Caring Hands Nottingham 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 inspection we rated this key question good. At this inspection the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The management team 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.

Staff skills and competency were regularly assessed to ensure they could meet individual people’s needs. The management team carried out regular spot checks, which assessed care quality and identified areas which might require improvement.

Staff explained how their training enabled them to effectively meet people’s needs. One staff member told us, “I am now caring for a service user who has very complex care needs, which demands certain competence. I have been trained to use specialist equipment, to be able to provide high quality care for this person.”

The management team did not always work effectively with people and healthcare partners to establish and maintain safe systems of care, to ensure safety was managed or monitored.

Most people and their relatives felt the service worked effectively in partnership with external agencies, although some felt communication could be improved. One relative told us, “I'm not sure how well they liaise with other organisations, for example my family member has a support worker. It seems like communication could be better between the services involved and nothing really seems to get resolved.” In relation to communication between agencies being improved, another relative told us, “I have recently had a meeting with Caring Hands as we had problems with the timings of care calls. The times in the morning were lapsing and becoming later, and they were coming earlier in the evening. This meant it was too long for my family member to be in bed without being repositioned overnight. The district nurse was involved in this discussion and had to speak with the management a few times before changes were made.”

The management team worked to ensure there was continuity of care, including when people moved between different services. The management team supported safe discharges from hospital by ensuring they completed a pre assessment to ensure they could meet people’s needs. A staff member said, “I feel communication is clear and effective between the service and external health and social care teams. There are established channels for information exchange by using methods like phone calls, secure messaging platforms, regular meetings to discuss updates and accessible documentation of service users’ information.” Another staff member told us, “In my opinion, the service is working to ensure people receive safe care and support by having a good system and procedures in place, training staff and listening to feedback.”

The management team 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 quickly and appropriately.

People and those important to them were supported to understand safeguarding and how to raise concerns when they did not feel safe. One relative told us, “We are happy with all of the carers who come and there is nobody who we feel unsafe or uncomfortable with. The carers do vary but it's normally people who've been here before and I just leave them to it as they seem to know what they're doing. They treat my family member with respect and care and make sure that they don’t come to any harm.” Another relative told us, “I feel my family member is safe because staff are well trained, we relate to them well & we are confident in their care.”

Staff understood their duty to protect people from abuse and knew how and when to report any concerns. When concerns had been raised, managers reported these promptly to the relevant agencies and worked proactively with them, to make sure timely action was taken to safeguard people from further risk.

The provider did not always work well with people to understand & manage risks. Staff strove to provide care which met people’s needs and was safe, supportive and enabled people to do the things that mattered to them.

Some people and relatives felt they could be more involved in care planning, particularly where changes made had not always had a positive impact. One relative, who had two family members receiving care at the same house told us, “One of my family members is more confused and needs more time. So having lots of carers going in for both of them was too much. After a couple of weeks, they reviewed all these carers going in for both of them and they've now combined the care, but the carers seem to focus on one family member, rather than the other now.” Another relative told us, “The staff are generally on time, although there have been times when they've been quite a bit late and it's usually because of things like the weather. They ring me or my family member if they're running late and they've never missed a visit. It's the same set of people who come and they are very good with them. My family member would say if they weren't good. I think they are wonderful and chat with them. I do feel that they are safe with staff, although I've only been there once when the carer was there.”

One staff member told us, “We communicate daily with other professionals when required and we understand who to contact. For example, if we notice a pressure sore presenting, I quickly ring to have the district nurses come in and check it. We have clear communication between the service and other professionals.”

The management team explained how they involved people in care planning and reviews. They conducted regular surveys with people & their relatives which showed the majority of people were happy with the level of involvement in their care planning. We reviewed risk assessments which described actions for staff to take to support people effectively and keep them safe.

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 management team ensured there were enough skilled and experienced staff, who received effective support, supervision and development. They worked together to provide safe care that met people’s individual needs.

Managers completed robust recruitment checks, ensuring only individuals deemed suitable and fit, were employed to support people. Recruitment records were robust & gaps in employment were fully explored prior to commencing employment.

The majority of people & relatives felt safe & confident with staff. One relative shared their views, which they had not raised with the service. They told us, “If you had contacted me 2 months ago, I would have said that my family member has lovely carers and it's all working well; over the last couple of months, it's changed and now it's all different staff. They come at all different times. When they do come my relative has to tell them where things are.”

One person said, “I feel safe with the staff who come because we've got used to them and they know me & know what they're doing. They are very respectful and make sure that I don't feel embarrassed or uncomfortable.” A relative told us, “We are very pleased with the carers who visit & we both feel that they are safe with them. They come in the mornings & help them to get up & with all their personal care. In the time that we've been with them there have only been two carers & both females. We really appreciate having regular carers who we can relate to well. They are generally on time unless they've had a problem with a previous visit & if they are late, they ring to let us know.”

Staff were confident there were enough of them to effectively support people. One staff member told us, “The company allows new staff to be paired with established care staff or senior carers every time we go to new service users’ homes. This has contributed to building my confidence in supporting people and also helps to build a healthy relationship with people.”

The management team assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People and their relatives were assured that staff were following the infection control policy. One relative told us, “They do use gloves and aprons, and they wear either a T-shirt or a sweatshirt with the name of the company and they always have an ID badge.”

Staff understood their responsibility to follow good practice in infection prevention and control. One staff member told us, “We are trained to always use PPE and are provided with sufficient stocks, which we replace in service users’ homes should the need arise. We actively promote good infection prevention and control.”

Another staff member told us, “I follow good infection control. I always wear my PPE (gloves, aprons, face mask, shoe covers). I also wash my hands before meal preparation and before administering medication. I always ensure the kitchen is cleaned and the rubbish is disposed of in the correct bins.”

The management team 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.

The management team ensured medicine records were audited regularly, and any errors were identified. The provider ensured staff received training and competency checks to ensure they were assessed as competent in medicines administration. Staff felt well trained and competent to administer medicines.

Staff told us they had received medicines training and understood the importance of recording this correctly where they assisted people to take medicines. Any changes in medicines were communicated to staff by the care co-ordinators to ensure these were actioned. This was recorded in people’s care plans.

People and their relatives told us their medicines were administered in a safe way, as they preferred. One relative told us, “There have been no problems with the medication and in fact they've been exemplary when it comes to the medication and generally to be honest. If the dosette box has had something in the wrong place the two regular carers will contact me directly about it.”