. Staff had received up to date infection and prevention control training. There were enough supplies of Personal Protective equipment (PPE). Staff wore the necessary PPE to keep themselves and others safe during personal care and support. People and their relatives confirmed staff compliance with PPE. The service had an infection prevention and control policy in place and kept up to date with changes and best practice guidance.

At our last inspection the provider had failed to ensure medicines were managed safely and people had been placed at risk of harm. This was a breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Enough improvement had been made at this inspection and the provider was found to no longer be in breach of regulation 12. Robust systems and processes had been put in place to ensure the safe administration of medicines.

People and relatives told us staff administered and managed their medicines safely. People were involved in assessments and reviews about the level of support they need to manage their medicines safely. One relative said, “the carers check [loved one] has taken all their medicines and they are always checking the medicine to make sure it’s all there and is correct.” Another person told us, “If I want some cream on, they don’t apply it unless it’s got a doctors label on it.”

The provider told us staff were only able to administer medicines once they had completed training and had been signed off by a senior member of staff competent to do so. We reviewed staff files and saw competency checks had been completed and reviewed during random spot checks conducted by senior members of staff. A medicines policy was in place which reflected best practice and professional guidance. Staff were updated of any changes to people’s prescribed medicines in a timely way through the use of telephone calls, meetings and with the use of an encrypted messaging service. Staff told us they were all up to date with last minute changes and had good communication with the senior staff working from the office to ensure medicines were administered safely.