The Jessie May Trust

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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

We reviewed the safe systems, pathways and transitions, and the safe and effective staffing quality statements for the safe key question. Safe Systems, Pathways and Transitions: The service provided safe care and treatment through established systems and processes. Monitoring and assurance processes were in place and were being improved on at the time of our assessment. Continuity of care was in place for patients both at home and during hospital admissions. Safe and Effective Staffing: The service had safe levels of staff for its caseload. Staff were qualified, skilled and experienced with access to support and training. All staff we spoke with reported timely supervisions and support with clinical development. Working relationships and communication between staff and external organisations involved with patients enabled safe care for people’s individual needs.

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.

Parents told us they felt safe handing over children’s care at the start of each respite visit and the use of Children and Young Persons Advanced Care Plans meant they had confidence staff knew how to support their child. Parents told us infection control was always a priority for staff and staff were person centred in their approach to children’s care. Families told us they were pleased with the supported transition from child to adult services where experienced.

Staff knew how to report incidents, were encouraged to do so and received feedback from incidents at protected team meetings. Staff knew how to access policies whilst working in the community and understood how to escalate to a medical professional if a child in their care became unwell. Staff had training in end of life and care after death. All staff we spoke with had a good understanding of their infection control responsibilities. Staff had support with checking updates to medical records for the people they cared for ahead of visits. However, a paper notes system caused delays to updating records held and a lack of access to the electronic Community Paediatric Medication Lists in house presented a challenge to staff when making sure medication lists were up to date before visits.

Plans were in place to improve this system and there was support from the local hospital’s pharmacy team to mitigate the risks.

Staff were all aware of policies which ensured medicines were never administered by staff if lists were outdated. There were procedures to support staff who were working alone, with a duty lead accessible in working hours for any incidents or concerns they needed to raise . There was a lone working policy and staff told us they were provided with lone working devices. However, some staff told us new starters did not always have access to these devices. There was an interim system to protect staff.

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

We did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.

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

Families told us that they were happy with the nursing staff visiting their children and felt staff had effective training to care for their children safely. Families told us they were offered choice in the staff they received care from and consistency of staffing was clear. Families told us this consistency benefitted their children’s well-being.

Most staff told us there were enough people employed to keep people safe and all staff reported they had access to timely training and development support. However, some people told us they felt pressure during periods of staff sickness. Staff told us that new secondments and improvements to the induction process for new starters had helped ease staffing pressures. Staff we spoke with had access to the service’s policies and procedures via their computer system or through an app whilst working in the community and were confident in applying these policies. There was a whistleblowing policy and all staff we spoke with told us they knew how to apply this and felt confident to speak up if needed.

Medicines were managed safely. Staff were confident in applying policies in line with care plans and parents reported medicines were always discussed at handover at the beginning and end of visits. Most staff were confident in end of life care and felt the bereavement service was helpful to families. Staff were aware of consent and how to apply the Mental Capacity Act 2005. However, some staff said there was more work to do in the service on learning around consent and independence for young people as more children with life limiting illnesses were living into their early adult years. There was a self-administration policy available to staff provided by the local hospital. However, staff were unaware of how they would approach a young person wishing to self-administer medication. All staff were aware of their responsibilities not to administer medicines without an up to date medicines list and care plan which ensured safe care. Families told us they were happy with support continuing from the service until children’s 19th year. However, some families expressed a need for continued support beyond this age.

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.