Ivy&Sage Homecare Office

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. The provider was previously in breach of the legal regulation in relation to management of medicines and assessing risk. Improvements were found at this assessment and the provider was no longer in breach of this regulation.

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 procedure for the investigation and review of incidents and accidents. Relatives told us they understood how to raise any concerns and if they had any questions they were responded to quickly. A relative said, “Yes I know about how to make a complaint and if I have any concerns, I can raise them directly with [the registered manager].” When an incident and accident occurred care workers completed a record form with details of what happened, and the immediate actions taken. Any actions to reduce further risk which had been identified through the investigation were recorded and shared with care workers. The person’s care plan and risk assessments had been updated to reflect the identified actions.

The provider supported people to transition into receiving support in their own home. Relatives confirmed that both they and their family member were involved in identifying the person’s support needs. The registered manager explained they met with the person and their relatives before the care package started to discuss their care needs and how they wanted their support provided.

The provider had a process to report and investigate any concerns related to the care being provided. Relatives commented that they felt their family member was safe when they received support. There was a safeguarding policy and care workers had completed training in relation to safeguarding adults. The registered manager told us that they would record any concerns and ensure the local authority and CQC are made aware. They would carry out an investigation and identify any actions to reduce the risk of recurrence. The provider had a process to assess if a person was able to make decisions about their care. The registered manager told us they undertook a competency assessment of the care worker’s understanding of safeguarding when providing care.

People’s risks associated to their health and wellbeing were identified and risk management plans developed. Relatives explained they felt their family members care needs were being met, they were safe, and the provider responded quickly if there was a change in their family members support needs. The registered manager said that if risks to health and wellbeing were identified they were discussed with the person and their relatives to consider ways the risk could be reduced. Information sheets on specific medical conditions such as epilepsy were provided for care workers with additional guidance on how the condition impacted a person’s care. Care workers told us people had detailed care plans and risk assessments, and they reviewed them if there were any changes in support need.

The provider carried out risk assessments to indicate if there were any risks in the home environment for the person or to the care worker providing support. A personal emergency evacuation plan (PEEP) had been completed for each person identifying how the care worker could support the person to leave their home in case of an emergency. A risk assessment on the home environment had also been completed identifying any possible risks and how these could be managed.

The provider ensured there were enough qualified, skilled and experienced care workers, who received effective support, supervision and development. The provider had a recruitment process which included obtaining references, checks on the applicant’s right to work in the United Kingdom, a criminal record check and an interview. New care workers completed an induction, a range of training including the care certificate and shadowed experienced care workers. Care workers confirmed they had regular supervision meetings, an annual appraisal, spot checks and undertook annual refresher training sessions. Relatives said they felt care workers had the training they needed to provider safe and appropriate care, “The care workers have the training to provide the support my [family member] needs.” Relatives confirmed that the care workers arrived on time and if they were running late, they were contacted. The registered manager told us they allocated care workers based on the person’s support needs. They monitored the times recorded on the records of care completed by care workers. They also contacted the person receiving care or their relative each month to discuss if the care workers stayed for the agreed time.

The provider had a process in relation to managing infection prevention and control. Care workers confirmed they had completed training for infection prevention and control and had access to enough personal protective equipment (PPE). Relatives confirmed that care workers used PPE, including gloves and aprons, when providing care to their family member. The provider explained that care workers could collect PPE from the office, or it could be delivered to the person’s home to ensure they had enough supplies.

People’s medicines were administered as prescribed. Care workers completed medicine administration record (MAR) when they supported a person with their medicines. The MAR included information on the prescribed medicine, dosage, when during the day and how often it should be administered. If a medicine had been prescribed to be administered as and when required there was guidance on when it should be given to the person and there was a separate administration record sheet that care workers completed. The MAR were reviewed monthly to ensure they had been completed in line with best practice and if there were any gaps in recording of medicines administration, care workers had recorded the reason. Care workers confirmed they had completed training on the administration of medicines, and they felt confident when supporting people. The provider carried out care worker competency assessments for the administration of medicines to assess the care worker’s knowledge.