Verve Homecare 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 is the first assessment for this newly registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

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 service had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events.

Lessons were learnt to continually identify and embed good practice. For example, the registered managers and clinical leads held regular meetings where staff could share safety concerns and good practice.

The registered managers had actively reviewed a package of care where it was not working as well as it was hoped. As part of the review some staffing changes were made. It was evident the family were listened to, concerns were acted upon with positive outcomes for the person and the family as their confidence in the new team had increased.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed and monitored. They made sure there was continuity of care, including when people moved between different services.

Health and social care professionals were positive about how people were supported and moved between services. There were clear lines of communication with regular meetings between the service and health and social care professionals. It was evident people were at the centre of the care being provided. A health professional told us how the service had supported a person to access dental treatment and attend hospital appointments. They said, “They have been great at supporting an individual with unpredictable behaviour, risk planning, and liaising with clinicians and professionals. Very professional conduct.”

A relative spoke positively about the management team and care staff in how they were supporting their relative to move from children to adult services with joined up meetings with all the professionals involved. A member of staff described how they worked in partnership with the local hospice supporting the family through a difficult period and liaising with all health and social care professionals involved.

People confirmed they were supported to attend health care appointments. Hospital passports were in place to support people when they were admitted to hospital to ensure continuity of care. Staff confirmed they supported people in hospital acknowledging that the ward environment could trigger a number of emotions for the person.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. 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. The provider shared concerns promptly and appropriately.

The provider had appropriately raised safeguarding concerns. This included sharing information with the local authority and the Care Quality Commission (CQC). The level of information shared with other agencies had been appropriate and sufficient to keep people safe. As a result of the safeguarding concerns and subsequent investigations, changes were made to people's care arrangements when required to keep them safe and help prevent recurrence.

Staff confirmed they knew what to do in the event of an allegation of abuse being made. All staff completed safeguarding training. Staff were aware of the reporting process for allegations of abuse. There were policies and procedures to guide the staff on what to do if an allegation of abuse was made and how staff could raise concerns using the whistle blowing policy.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risk assessments were in place to help keep people safe whilst they were in their home and the community. Staff described how they kept people safe without restricting them and supported them to have control over their life.

There was a lone working policy for staff and each person had clear risk assessments that described their support needs and staffing they required. Environmental risk assessments had been completed to help keep people and staff safe.

Feedback from professionals was positive in relation to the management of risk. A professional told us they received regular updates on accidents and incidents and what actions had been taken to minimise further risks to the person. Another professional told us, “They are really proactive and support individuals with very complex behaviours and risk assess effectively.” A relative told us, “They keep [person] safe in the family home and when out and about. They know them well.”

There was a clear commitment to minimising the use of restrictive interventions. Where a restrictive intervention was in place or had been used, staff, clinical leads and managers took the time to reflect as to why this took place and what could be done to reduce or remove it. Staff received training in the prevention and management of violence and aggression. Where restraint was used this was clearly recorded in the person’s care plan and agreed within a multi-disciplinary approach. The provider had taken into account the legal and ethical considerations when implementing physical intervention.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Systems were in place to help ensure the safety of people’s home environment and any equipment, such as mobility equipment. Assessments of the environment were carried out to ensure the safety and well-being of both people and staff.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

People were cared for by suitable numbers of staff. Staffing was planned in conjunction with the integrated care board (ICB) who prescribed the hours of support each person required, based on their individual care and support needs. This was kept under review as people's needs changed. We were given examples where hours had been increased due to the person needing more support due to changes in presentation. We were told of a person who increased their independence and confidence, so their package of care was reduced.

Staff were recruited safely by the provider, and relevant checks were carried out before new staff started working at the service. This included criminal record and employment checks to confirm staff were suitable to care for people.

People were supported by staff who had an induction that included shadowing more experienced staff, ongoing training and formal competency checks. A relative said, new staff were only introduced after working with staff that knew their loved one well. Staff new to care completed the care certificate as part of their 12-week induction.

There was a training programme, which was monitored by the registered managers, clinical leads, care co-ordinators and the compliance team. All staff had to complete refresher training at regular intervals. Examples included safeguarding, equality and diversity, health and safety, first aid, safe medicines administration, food hygiene, moving and handling, deprivation of liberty safeguards and mental capacity.

Train the trainers were appointed to assist with face-to-face training such as restraint, moving and handling or supporting people with a specific health condition. They liaised with a local hospital for some of the clinical training.

The provider assessed and managed the risk of infection associated with people’s care. Staff confirmed they had completed infection control training and always had access to supplies of personal protective equipment such as gloves, aprons and hand gel. Policies and procedures were in place to guide staff. Spot checks were completed to ensure staff were following the policies and procedures and not putting people at risk.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

People's medicines were managed according to their needs. Individual arrangements were in place to make sure each person received their medicines appropriately and safely. Clear records were kept of all medicines received and administered to people. Records of administration were kept ensuring that all medicines were accounted for.

Staff had been trained in the safe handling, administration and disposal of medicines. All staff who gave medicines to people had their competency assessed annually and had attended training. This was confirmed in the training records and speaking with staff.

Medicine management administration could be monitored remotely by clinical leads to ensure people received their medicines in a timely manner. Clinical leads were responsible for completing regular audits of medicines and staff competence.

The service ensured people’s behaviour was not controlled by excessive and inappropriate use of medicines. Staff understood and implemented the principles of STOMP (stopping over-medication of people with a learning disability, autism or both) and ensured people’s medicines were reviewed by prescribers in line with these principles.