Carewise 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

Risks to people were now managed and mitigated safely. Specific risks were identified and documented within people’s care plans, with advice and guidance which staff followed. Advice from healthcare professionals was sought when required and included in care plans. Medicines were now managed safely, and staff received training, providing support to people when needed. Safeguarding processes had improved, and staff knew what action to take in the event of potential abuse. People received support from staff according to planned call times. New staff were recruited safely.

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 provider operated an open and honest culture. People called the service office if they had any concerns or issues. A relative said, “I would call the office and speak to the manager. Nothing major has happened. With the carers, there was some issue with training. It was dealt with, a good result all round.”

Lessons were learned as a result of any incidents. The manager explained the process for reporting and responding to any incidents. They said, “We have an incidents spreadsheet which helps us to audit actions taken, lessons learned, and how we share it. Issues are discussed in team meetings and shared with staff. Duty of candour is being open and transparent over any incident or safeguarding, apologising and taking action to mitigate any further risks.”

Systems had been implemented to record any issues or concerns, and were used to drive improvements. For example, after a person had a fall, the incident was discussed with a relative, and with the person’s GP. Lessons were learned and guidance given to staff which was shared at a staff meeting and in a newsletter, in order to prevent further falls.

Safe systems of care had been established to ensure continuity of care when people moved between services. One person said, “The social services set up my calls in the beginning.” Another person told us, “I was transferred from another agency.”

The management and staff worked alongside people to maintain safe systems of care. The manager said, “If someone is in hospital and due to come out after quite a long time, we would go to the hospital. Some people may not be able to walk independently and so we would check they have all the right equipment. We do an assessment at the hospital and in the home. We will look at the risks. The hospital will refer to the occupational therapist.”

The service worked alongside a variety of health and social care professionals to ensure people’s safety. For example, a staff member explained they could refer people to social services if it was felt they needed extra care. They told us, “When a social worker does a review, we know everything will be covered. Social services are quite good about extending calls, so we can provide extra support. Any changes with the person’s care needs will be discussed.”

Systems had been established to maintain safe systems of care. People’s risks were identified, assessed and managed well. If needed, referrals could be made to professionals for guidance and support, such as occupational therapists and speech and language therapists. People's care and support needs were continually reviewed and updated, and care records confirmed this.

People received a safe standard of care from staff and were protected from the risk of harm. A relative told us, “He is safe; staff are there 4 times a day. He has personal care and they help a lot.”

Staff had completed safeguarding training, and understood what to do if they had any concerns about people’s welfare. A staff member said, “Safeguarding is ensuring the wellbeing rights of people from harm and neglect, either from others, themselves or families.” The provider’s safeguarding policy was shared with staff.

The provider’s systems were effective and included the reporting of accidents, incidents and a safeguarding audit. When a person experienced harm, information about the incident was recorded, the actions taken and how to prevent similar events from reoccurring. The provider and manager reported any concerns to the appropriate local safeguarding authority and to CQC.

Staff worked with people to understand and manage their risks. Risks to people were now identified, assessed and managed safely. One person told us, “I am partially blind and if my commode is not close by, I don’t feel safe, so staff always ensure it is.”

Staff supported people to understand any potential risks, whilst promoting their independence. The manager said, “From the first assessment when the supervisor goes out, we gather what we can about risks. When a carer goes somewhere they have not been before, we would speak with the carer about the person, and let them know about any risks.” Staff confirmed they had time to read people’s risk assessments which were provided on a phone application. A staff member said, “Because the information is on my app, it is easy to read. With any new client, you have to read the care plan, so you have a full idea of how to support and care for the person.”

The provider had now set up a system to manage people's risks. An app available to staff provided holistic information about people’s care and support needs, and included any associated risks. Care plans now included detailed information for staff to follow. For example, for a person who had a history of falls, staff were advised the person could mobilise for short distances using a walking frame and with the assistance of a carer. A commode in their living room meant they did not have to walk to the bathroom.

People’s homes were assessed by staff to ensure they provided a safe environment. Equipment was provided, such as hoists, to support people to be safely moved. A relative told us, “She has a walking frame to help her walk.” A person explained they needed a hoist for repositioning and added, “Yes, and staff know how to use it.”

Environmental risk assessments were completed when people started to receive care and support. The manager said, “An environmental risk assessment is always completed, for the kitchen, bathroom, etc., any room where care is provided, we do a risk assessment.” Staff were trained in the use of equipment for each person. A staff member said, “I’ve done online training in moving and handling and they train us on how to use each piece of equipment, like a hoist.”

Care plans included assessments of people’s home environments. For example, a care plan documented the person’s independence was maximised as a result of using equipment at home. A pendant alarm worn around their wrist also provided reassurance in an emergency.

Sufficient numbers of trained, qualified staff enabled people to receive the care they needed in their own homes. The majority of people told us staff arrived on time. One person said, “There is enough staff, and they are on time most of the time. I get the time that I need.”

The number of staff recruited was based on people’s care and support needs. Staff were given time to travel between calls. The manager said, “If we don’t have enough staff, we tell social services that we can’t take the package [cater for that person].” Staff told us they had enough time to spend with people. A staff member said, “Before we didn’t get travel time, but now there is 5 to 10 minutes between each call which I really like. If you get caught in traffic, it is needed. I like to chat with people and not feel rushed.” The provider had an ongoing recruitment programme to enable people to receive the care and support they required. Staff received regular supervision. One staff member explained, “I have supervision with my manager every 3 months. We discuss my wellbeing, any concerns I might have about clients, training, policies and procedures. My manager is really easy to talk to.”

Systems for recruiting staff were robust. Checks were completed to ensure new staff were suitable and safe to work in care. Staffing rotas were shared with people and staff in advance. People’s preferences for male or female staff were documented and acknowledged. Staff received regular supervision with their line managers and records confirmed this.

People were protected from the risk of infection. One person told us, “I feel safe. They look after me and make sure everything is nice and clean.”

Staff completed training on infection prevention and control. Spot checks were undertaken by a supervisor at people’s homes to check staff were using personal protective equipment (PPE) and hand sanitisation. The manager explained the additional steps staff would take if a person had COVID-19, such as wearing full PPE, including masks and shoe covers. A staff member said, “Infection prevention training is mandatory. Before you do anything in a person’s home, you should wear your PPE, wash your hands and follow the policies. It’s about the safety of your client.”

Training was organised and mandatory for staff on infection prevention and control. Staff were also trained on food hygiene to prevent cross-contamination of food products. Spot checks provided ongoing monitoring of staff when providing care for people in their own homes.

People were supported by staff to take their prescribed medicines. One person said, “The carers help me with medicines. They put my eye drops in as well.” People had the right to refuse to take their medicines if they wished. If this occurred, staff would inform the office and receive advice. Sometimes people were happy to receive their medicines from staff later during the call, having refused initially.

All staff were trained in the administration of medicines. For medicines to be taken ‘as required’ (PRN), staff now completed specific training. People now had medication care plans. A staff member said, “We have an app which documents the medicines people take. Everything is on there, what they are taking, dosage, everything. I can see what is needed. I’ve never had a person refuse to take their medicine, but if they did, I would report it to the office and write it in the notes.”

Staff completed online and face to face training on how to support people to take their medicines. Medicines competencies were regularly completed for all staff to ensure they administered medicines safely. Care plans included people’s prescribed medicines, what they were for, and when they should be taken.