PSA Home Care Ltd

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

Our rating for this key question remains good. People’s safety was a priority in the service. Robust safeguarding procedures were in place to protect people from abuse and neglect. Incidents, accidents, complaints, concerns and people’s feedback were monitored on an ongoing basis to identify risks, areas for improvement and ensure learning was shared. Risks were assessed, reviewed and managed with people and, where appropriate, their relatives. The punctuality and duration of people’s care calls was monitored to ensure they received a consistent and reliable service. Staff received ongoing training, supervision and support to ensure they had the knowledge and skills to work safely and effectively.

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.

People and their relatives told us staff supported them in a safe way. They explained how senior staff met with them to understand their risks and to agree how care and support would be provided to manage these. They confirmed they had been provided with information, from the outset of their care, about how to raise concerns and felt confident in doing so.

The management team demonstrated they understood the importance of identifying, investigating and learning from any safety concerns and were able to explain the systems and processes in place to achieve this. This included the ongoing analysis of concerns, complaints, near misses, safeguarding issues, incidents and accidents. Robust procedures were in place designed to ensure learning from adverse events was shared across the staff team, such as through one-to-one supervision meetings and the monthly staff meetings. Staff demonstrated they understood the importance of keeping people safe at all times and confirmed the provider ensured they had the up-to-date information and guidance on people’s risks. They understood the provider’s procedures for reporting concerns and told us they followed these.

The provider encouraged a culture of openness in which people, their relatives, health and social care professionals involved in people’s care and staff were encouraged to raise any safety concerns. Clear systems and processes were in place to ensure any such concerns were reported, monitored, investigated and learned from to put things right, learn and improve.

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 and their relatives told us they felt safe receiving care and support from staff. They knew how to contact the provider if, at any point, they had concerns or felt unsafe. One relative told us, “We have a booklet that has all the information in and the contact number.”

Staff we spoke with understood the importance of protecting people from abuse and neglect, the types and signs of abuse to look out for and the need to report any abuse concerns immediately. They had confidence the management team would take prompt action to keep people safe. One staff member told us, “Safeguarding means protecting people from any abuse … We go to see people every day and so know their body language and nature. If there’s a change in their mood, facial expression, physical signs or other changes in the home, we discuss it a little with the person to gather information and then contact the manager.” The registered manager, who was the safeguarding lead, demonstrated a clear understanding of their safeguarding responsibilities, including the need to promptly inform relevant agencies of any abuse concerns. They explained how they ensured all staff understood their responsibility to protect people from abuse and neglect, from induction onwards.

The provider had robust safeguarding processes in place to ensure people were protected from abuse and neglect. This included safeguarding training for staff, and regular checks on staff’s understanding of their associated responsibilities. The provider completed regular audits on any concerns, complaints or safeguarding issues raised, to ensure these had been promptly and properly responded to, to identify any patterns and trends in these, and to promote learning. We reviewed a recent safeguarding concern raised by a person’s relative and saw this had been investigated and steps taken to learn from this. The provider supported people and their relatives to understand safeguarding and what to do in the event they had any concerns about their safety. People and their relatives were provided with information on safeguarding and key contact numbers for raising complaints or concerns, from the outset of their care.

People told us they felt safe when receiving care and support from staff. One person spoke about the support staff gave them to move, adding, “[Staff are] all really young girls, but I do feel safe.” A relative spoke about the positive manner in which staff managed their family member’s emotional needs. People and their relatives said senior staff met with them, before they started using the service, to assess risks associated with their care and support and agree how these could be minimised. They spoke about some of the ways in which staff helped them manage these risks, including risks associated with their health conditions. People told us they knew how to contact the provider if things were at risk of going wrong with their care and support and felt confident doing so.

Staff told us the management team ensured they had the information and guidance they needed about people’s risks and how to deliver safe care before their care started. One staff member said, “The company assesses the person and uploads the file onto Care Planner [electronic care management system] and leaves a copy of the care plan in the [person’s] house. We try to read everything about the person before we go in, including their likes and dislikes. We are told about all risks.” Staff told us they would promptly report any changes in people’s risks or health to the management team. One staff member said, “If [a person’s] needs have changed, I would inform the office and I would speak to the person and ask them what to do [during that care call]. They [management team] would modify and update care plan.” Staff understood how to report accidents and incidents to the provider and felt confident they would take prompt action to keep people safe. One staff member explained the action they had taken when the person they were supporting had fallen. This included calling an ambulance, reporting the accident to the provider’s office staff, making a clear record in the person’s care notes and staying with them until the ambulance arrived. Staff told us they had training on people’s care equipment and felt confident using this. One staff member said, “We use lots of equipment and I have been trained on them during manual handling training.”

The provider had processes in place to ensure people and, where appropriate, their relatives were fully involved in the assessment and review of risks. Comprehensive risk assessments were completed with people as part of their pre-assessment before their care started, with arrangements in place to review these. The registered manager explained, “When we carry out risk assessments, we speak with the citizen about their strengths, needs, joys and what they want to achieve … and how they’d like to be supported.” Information about risks to people and detailed guidance on how to manage these was promptly added to the provider’s electronic care management system so staff could access this whenever needed. This same system enabled staff to report any changes in risks without delay. People’s risk assessments were person-centred and plans to manage risks focused on people’s strengths. We identified contradictory and inaccurate information in 1 person’s risk assessment about support with eating and drinking. Once brought to their attention, the provider took prompt action to address this and to reduce the likelihood of reoccurrence. Staff liaised with the healthcare professionals involved in people’s care, such as the district nurses, to manage risks. The provider had clear processes in place for the reporting, recording, monitoring, investigation and learning from accidents and incidents. This included regular analysis by the management team of any patterns of trends in these events. Learning from events was shared with staff through, for example, team meetings, individual supervision meetings and the staff newsletter.

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 and their relatives told us that, overall, they received a consistent and reliable service from the provider and were supported by the same staff member or small group of staff. They spoke positively about the friendly approach and competence of staff. One relative told us, “Staff sit and have a chat and make sure [person] is ok and has everything.” They went on to say, “It has been the same person who comes and he is very friendly.” Another relative described staff as ‘absolutely brilliant’, adding, “Their timekeeping is excellent.”

Staff spoke positively about the induction, training and ongoing support they received from the provider to fulfil their roles with confidence. They told us they could request more training when they needed it and received constructive feedback on their work performance following observations or spot-checks. One staff member described the comprehensive training they had on their induction, supplemented by opportunities to work alongside more experienced staff until they felt comfortable working alone. They added, “They [management team] encourage us that we can do things and, if you have doubts, you can contact the office directly to clear up your doubts.’ The registered manager spoke about the ways in which they ensured their staff felt valued, supported and able to approach the management team at any time. They added, “If we look after care staff then they will look after citizens [people who use the service] well.”

The provider had robust recruitment and selection practices to ensure prospective staff were suitable to work with people. This included identification checks, right to work checks and Disclosure and Barring Service (DBS) checks on prospective staff before they were allowed to start work with people. New staff were provided with a structured induction, involving face-to-face training and working alongside (‘shadowing’) more experienced colleagues. Staff new to care were supported to complete the Care Certificate, which covers an agreed set of standards that care staff are expected to adhere to in their work. Following induction, staff received a rolling programme of training reflecting their role and people’s individual needs. This included, for example, training on pressure care, person-centred care, dementia awareness, nutrition and hydration, manual handling and effective communication. The provider checked the effectiveness of staff training through, for example, staff supervision and spot-checks. The provider used electronic call monitoring to ensure people received a consistent and reliable service. Care coordinators monitored if staff were running late and ensured people were informed and received an apology.

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.

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