APT Care Nottingham

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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

People felt safe and were protected from the risk of abuse. Staff understood the principles of safeguarding and how to raise concerns if there was a need to. Appropriate referrals were made where concerns had been raised and staff and management worked together to ensure people were kept safe and to minimise further risk. People’s risks were identified and managed appropriately. People and relatives were involved in care planning to ensure care plans were person centred. Care plans and risk assessments contained specific information to guide staff on how to support people safely; these were regularly reviewed. Medicines were administered safely staff received training and competency assessments in this area. Staff were recruited safely. Records showed pre-employment checks and a Disclosure Barring Service (DBS) check were undertaken prior to staff starting employment. Disclosure and Barring Service (DBS) checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. There were enough staff to meet the needs of people using the service. Staff and relatives felt there were enough staff to support people safely. Staff received appropriate training which ensured they had the right knowledge and skills to support people safely. Management also completed competency assessments with staff to ensure staff continually remain competent in their roles.

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.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

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.

The provider had effective safeguarding processes and policy for staff and people using the service. The registered manager recorded all safeguarding concerns, and these were shared with the appropriate external professionals. The inspection team saw that the registered manager reviewed all safeguarding concerns. There was evidence that safeguarding concerns were reviewed to look for and themes and trends that should be addressed. There was a record of referrals made to the Local Authority safeguarding team, CQC notifications, actions taken, for example: internal investigation, and communication with the person, family where appropriate, staff and other professionals.

Staff had received safeguarding training and had a good understanding of signs that may indicate that someone was experiencing abuse. Staff knew what to do if they had any concerns about a person being abused or at risk of abuse as well as how to escalate concerns. One staff member told us, "I did safeguarding training, I am confident reporting to the manager and I believe they would deal with it." The team had a nominated Safeguarding Champion who told us "Safeguarding is something everyone needs to know about." We spoke with the registered manager and the nominated individual who had clear processes in place for recording and reporting any concerns including alerting the Local Authority Safeguarding Team and the CQC. A nominated individual supervises the management of a regulated activity across an organisation.

People told us they felt safe and if they had concerns, they knew who to contact and were confident on receiving support to resolve any issues which affected their safety and welfare. One relative told us, “My loved one is totally safe with the carers I do not need to worry about the support received.” Another person told us, “The carers stay the length of time they should and have never let us down." People had been able to raise concerns with the registered manager about their care and the matter had been responded to appropriately.

We reviewed care plan documents which evidenced that people had been involved in managing risk. Risk assessments were completed in conjunction with people and their relatives and specific risk issues were discussed with individuals to get their input.

The registered manager was able to provide a number of examples of how people were involved to manage risks. In one example they described a concern regarding a person who was a smoker and staff felt there was a fire risk as they had found burns in blankets at the person’s home. The registered manager went out and spoke to the person about the concerns and how they could support them to manage the risks. “We talked about fire safety, getting an oil free heater and a fire-retardant blanket which they agreed to. I wouldn’t do anything without consent and the person can provide additional information for the process.”

People told us they were involved in managing risks through assessment, care planning and review of their care. One person told us, “My needs were discussed at the initial meeting we sat down and discussed what support I required.”

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

Staff told us they had received training, an induction and shadowing with experienced staff, as well as competency assessments completed by the management team to ensure they can safely and effectively carry out their role. One staff member told us, “When I started I had an induction, I did lots of training including medication training in the office, e-learning, moving and handling, and competency checked and spot checks.”

People told us that they felt there were enough care staff available, people who required 2 staff to support with mobility had the correct level of support and staff were well trained. One person told us, “Care staff are very well trained and familiar with my loved ones needs.”

The provider had policy and processes in place to ensure that staff were safely recruited. The provider is moving to keeping staff records electronically and at the time of the assessment documents were being moved to computer based. We noted that the process for recruitment had improved recently, and the provider was following a more robust recruitment process. We observed that staff had received a Disclosure and Barring Service (DBS) check. A DBS check is a way for employers to check a staff members criminal record, to help decide whether they are a suitable person to work for them.

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.

The provider had a current medication policy and procedures and processes were followed by the registered manager to audit medication administration and recording (MAR) charts. We reviewed evidence of auditing processes and the follow up actions that the registered manager had taken to address any identified concerns. People’s care and support needs were identified and this was documented in their care plan to provide guidance for staff on how to support the person with the medicines.

People who received support with medicines told us they had confidence in the staff. One person told us, “The carers help me with my tablets and make sure I take them.” People felt that staff were well trained and able to safely support them with their medicines.

Staff and the management team described that staff had received training in administering medicines and competency checks were carried out to ensure staff were following their training. One staff member told us, “I wasn’t allowed out on shift until I had done my training. Then I did shadowing, and my competency has been assessed.”