Wishes Care and Support Yorkshire Ltd- Richmond

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 inspection for this service. This key question has been rated requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed. The service was in breach of legal regulations in relation to safe care and treatment as records relating to people’s medicines were not always detailed and safe and effective staffing as all the required pre-employment checks had not been made.

This service scored 56 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Accidents and incidents were recorded and action was taken where required. However, the provider did not have a formal system in place to ensure oversight or that lessons that could be learned were identified or embedded as good practice.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. We saw that assessments and information about people’s needs from other agencies was used towards developing people’s care records.

The service worked with people and healthcare partners to understand what being safe meant to them and how to achieve that. Staff were aware of their safeguarding responsibilities and people told us they felt safe using the service. Action had been taken by managers when safeguarding concerns had been raised. Staff were confident any concerns would be dealt with promptly. One staff member said, “There is a whistleblowing policy, and I’d be happy to speak up. Management takes concerns seriously.” However, the provider did not have an overview record of safeguarding’s. One safeguarding had not been notified to CQC in a timely manner. We discussed this with the provider who showed us this had been an error and new systems were being put in place.

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Risks were identified but not all records indicated how the risk may affect the person or how it was managed. We saw records relating to individual risks were in the process of being updated to include this information.

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Risks to people and staff related to people’s homes had been identified and well documented.

The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. However, all required checks had not been made prior to staff starting their roles. This included gaps in employment history and references. Staff training and supervision was in the process of being improved. Staff told us they felt supported and the training was good. One staff member said, “I had shadow training with two senior members of staff. I definitely have access to all of the training I need.” People told us staff arrived at the expected time and stayed for the correct length of time. Staff told us they were able to complete visits as planned. One said, “People have regular calls. We have enough time. We also have the time to chat with the people which is nice.”

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Staff had received training in infection control and they had access to Personal Protective Equipment (PPE).

The service did not always make sure that records relating to medicines and treatments were safe and met people’s needs, capacities and preferences. People we spoke with told us they received their medicine correctly. However, medicines administration records (MAR) were not all sufficiently detailed. For example, they did not contain medication dosage or how long a time gap there should be in between administration of some medicines. Medication audits did not contain individual’s names or dates of when they had been completed. Following the assessment, the provider showed us that records had been reviewed and that new records included the required information.