Care 24/7 Healthcare Limited

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 as requires improvement. At this assessment the rating has remained requires improvement. This meant people were not always safe and protected from avoidable harm.

The service was in breach of legal regulation regarding ensuring staff were qualified, competent, skilled and experienced and received regular supervision and appraisal to support them in their duties.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. The management team encouraged staff to report any incident accident or concern. They respond promptly dealing with safety issues effectively and using information to improve. However, incidents, actions and learning were not well recorded. Therefore, it was not easy to monitor trends and patterns or to evidence any learning. Staff told us they were confident the management team would be supportive and take the necessary action if they reported any incidents across the service.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed and monitored. For example, strong links were maintained with the local hospice and district nursing team to support end of life care. A full assessment of need and equipment needed completed before a package of care was agreed ensured smooth transitions. The provider told us this assessment “ensured equipment like hospital beds were in place”.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff completed safeguarding training and understood the importance of safeguarding people who may be at risk of abuse. One staff member said, “People we look after are usually very vulnerable and we need to be aware of the risk of abuse”. There were systems in place to support the reporting of any safeguarding concern. The management team understood their responsibility and worked with staff and other agencies to protect people and their rights.

The service worked with people to understand and manage risks. People’s risks were assessed with people and their relatives using the service’s assessment care documentation. Staff showed us they had access to risk assessment information via the provider’s electronic care planning system. A staff member told us, “We check people’s risk each time we visit, for example people’s pain is always checked and we report any concerns back to the office”.

The service detected and controlled potential risks in the care environment. A full assessment of the environment was completed before a package of care was agreed. This included the home environment any equipment, facilities and technology that supported the safe delivery of care. For example, risks associated with fire were assessed and responded to with a fire safety referral to the local fire brigade if needed. The presence of any pets was also assessed and managed from a safety perspective. This included ensuring dogs were not in the room when moving hoisting equipment.

Training records confirmed staff had not completed all relevant training to meet the needs of people they were supporting. For example, staff supporting people needing end of life care and living with diabetes had not received specific training in these areas. Staff did not have regular supervision or spot check visits completed. The provider could therefore not be assured that staff were competent or followed best practice guidelines. This had not improved since the last inspection.

The service made sure there were enough staff deployed to cover the hours required but they had not ensured they were qualified, skilled and experienced.

The provider had improved some staff training since the last inspection and training schedules including an induction package were being developed to ensure staff were qualified and had relevant skills.

Some records relating to recruitment were not complete. The new office manager had identified this and had taken action to address this matter. They immediately followed up on the missing records and ensured they were provided.

The service assessed and managed the risk of infection. Staff completed training on infection control. This included the appropriate use of personal protective equipment (PPE). Staff confirmed they always had access to supplies of PPE, and we saw people collecting gloves during our site visit.

There was guidance within people’s care plans to support good infection control practice. For example, a person with a urinary catheter had clear guidelines on how to care for this following best infection control practice. People’s daily logs showed staff were aware of best practice.

Suitable procedures and systems were in place for the safe management of medicines when included in the package of care.

At the time of inspection, no one was being supported to take their medicines.

The provider confirmed staff completed appropriate training and had regular competency assessments when involved in the handling of medicines. The provider had completed a qualification on training people on the safe management of medicines.

A safeguarding concern regarding medicine administration in the past had resulted in a number of lessons learnt to improve practice. The provider had completed an action plan to support this.