Active Care Group Supported Services

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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

Staff were able to report accidents and incidents effectively and demonstrated knowledge of the reporting procedures. Accidents and incidents were managed robustly, however, there were instances where they were not appropriately reported. Staff understood what constitutes abuse and how to report any concerns. Staff received suitable training according to their role. The safety of people was ensured by the effective management of the risks associated with their care. There were sufficient staff members, however they were not always effectively deployed.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People said that steps were taken by staff to mitigate and reduce risks after incidents. One person told us “I waited a long time to get an assessment, but the staff here supported me through that and now it is all better. The staff supported me to do exercises every day and now it is all better.” Regarding an incident involving a staff member, one relative told us “The last night staff incident was probably a year ago… I believe the management addressed it by providing extra training to the staff and bringing her to the attention of the supervisor.”

Staff told us that any learning from incidents and accidents would be discussed at meetings. The registered manager said, “We discuss incidents and accidents in team meetings and we also have a document where we write the lessons learned.” One staff member told us “We have team meetings, every month. They are good and useful. Sometimes, we talk about different things such as incidents, lessons learnt, ways forward.”

One partner told us improvements have been made to reduce medication errors, such as implementing medication checks, assessing staff competency and by discussing medication errors in monthly meetings. However, not all medication related incidents were reported externally in a timely manner.

Incidents and accidents were recorded and managed robustly. There is an incident management policy in place. However, not all incidents were reported in a timely manner. Incidents were discussed during team meetings.

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 said they felt safe living at the service. One person said “I feel safe when here. I feel really safe when with the staff because I have 24-hour care with one of the staff here.” Relatives stated that their family members were in a safe environment. One relative told us “I think she is as safe as she can be. If she wasn’t, we’d move her with her consent.”

Staff were able to recognise the signs of abuse and were knowledgeable on what actions to take if they suspected any type of abuse. One staff member told us “I would report unexpected bruising, marks, unexpected injuries. If there are fingerprint types of bruises. Depending on where the bruising is on the body. It may be something small, but it is better to raise it than ignore it because otherwise the abuse could carry on. “A manager in one of the settings told us, “Me and [staff member] are safeguarding leads. We put posters in the house. We talk about safeguarding at every meeting. I go to the clients after each handover and observe for any change in behaviour. I tell this to staff too, to check if they are any changes in behaviour. On the safeguarding posters there are guidelines how the staff can raise safeguarding in case [staff member], and I are not here.”

We observed people were seen to be relaxed and comfortable in staff presence. People were seen to approach staff with any concerns they had, and staff responded in a responsive and caring way. We did not observe any safeguarding concerns during the visit to the settings.

Staff received training in safeguarding people and a safeguarding adult’s policy was in place. Additionally, safeguarding was a topic of discussion during team meetings. The safeguarding incidents were reported to the Local Authority and CQC.

People told us they felt involved in care planning and managing risks relating to care. People said that risks associated with their care were effectively managed. One relative said “I have been given a copy of the care plans during the review. I was asked to contribute to it.”

Staff demonstrated a good understanding of the risks involved in people’s care and actively contributed to updating and reviewing risk assessments. One staff member told us, “The care plans are reviewed every three months or when it is needed. The team supervisors update the care plans, but the support workers have to tell them about changes as we work on the floor. “

People were supported safely and in line with their individualised risk assessments on the day of the site visit. Where people required support with their mobility, staff ensured this was provided in a safe way.

Care plans contained assessments to identify risks and ensure people’s safety. Examples include nutrition, mobility, communication, mental health and positive behavioural support. The risk assessments contained guidelines for staff to manage the associated risks.

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 told us that there were sufficient staff members at the service. One person said “There is enough staff members. There is always loads of staff. Sometimes they are short, but they are covered. Everyone is covered.” However, people stated that assistance was not always given promptly when requested. Comments include “The staff try to get to places within the time I am buzzing. They try to get to you as quick as possible. There might be situations where you’re buzzing away, but there might be a delay when they are helping somebody else.

Staff told us that the current staffing level was sufficient and that whenever there was a shortage of staff, this was addressed quickly. One staff member told us “We are very rarely short staffed. Sometimes if there is an emergency and the staff need to leave, I contact scheduling to get an additional staff member and a replacement is sent.” A manager at one of the settings told us, “We look at their needs and that’s how we determine the right number of staff… If we need more staff, we inform our scheduling department, and they always approve it.”

We observed there to be sufficient staff around at 2 of the settings to provide care to people when needed. However, the deployment of staff at 1 of the settings could have been improved upon. There were times staff were grouped together at this setting rather than deployed more effectively around the home.

There was a robust recruitment process in place. Staff underwent training specific to their roles and their competency was regularly assessed to ensure effectiveness. There was an effective system in place to ensure that staff shortages were addressed.

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.

People told us that they were aware of how medication is administered and that they are informed of any changes. Comments included, “I have people checking the MAR charts, in terms in medication giving, I am able to give it to myself. One person said, “The staff discuss the medication with me, and they have a form that I fill in. I know what my medication looks like.”

Staff told us that they received training in medication administration and that they have their competency assessed regularly. One staff member said “The supervisor does observations without the person knowing. We also do yearly competencies.” Another staff member told us “You attend an online training and then you are observed on site. Once you are competent you get a sign off.”

Medication management was efficient with no gaps in records. Medicines were securely stored and protocols were in place. Medication reviews were conducted annually. Temperature charts were maintained, and deviations were addressed.

A medication administration policy was in place and easily accessible by staff. There was an effective system in place for storing medicines. Regular audits were undertaken and any shortfalls were promptly addressed. The administration of medicines was recorded accurately. Medication that was administered “as and when” had clear guidance in place. Most staff received medication administration training and their competency was assessed regularly and medication was administered only by fully trained, competent staff.