Caring Direct Ltd

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. This service was previously registered at a different address. This is the first assessment for the service at this address. This key question has been rated 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. The provider was in breach of legal regulation in relation to staffing.

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 always have a proactive and positive culture of learning in order to improve people’s safety. For example, we found incident forms had not been fully completed to evidence how managers had reviewed or addressed concerns. Managers were not able to demonstrate how they maintained oversight of accidents and incidents in order to identify any trends and themes. This meant it was not always clear how further risks to people’s safety were being mitigated. Following our feedback, the provider confirmed they had implemented a review of their monitoring processes to ensure more robust oversight of incidents.

The provider worked with people and healthcare partners to establish and maintain safe systems of care. The provider shared information and updates with other health professionals when required to support people’s needs, including when people moved between different health services.

The provider worked with people and healthcare partners to understand what being safe meant to them. People were provided with information about how to raise concerns and they told us they felt safe. Staff had received safeguarding training and had access to a safeguarding procedure. The provider shared concerns appropriately.

The provider did not always work well with people to understand and manage risks. People did not always have risk assessments in place in relation to health needs, such as pressure care and continence care. Where people’s health needs had changed, we found their care plan documentation had not been updated to reflect their current needs. This meant staff did not have accurate guidance in place about how to support people to manage their health needs safely. Following our feedback, the provider confirmed they were reviewing all risk assessment documentation to ensure it was up to date and accurate.

The provider identified and monitored risks in the care environment. Environmental risk assessments were completed to manage any potential hazards.

The provider had not deployed staff appropriately to ensure people received consistently safe, good quality care that met their needs. People told us the timing of their care was inconsistent and punctuality was poor. They said staff did not always stay the full allocated time. People and relatives raised concerns about the timing between care visits and the impact this had on their support. One relative told us, “[Person] doesn't like going to bed early. On one occasion they had been [supported] to bed at 7:45pm and no one turned up until 10:00am the following morning.” We received mixed feedback about staff knowledge and how well staff understood people’s support needs. Comments included, “The staff aren’t familiar with me”, “The new staff are not quite there yet with their training” and “I can't always see why they did something.” Staff told us they did not always have travel time between care visits and this impacted on people’s care. Comments included, “At times we have to cut visits short. When the calls are back to back, we can’t get there on time. People are unhappy when we’re late” and “It can be a push, especially if we run over and we have to try and make up time. Some days you don’t get a break.” The provider had an electronic system in place to monitor staff arriving and leaving people’s homes. We analysed this data and found a significant number of staff did not have travel time between visits. This meant we could not be assured people were receiving care for the agreed duration. The provider had a recruitment process in place to ensure staff were employed safely. However, not all relevant checks had been completed. For example, we found the provider had not always ensured applicant’s full employment history was documented.

The provider assessed and managed the risk of infection. Staff had received infection prevention and control training and had access to appropriate personal protective equipment [PPE]. There was an infection prevention and control policy in place for staff to follow.

The provider ensured people’s medicines were safe and met their needs. Managers monitored the safe administration of medicines via an electronic medicines monitoring system which allowed them to check people had received appropriate support and alerted them to any missed or delayed medicines. Staff had received medicines training and had their competency checked prior to administering.