Infinity Care 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 inadequate. At this assessment the rating has improved to requires improvement: This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed. We found a continuing breach of legal Regulations in relation to people’s safe care and treatment. However, other improvements had been made and the service was no longer in breach of Regulations relating to fit and proper persons employed or safeguarding people from abuse.

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 provider did not consistently demonstrate a proactive culture of safety. Staff were encouraged to raise concerns, and these were investigated and actions taken in response such as removing trip hazards for example. However, improvements were needed to ensure lessons were learnt to continually identify and embed good practice. We found some examples, where reviews of incidents had not been sufficiently robust or had not addressed all of the identified concerns. Monthly audits of accidents and incidents and complaints had been introduced, but these needed to be refined and analysed further to ensure they were effective at identifying any themes or trends and managing and mitigating future risks. We did see some examples where lessons had been learnt and changes made to embed good practice. For example, an electronic medicines administration record had been implemented to help prevent medicines errors occurring and the provider had recently changed to a different digital social care record after identifying that their existing tool was not able to provide all of the functionality they required. Learning from a recent mock inspection had been shared with staff as had the outcome of a safeguarding investigation relating to a medicines error.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. Leaders undertook assessments in collaboration with health and social care staff to ensure they were able to meet the needs of those new to the service. The registered manager told us, “We go to the hospital to do an assessment, we would make sure before they came home everything was in place, we observe their mobility and ask the hospital nurses to do observations during the night so that we are clear about their needs”. The provider’s digital social care record was able to be shared securely with emergency healthcare professionals visiting people in their homes. This allowed those professionals to access the persons care plan, information about their medicines and the person’s wishes in relation to escalation of treatment to hospital settings in a timely way. People told us the service monitored and reviewed their care and support following hospital admissions. For example, 1 person said, “[Person] has dementia and has been in and out of hospital… the care plan is updated each time as necessary”.

The service worked with people to ensure they were supported to stay safe and were protected from abuse. 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. Improvements had been made following our last inspection and the provider was no longer in breach of the Regulation relating to safeguarding people from abuse. A suitable safeguarding policy was now in place. Following safeguarding concerns, staff had put plans in place to keep people safe. Whilst a safeguarding tracker tool was now being used, this needed to be further refined and developed to ensure it assisted in identifying all indicators of abuse, themes, and trends and to clearly identify learning. The registered manager told us, “Team meetings are used to discuss scenarios, we go round and explore their understanding of safeguarding.” Staff were able to describe their role and responsibility in relation to keeping people safe from abuse and were confident the leadership team would take any concerns raised seriously. One staff member said, “I have never had to report one [safeguarding concern] but they would take it seriously”. People told us staff helped them to stay safe. One person said, “There is no form of abuse ever, any concerns I would contact the office” and a relative said, “I have no safeguarding or abuse concerns at all.”

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive, and enabled people to do the things that mattered to them. Whilst we did not identify that anyone had experienced harm, the assessment and mitigation of some risks were not always effective. One person experienced a choking incident, but this had not been escalated to relevant health care professionals. The food being offered to the person was not in line with their assessed needs and there was no choking risk assessment. Seizure, catheter, and diabetic care plans were in place, but needed to be more detailed. Whilst we saw many examples where staff had escalated concerns to healthcare professionals, this was not consistently evidenced. One person required repositioning on a regular basis to prevent pressure injuries from developing. Records did not provide assurances that this was happening consistently or effectively. The bed rail risk assessment in place for 1 person was not in line with best practice. Staff were allocated to attend calls where people had specific needs such as epilepsy, but they had not been trained in those areas. The provider has taken action to address this. People and their families were confident safety was a priority. They all felt involved in managing risks related to the care being provided. One relative said “Absolutely, [Person] is safe, their general approach is meticulous.”

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Health and safety and fire safety risk assessments were completed and checks made of equipment to ensure this was safe to use.

The provider made sure there were enough qualified, skilled, and experienced staff who received effective support, supervision, and development. Staff worked together well to meet people’s individual needs. Rotas were planned in advance and the provider had effective systems in place to monitor call times, their duration and medicines were administered as planned. This helped the leadership team to have effective oversight of care delivery and address any issues promptly. Staff confirmed they usually had sufficient time to complete assigned tasks. People were extremely positive about the support they received from staff with all those we spoke with saying staff were kind, well trained and attentive. Comments included, “I have full confidence in [Staffs] experience and care” and “There is a good regular team of carers, trained well and familiar with [Person’s] equipment, any new staff are trained and shown how to use the mobility aids safely.” Staff told us they received a helpful induction and appropriate training which included practical sessions on moving and handling and emergency first aid. There were systems in place to undertake supervision. One staff member said, “Yes, I have supervision every 2 months. It is a time to regroup and if you have any problems, it’s an opportunity to raise them and get their feedback on your performance.” Robust competency assessments and spot checks were also undertaken. Records showed that some training, not considered to be mandatory by the provider, had not been refreshed for some time. The provider has taken action to address this.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. People told us staff followed good infection control practices with 1 person telling us, “They are very aware of hygiene and infection control” and a relative saying, “First things the carers do when they come in is to put their gloves and aprons on”. Staff confirmed there were always adequate supplies of personal protective equipment (PPE). One staff member said, “Yes we can go to the office and pick it up, it’s always available.”

The service did not always make sure that medicines and treatments were safe and met people’s needs, capacities, and preferences. They did not always involve people in planning. Improvements had been made following our last inspection and the provider was no longer in breach of the part of Regulation 12 relating to medicines, but there were areas where some improvements were still needed. ‘As required’ or PRN protocols were now in place, although some of these needed to be more detailed, for example, some protocols contained a lack of guidance for staff on how to respond to people’s distressed behaviours before administering PRN medicines. Staff were not consistently recording the actual dose given when administering variable dose medicines, or the reason why PRN medicines had been administered. A suitable medicines policy was in place and an electronic medicines administration (EMAR) had been introduced and those viewed contained no gaps. Staff received training and had their competency assessed. Anticoagulants risk assessments were in place and risks relating to paraffin based emollients assessed. People were confident staff understood how to manage medicines safely. Comments included, “The carers always check I have taken my medication” and “The carers encourage her to take her medication with her breakfast… they check the day of the week with her so as to involve with the medication.”