Covenant Healthcare Ltd Also known as Heritatge Healthcare Coventry

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 – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

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.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. People and relatives told us if they provided feedback on areas of learning, staff practice changed, which improved the care provided. For example, in relation to adjustments needed to ensure people continued to be safely moved around their home by staff. Staff understood the importance of escalating any incidents and gave examples showing how learning from incidents were communicated to them. This included learning gathered from incidents in other care settings. One staff member said, “It's for our own good and the betterment of the service. It’s about controlling mistakes.”

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. People were confident staff would take appropriate action to seek support if they wanted or needed care from other health professionals. Relatives gave examples showing how staff continued to support their family members until emergency services arrived. This helped ensure key information about people’s needs was communicated to other health professionals. A staff member explained how they worked with people, their families and other health professionals so they could be assured people would continue to receive safe care when they were discharged from hospital. The staff member said, “We check if the person needs more care, or [has] any changes to their care needs, such as medication.” Systems were in place to capture key information about people’s needs.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider understood their responsibility to share concerns quickly and appropriately, should they occur. People told us they felt safe with the staff caring for them and said staff were respectful and gentle when supporting them. Staff knew how to recognise any signs of abuse and understood what action they needed to take to protect people. Staff were confident the registered manager and senior staff would promptly take action to support people, if this happened. One staff member told us, “They, [senior staff], don’t joke with safeguarding, they tell us we must report it. They would do something about it.” Another staff member told us about other organisations who would support people, should they require it. The staff member said, “I cannot see someone under my care being abused. If I do ignore it, that is as bad.” Systems and processes were in place to investigate any concerns and to support the communication of information to key agencies, so people would be protected.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. People told us staff talked to them about their safety needs. One person told us staff ensured they took time to work at their pace when they moved around their home, so their independence was safely promoted. Staff gave examples about people’s individual risks, and how they supported them, so these were reduced. This included in relation to risks people experienced regarding falls, health support requirements and the security of their homes. People’s care plans reflected their individual risks and provided staff with guidance to mitigate these.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People told us staff used the equipment provided to ensure they were able to maintain their independence and safety. One person told us, because staff always ensured their home was safely secured at the end of their care calls, “I always feel safe.” Staff said they were supported to provide safe care to people and to manage their own safety through checks undertaken by senior staff on the environment. This happened before staff started to care for people. We found the provider’s environmental risk assessments considered an appropriate range of risks and detailed how these risks could be controlled.

The provider made sure there were enough trained and skilled staff, who received effective support, supervision and development. They worked together to provide safe care that met people’s individual needs. People told us staff knew how to care for them. People and relatives told us they could rely on staff providing care at the times, and for the duration, planned. One person said, “They [staff] come every day, 7 days a week, they even turned up on Christmas Day. There are no concerns.” Some people required support form 2 staff members to provide their care. People, relatives and staff told us 2 staff always attended these calls, as planned. Staff told us they received training when they first started working for Covenant Healthcare Limited and their ability to care for people was checked. Staff were supported through on-going supervisions and competency checks. Systems were in place to check the suitability of staff before they commenced employment.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading. People told us staff carefully considered what PPE, [personal protective equipment], was required when supporting them and said staff always used PPE appropriately. Staff confirmed they had enough PPE, knew when to wear PPE, and appreciated the importance of changing it between different care tasks. Staff understood the links between good infection prevention practices and the reduction in the spread of infections, such as safe disposal of soiled items. People’s care plans provided staff with detailed guidance on how to reduce each person’s risk of infection. Senior staff checked staff practice to assure themselves staff followed good infection control practices. The registered manager agreed to review how they promoted good infection prevention within the office’s rest room, as office-based staff also undertook care calls. This would help to further reduce the likelihood of the spread of infection.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. There had been improvements in the way people's medicines were managed. Staff were now given detailed guidance to ensure people received their medicines safely. Protocols had been introduced for staff to follow where people required ‘as and when’ medicines. There had been improvements in staff following manufacturer’s instructions in relation to the administration of medicines administered via patches. For example, we only identified 1 instance over a 12 week medicine administration cycle where staff practice had resulted in a person’s patch not being rotated as required. There was no evidence of harm to the person and the registered manager took immediate action to address this. People's care plans now provided staff with detailed guidance to follow, where people with complex needs were supported to have their medicines. For example, where people’s medicines were not administered orally. Some people managed their own medicines, or with support from their family members. Other people received support from staff to ensure they had the medicines they needed to remain well. One person told us, “[Staff] watch me taking my medicines, I wait until they come, they record it.” Staff were not allowed to administer medicines until they had been trained to do this, and their competency to continue to administer people’s medicines was checked over time. However, we found occasional inconsistencies in staff recording relating to medicinal creams. The registered manager gave us their assurances they would address this without delay.