Sagecare (Biggleswade)

In recent months the provider had taken steps to address these issues and improvements had been made, with further work to do.

Staff had received training in safeguarding people from harm and understood their responsibilities to report concerns. The management team reported concerns appropriately to the required external bodies. Risks were assessed and regularly reviewed, and people felt safe. However, risk assessments for one person had not been updated to reflect a change in their needs. This was addressed before the end of the inspection.

Staff did not have a good understanding of the provider's systems and processes to report and record accidents and incidents at the service. As a result, individual staff were making their own judgement about whether an incident needed to be reported. This meant some risks to people or incidents of harm were not identified and acted upon.

People's medicines were managed safely, and they were protected from the risk of infection. Where they needed support with this, people were assisted to have enough to eat and drink and staff took action to ensure their healthcare needs were met.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff were up to date with most training and people said staff knew their jobs well, with some people feeling less confident about new and unfamiliar staff. People reported that care staff were caring and treated them with respect, maintaining their dignity and encouraging them to be as independent as possible.

Newly developed care plans were person centred, written in respectful language and people were aware of their contents, having been involved in their development. We have made a recommendation about improving care planning in relation to people's end of life wishes.

A manager who had previously worked at the service had returned to the role. This was welcomed by people, who had confidence in the manager's ability to stabilise the service.

The manager was ensuring systems and processes were used to effectively monitor the quality of the service, and this was resulting in a reduction in late and cut short calls.