Winncare

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

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. This is the first assessment for this service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

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 and staff were encouraged and supported to raise concerns and felt confident they would be treated with compassion and understanding if they did so. We were told they knew who to speak to if they were concerned about safety, and were confident appropriate action would be taken in response. Raising concerns helped to proactively identify and manage risks before safety events happened, and incidents were appropriately investigated and reported. The service had taken appropriate action to prevent and respond to a recent safety event in which a person had fallen and sustained an injury. Appropriate referrals had been made prior to the fall in attempt to minimise risk. Following the incident staff offered reassurance, sought medical attention, completed the appropriate documentation and considered action needed to prevent reoccurrence.

Staff planned and organised care and support with people, together with partners and relatives in ways that ensured continuity. The registered manager explained information from partners was reviewed prior to delivering care to any new people. Senior staff would attend the first several visits, to further assess people’s needs and the level of support people required to stay safe. New staff were then introduced to people, and information about them shared via the service’s electronic care planning system.

Staff had a strong understanding of safeguarding and how to take appropriate action, confirming they had access to safeguarding policies and undertook annual training. Staff could give examples of what kind of things they would report. A staff member explained, “I would report people being mistreated, the way they were spoken to, or staff’s [poor] attitude towards them.”

The service had not always assessed risks, to ensure people and staff could understand them. Some information in people’s care plans lacked detail around risk, or information conflicted. For example: information around allergies conflicted in 1 person’s records, and their reluctance to follow healthcare guidance had not been risk assessed. However, risk assessments about care were regularly reviewed with the person receiving care. People had signed their risk assessments to evidence they were consulted and agreed with information. The registered manager took action to address disparities in people’s care records, following our assessment.

The service had effective arrangements to monitor the safety of premises. Staff had access to details about people’s homes including stop tap locations and security arrangements, and risk assessments were carried out as part of the initial assessment process. The service ensured equipment used to deliver care and support was suitable for the intended purpose and used properly. Moving and handling equipment was serviced and checked in line with best practice guidance, and staff received face-to-face training and competency checks to ensure they could use it safely.

The service had not always ensured recruitment practices were robust and safe. We reviewed 2 staff files in which staff had started working with vulnerable people prior to their Disclosure and Barring Service (DBS) checks clearing. Whilst we were assured staff had not been allowed to work alone during this time, the service had not followed legislation or their own recruitment policy. DBS checks provide information including details of convictions and cautions held on the Police National Computer and helps employers make safer recruitment decisions. However, the service ensured there were appropriate staffing levels and skills mix to make sure people received consistently safe, good quality care that met their needs. Staff advised absences were always covered amongst the team to ensure consistency and a relative told us, “The service has never missed any visits.” Training levels were generally good, including specific training to meet people’s individual needs. For example: stoma care and suction training. Suctioning is a procedure which involves removing fluids from a person’s airways using a specialist device.

The service had an effective approach to managing the risk of infection, which was in line with current relevant national guidance. People confirmed staff wore personal protective equipment when handling food, supporting with medicines or assisting with personal care; and 3 monthly reviews included spot checks on staff hygiene and food safety. There were clear roles and responsibilities around IPC. Staff were informed of what aspects of IPC people needed support with, or what they could manage independently or with help from relatives. For example: personal hygiene tasks or cleaning.

The service had not ensured information about people’s medicines was always accurate or up to date in line with current national guidance. ‘When required’ medicines lacked detailed information to guide staff around what medicines were prescribed for, and specific dosages. Transdermal patch records did not include information about where the patch had been applied, to evidence adequate rotation. Risk assessments did not always accurately reflect how people’s medicines were stored. However, people’s medicines were appropriately administered in line with the relevant legislation and current national guidance, and in line with the Mental Capacity Act 2005. People confirmed they received their medicines when they needed them, and relatives were involved in managing medicines as agreed in their care plans. Staff told us they undertook appropriate training to enable them to administer medicines safely and demonstrated a good knowledge of medicines for people they supported. Since our assessment, the registered manager has reviewed information for ‘when required’ medicines and updated the form to record placement details for transdermal patches.