Blossoming Hearts Care Agency 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. At our last assessment we rated this key question requires improvement. At this

assessment the rating has remained 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.

This service scored 59 (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 had a positive culture of safety based on openness and honesty. However, concerns were not always well documented to evidence if lessons had been learnt. Accident and incident recording was not effective. For example, the service did not have a log or know how many incidents had happened in the past month. This meant there was a risk that not all notifiable incidents had been reported to either the local authority or CQC. This made it difficult for the provider to identify themes and trends and implement learning. During the inspection the registered manager said that they had identified a system where they could better log incidents and accidents and would utilise more effective systems going forward.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. People using the service and their families told us that the registered manager made sure they did a full assessment prior to delivering a care package. The registered manager told us when they supported people who were in hospital and due to return home, they would gain information from the person and the hospital to ensure they had all the information they needed to deliver safe care.

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 and worked with other agencies, but did not always recognise their duty to raise concerns with all other relevant organisations. For example, there had been an incident where staff notified the police that due to social issues the person receiving care had not feel safe. However, the service had not recognised that the person would also benefit from support from the local authority safeguarding team. Nor had they notified CQC of this incident. Staff had received training on safeguarding adults. However, it was unclear from the provider’s records how frequently staff were required to complete this training as some staff were doing so every year whilst others were not expected to complete a refresher training course for 2 years. People receiving support from the service said that they felt safe.

The provider worked with people to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. People’s risk assessments were updated when their care needs changed. The registered manager told us that they informed staff when changes had been made. Staff confirmed that they were able to view this information via the provider’s electronic care records systems. People and their relatives told us that risk was discussed, and that staff ensured they understood what risks there were in relation to their care needs.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The provider knew who to contact and made referrals should people need support of additional aids or equipment. People told us that staff knew how to use equipment safely.

The provider did not always make sure there were enough qualified, skilled and experienced staff. People told us that they always received their care calls, and that staff informed them if they were going to be late. However, one person supported by the service required 2 staff to support them during their care calls. Information the service shared with us showed that there were occasions when the 2 carers were not at the person’s home for the same amount of time with occasions where the overlap was less than 15 minutes. This meant there was not always the right number of staff available in order to deliver safe care. Records relating to staff supervision did not evidence that the staff were receiving effective support, supervision and development. Staff told us they would benefit from more face to face training.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Staff followed infection prevention and control guidance. All people and relatives we spoke with said that staff always wore personal protective equipment (PPE) when carrying out personal care tasks. People told us that staff disposed of their PPE safely. We observed the service to have substantial stocks of PPE which they monitored to ensure good stock rotation.

We were not assured that the service always made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. The provider was not able to provide evidence that all staff who were supporting people with their medicines had been assessed as competent to carry out the task. Audits carried out to ensure the safety of medicine management were not completed frequently enough to ensure issues were identified in a timely way. The scope of the medicines audit did not cover all potential issues. Some people supported by the service managed their own medicines or were supported to do so by family members.