Bespoke Care Services East Dorset 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

Safe procedures were in place to ensure people were protected from harm. Risks were identified, assessed and instructions for staff to promote safe ways of working were in place. There were enough staff who were skilled to provide care and support. People received medicines as prescribed. Information about people’s needs was in place to ensure they could safely access other services. Infection prevention and control measures were robust. The service was strengthening systems to learn from events. We were assured by the improvements made.

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 the staff helped them with anything they needed to ensure they could live independently. This had included accessing support from external professionals. One relative said, “Staff are always looking to problem solve.”

Staff reported concerns and were confident they were followed up. The registered manager ensured there were detailed records of incidents and clear actions taken. The registered manager understood the concept of learning and identifying trends and although this was in place informally, they put in a formal system during the inspection.

Records were made of events and incidents that occurred within the service and the appropriate action taken. During the inspection the provider and registered manager strengthened the system for analysing and planning for events that occurred within the service.

People told us they felt safe and relatives confirmed their loved ones were safe. Relatives and people we spoke with told us staff work effectively with external professionals.

Staff and the registered manager told us they had good, strong working relationships with external professionals to ensure care was joined up. Communications with doctors, nurses and the hospital meant people, where possible had seamless care.

Partnership relationships were established and operating well, feedback collected during the assessment and inspection was positive. One professional said, “The standard of relationship is high based on good communication, quick response and evidence of changes being made when something has been highlighted.”

There were safe systems in place to ensure essential information was shared with the necessary health and social care professionals. The providers electronic care planning system produced a summary of people’s needs and requirements, this meant a safe transition between services, such as, for admission to hospital.

People and their relatives told us they felt safe with the care and support they received from Bespoke Care Services East Dorset Limited. One relative told us, “My loved one [name] is definitely safe, it gives me peace of mind.” A person told us, “I feel the service I receive is safe, the staff are wonderful.”

Staff knew how to ensure people were protected from harm and abuse. They told us how they would raise concerns both within the home and outside. Staff were confident the registered manager would follow up any concerns and make the necessary referrals. Staff understood how to ensure people’s rights were fully respected and had received training in safeguarding adults with regular refreshers. The registered manager and provider were clear about the process to follow to ensure people were protected and concerns were reported and without delay. Feedback we received from professionals was positive in terms of the appropriateness of referrals and actions taken by the service to keep people safe.

Safeguarding policies and procedures were in place and staff knew the correct reporting procedures. Records showed all safeguarding concerns were logged and followed up.

People and their relatives told us staff worked to keep them safe and understood their needs. An example was where a person was at risk due to their mobility, staff worked well to ensure they supported the person correctly using equipment. People told us they felt involved.

Staff told us they had enough information about people’s risks and detailed some of the risks the people they support faced each day. Safe ways of working were in operation and staff were able to be involved in their creation and update. A member of staff told us, “I feel confident when I'm doing my job because I know I have enough information about my clients' needs and risks. I know they feel safe and comfortable with me because of the training that I have received and my experience.”

People’s risks were assessed before they started to use the service and added to as needed. Risk assessments were created and maintained within the provider electronic care planning system. Assessments were updated regularly and as things changed. However, some assessments contained minor conflicts within them. We raised this with the registered manager, and they immediately adjusted the system for review, and we were assured by the action taken. The electronic care planning system meant updates could be made instantly. All these measures contributed to the safe management of risk within the service.

People and their relatives told us staff worked in a safe way. People told us they were confident staff were trained and had made a thorough assessment of their home environment.

Staffing numbers had been planned to meet people’s needs and provide care and support safely. Continual assessment was carried out to balance the staff numbers with care hours available, this contributed to safe planning. Training records showed staff were up to date with their essential training and attended regular updates to ensure their knowledge and skills were maintained. Supervision and appraisal records confirmed staff received the support they needed to deliver safe care. However, the correct process for completion of records was not always followed, we raised this with the registered manager, and they made immediate adjustments to ensure the record reflected the conversations held. A member of staff told us about how they are supported and said, “I really enjoy working for Bespoke Care Services. This is a very friendly company. I feel that I'm part of the team, supported by office staff and my colleagues at work because of good communication.” Staff were recruited safely, and recruitment records reflected this. Procedures were in place to ensure the required checks were carried out on staff before they commenced their employment. This included enhanced Disclosure and Barring Service (DBS) checks for adults. DBS checks provide information including details about convictions and cautions held on the police national computer. The information helps employers make safer recruitment decisions.

Risk assessments were carried out to ensure staff had a safe working environment in people’s homes. Equipment checks were maintained where it was used, and consideration had been given to emergency situations such as fire or utilities failure, this included how to safely evacuate the home. Records confirmed all people using the service had the necessary risk assessments and guidance for staff in place.

People were supported by a regular team of staff who knew them well and understood their needs. The registered manager and provider told us keeping the same staff with people where possible was their priority. People told us seeing the same staff where possible was important. One person told us, “I am absolutely delighted, the staff are so reliable and wonderful.” A relative told us, “Bespoke have good time keeping, I just love them, all the staff are friendly and they try and involve my loved one in things.”

Staff told us they were supported and had received enough training within their induction and ongoing to help them carry out their role well. Training was varied and covered all the subjects required for staff to carry out their duties safely. One staff member said, “We can have training on things that we would like to know more about which is nice as it makes you more confident on some subjects.” Another member of staff told us, “All my training is up to date, I attended face to face training with professionals, and I have done online training as well.”

Staffing numbers had been planned to meet people’s needs and provide care and support safely. Continual assessment was carried out to balance the staff numbers with care hours available, this contributed to safe planning. Training records showed staff were up to date with their essential training and attended regular updates to ensure their knowledge and skills were maintained. Supervision and appraisal records confirmed staff received the support they needed to deliver safe care. However, the correct process for completion of records was not always followed, we raised this with the registered manager, and they made immediate adjustments to ensure the record reflected the conversations held. A member of staff told us about how they are supported and said, “I really enjoy working for Bespoke Care Services. This is a very friendly company. I feel that I'm part of the team, supported by office staff and my colleagues at work because of good communication.” Staff were recruited safely, and recruitment records reflected this. Procedures were in place to ensure the required checks were carried out on staff before they commenced their employment. This included enhanced Disclosure and Barring Service (DBS) checks for adults. DBS checks provide information including details about convictions and cautions held on the police national computer. The information helps employers make safer recruitment decisions.

People and their relatives told us the staff worked in a safe and hygienic way; they did not have concerns about staffing in terms of infection control. People and their relatives told us staff wore their personal protective equipment (PPE) when needed.

Infection prevention and control was at the core of the service and staff had received training with regular updates. Due to the global pandemic in recent years infection prevention had become more in depth, training and procedures were more robust. Staff were more aware of the importance of cleanliness and hygiene. Staff told us supplies of PPE were plentiful, one member of staff said, “If we are too busy to get to the office then the office will bring PPE out to us.”

Infection prevention and control procedures were robust, in line with the providers policy. Compliance with the infection control policy was observed during monitoring checks in people’s homes where staff demonstrated how to work in a safe and clean way.

People received their medicines as prescribed. There were safe procedures in place for ordering and administration of medicines where it was part of the care plan. People were confident they received their medicines on time and records reflected this. One person told us, “Staff are very good, they make sure I take my medicines on time.”

Staff worked to ensure people had their medicines on time, where this was part of their care plan, visits were spaced to ensure safe administration, such as allowing adequate gaps between doses. Staff received training, both theory and practical together with ongoing checks to ensure safe practices. The team communicated with the surgery and pharmacies to ensure people has the right medicines at the right time and was safe.

Safe procedures were in place for the administration of medicines. This included medicines taken occasionally. Actions taken where there was an error was immediate and effective to ensure people’s safety. However, we found staff guidance following an incident was not always robust, we raised this with the registered manager and provider, and they acted immediately to strengthen the process. There was detailed medicines policy and procedure in place.