Adjoy Healthcare Westberkshire

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

People were supported by staff to stay safe and free from harm. This was because staff undertook suitable training and put this training into practice. In addition, information relating to people and their individual risks was contained in their care plans. There were sufficient staff to care for people and people told us staff turned up when they expected them. Staff were recruited through safe practices and they undertook training specific to their role before working in the field. This included medicines and infection control training.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Areas for improvement made by people and their relatives were taken on board and actioned. One person told us, “I spoke to the management at the beginning. They’ve got more carers now and its perfect. I had to raise some issues at the beginning about the timing of the calls and they sorted quickly.”

The registered manager told us, “As a result of safeguarding concerns, we have done a lot of training. We are ensuring staff document everything that has happened and we get family members involved as well.” Staff said they were involved in learning from incidents and accidents. They said, “Learning raises awareness and understanding of things that went wrong and perhaps can go wrong again and how they can be tackled in other to prevent reoccurrence” and, “Learnings from incidents are shared with staff to improve practice and promote the safety of service users.”

The registered manager carried out supervisions with staff to discuss any shortfalls. For example, when a staff member had not fully followed a person's care plan they were called into the office to discuss and reflect on their actions. Reflective practice took place with staff on an individual basis as well as in a group.

People’s feedback to the agency upon transitioning to receiving care from them was positive. One person had expressed their happiness, and satisfaction with the level of care they were receiving.

A staff member told us, “We have to have to have information provided in accessible ways. This can help people understand the different types of risk. It can also support them to raise a concern about their safety.”

We did not receive any feedback from partners for this quality statement as part of this assessment.

Calls were made to people to check the transition from being able to care for themselves to receiving care from the agency. This helped ensure that staff provided care and support that met people's needs.

People and their relatives told us they felt safe receiving care from the service. One person said, “I feel safe because they do it well.” Another person told us, “I 100% feel safe. They’re so kind and gentle. They’re like family.” A relative said, “[Staff member] is really nice. I’m around when they’re here but she’s great and that makes me feel like he’s safe.”

Staff were aware of their responsibilities in reporting safeguarding concerns. The registered manager told us, “Staff will go to the care coordinator first of all, then it will come to me and I will raise a safeguarding concern with the local authority.” Staff told us, “I will report to my care coordinator. I will report to their next of kin. I will document it” and, “If I suspect someone is being harmed (abused or neglected) in any form, I will immediately alert the management of Adjoy through the care coordinator. I will ensure I record my observations in my report providing as much detail as possible, including dates following Adjoy’s safeguarding policy so management has baseline information to follow up on.

Staff received safeguarding training as part of their induction into the agency and there was a process in place which helped ensure that any safeguarding concerns were raised with the relevant authorities. However, at present the registered manager did not hold a safeguarding log which would help them with their oversight of any concerns. We have covered this in more detail in our key question of Well-led.

Risks to people were managed safely. One person told us, “They use the right equipment.” Another person told us, “They wheel me into the bedroom on a seat, they manage my mobility well.” A relative told us, “[My family member] likes to go downstairs for breakfast and the carer helps him appropriately and safely.”

Staff told us they put people’s safety at the forefront of everything they did. We were told, “I feel that it’s the duty of a caregiver to keep people safe from risk by creating awareness,” and “I make sure the clients are positioned properly on their beds or chairs so they do not fall. I keep everything they might need within their reach to avoid accidents.”

People’s care plans contained risk assessments. These guided staff and helped staff keep people free from harm. Where people were at risk of their skin breaking down, pressure sore risk assessments highlighted what staff should look out for and who to contact if they had any concerns.

We did not speak with people about their home environments as part of this inspection.

Staff were aware of people’s environment being a safe place for them. A staff member told us, “I have a client that is bed bound, and I noticed that the bed rail had been removed, I called the attention of the next of kin immediately for it to be replaced.”

When people were assessed prior to commencing with the agency, the assessment included details around the person’s environment, highlighting any areas that may be of risk to either the person or the staff member.

People were happy with the time staff spent with them and they told us they had never experienced a missed call. People said, “Most the time it’s the same person. They arrive on time mostly and stay the right length of time,” “They mostly stay the full length. If they finish early, I let them go early. They’re usually on time or arrive within half an hour” and, “I must admit the carers I have at the moment, two of them that have been coming recently due to being a double up. I couldn’t wish for any more help than I get.” A relative told us, “They’re on time and stay the correct amount of time. I’m here so I know.”

Staff felt there were enough of them to provide safe care calls. They told us they had travelling time factored in between calls to help ensure they kept to time. They told us, “My time on call is sufficient and my travelling time is accurate,” “There is sufficient time and the appropriate number of carers are assigned to people” and, “We have enough time for the service users, and based on the individual care plans, the time spent on different clients varies, for example, some peoples morning calls are one hour, some 45 mins.”

The registered manager told us they current had 11 permanent staff employed which they felt was sufficient for the number of clients they had. They said, “We have on-going recruitment. We use an electronic system for monitoring staff attendance. Care notes are audited for the length of time stayed at calls and we try our best to ensure that people see the same staff consistently.” Staff receiving training before they commenced in their role. This included completing the care certificate which is a set of modules designed specifically for staff working in this type of work. Staff were recruited through a robust system which meant they provided previous work history, references and evidence of their right to work in the UK. Staff also underwent a Disclosure and Barring Check prior to starting to work to help ensure they were suitable to work with people.

People were protected from illness and harm due to good infection prevention and control processes. One person told us, “[Staff] do wear aprons and gloves.” A relative we spoke to also confirmed this.

The registered manager told us it was compulsory for staff to complete infection control training modules. They told us, “We have a stock of PPE here and we leave PPE in people’s houses.” Staff said they had access to sufficient PPE. They told us, “Adjoy make provision for PPE and its mandatory to all staff to always put on your PPE when you are in on care calls. A disposable plastic apron, surgical mask, disposable shoe covers and disposable gloves,” and, “I am provided with suitable and safe tools and equipment for my work and this are accompanied with relevant training.”

Management carried out regular spot checks on staff to help ensure they were wearing their PPE as expected. The registered manager said, “This would be apron, gloves and masks if a person was unwell or the staff member had a cold.”

People were happy with this aspect of their care, telling us there had been no issues with their medication. One person said, “They help me with eye drops” and a second told us, “There’s been no problems whatsoever.”

The registered manager told us, “All staff have medicines training and competency checks are done once a year.” Staff confirmed this telling us, “I was given training on medication and I was confirmed competent” and, “I have been trained on medication both virtually and in-person.”

The registered manager said at present most people were just prompted with their medicines as people had capacity to understand the medicines they were taking and were independent in this matter. Although, we heard from the registered manager that some staff put people’s medicines onto a saucer for people to take. This meant they were removing people’s medicines from their medicine box and putting it in front of the person to ensure they took it. Despite this, there were no medicines administration records held by staff. We have referred to this in further detail under our key question of Well-led.