Day to Day 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 inspection we rated this key question good. At this inspection the rating remained good.

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.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

Staff worked with people and health and social care partners to understand what being safe meant to them and the best way to ensure that. The provider shared concerns quickly and appropriately when required.

People told us they felt safe. One person said, “I feel safe, the carers are very attentive and take their time. They are never hurried.” The provider had a safeguarding adult’s policy and procedure in place and staff had received training on safeguarding adults. Staff were aware of their responsibilities to report and respond to concerns. A staff member told us, “If I thought or found a person was being abused, I would report my concerns to the registered manager and to the local authorities safeguarding team and CQC if I thought I had to.”

The registered manager was aware of their responsibilities for reporting safeguarding concerns to the local authority safeguarding team and the CQC. A safeguarding log was in place that securely kept safeguarding referral documents sent to the local authority and the CQC and information on actions taken to address any concerns. The registered manager told us they learned lessons from safeguarding concerns and would follow any recommendations made from the local authority if required.

We checked whether the service was working within the principles of the MCA. The provider informed people about their rights around consent and respected these when delivering person-centred care. People were consulted and supported to make choices and decisions for themselves. Staff promoted people's rights and worked within the principles of the MCA.

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.

Risks to people were managed safely. One person told us, “I and my daughter were asked about my needs and the care I wanted. A senior carer came to do an assessment. It was a three-way discussion. My falls risk and need for breakfast and lunch were covered. I’ve no falls with the carers there.”

Staff understood people’s needs and risks and how best to support them safely. A staff member told us they supported a person at risk of developing pressure sores to receive the right support from healthcare professionals. They told us, “Peoples care plans identify their risks and direct us on how we need to support them. I always read people’s care plans and risk assessments prior to supporting them. The plans give a good overall picture of the person.” Another staff member commented, “Risks to people are recorded and easy to follow so we know how to support people safely. Everything is accessed on our phones. I recently had to call for an ambulance for a person and all the information the ambulance crew needed to know about the persons history was on my phone.”

The provider was in the process of transferring people’s care records onto a new electronic care planning system and an action plan was in place to oversee this. Risks to people were assessed, planned for and reviewed to ensure their safety and well-being. Care records included risk assessments for areas such as, moving and handling, medicines, nutrition and hydration, communication and environment. Risk assessments included information and guidance for staff on actions to take to minimise the risk of accidents occurring.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked well together to provide safe care that met people’s individual needs. People told us there were enough staff to meet their needs. One person said, “We get two carers three times a day. They meet our needs, and all is fine. They do all the hours allocated. We get advance notification each week of the time of the carer’s visits.” A staff member told us, “There was usually enough time for them to get between calls. However, there are lots of roadworks now, so they let people know if we are going to be late.” Another staff member said, “I like to be early; they [registered manager] make sure we have time to get between calls.”

The registered managed used an electronic call monitoring system (ECM) to plan staff rotas and log people’s calls. They told us staff are given a 15 minute time window either side of people’s preferred time of visit, after this allowance it is then recorded as a late visit. Office staff monitored the ECM in real time and if a call appeared late, they would contact the member of staff and inform the person of when the carer would arrive. The registered manager told us they had rarely had a missed call, and the system helped them to ensure people received care at the right time.

Processes were in place to ensure staff were safely recruited. Staff files showed the provider completed all necessary pre-employment checks before staff commenced employment. These include DBS checks, employment history and references from previous employers. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. All staff were trained to ensure people’s needs were safely met. Training provided included areas such as safeguarding, fire safety, first aid and food hygiene.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

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.

Some people required support from staff to administer their medicines and some people took responsibility for their own medicines or were supported by family members. A relative told us, weekend carers gave their loved one their medicines. The carers were quite clear on the procedures for medication. They logged in on their system and they could see what’s been recorded. Their loved one’s medicines were increased after issues were raised by the carers. The carers found it hard to give their loved one their medicines orally. The G.P was involved, and they were happy to have their loved one’s medicines crushed and given with food.

Staff told us they had received training on administering medicines. Their competency to administer medicines had been assessed by their line managers or the registered manager to ensure safe practice. A staff member told us, “The medicines part of people’s care plans is easy to follow. I follow the instructions on people’s prescribed medicines labels. This is also explained in the persons care plan.”

Medicines were administered by staff who were appropriately trained to do so, and Medicines Administration Records [MAR] were completed on the providers electronic care planning system according to administration instructions. Where covert medicines (given to people without their knowledge) were recommended by health care professionals, the GP and pharmacy had provided advice and guidance about administration. People told us about the medicines they were offered by staff, and this was done in a friendly, respectful way. Medicines audits were routinely completed by the registered manager to ensure continued safe practice.