Companion Homecare

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

Staff and people shared concerns relating to learning and risks, and we found processes relating to risk was not robust. Staff knowledge around safeguarding was mixed and during our inspection we had to raise concerns with the local safeguarding team. Appropriate training and supervision of staff was not always in place. People and staff told us medicines were not always safely managed.

This service scored 47 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Four people we spoke with mentioned communication difficulties including a negative attitude and repercussions from making complaints. For example, continuous male care workers being deployed when female workers had been requested there was an unwillingness to adjust rotas when required.

A staff member told us that there was no intention of learning from safety incidents and spoke of mishaps with medicines within the past few months.

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.

People had different experiences in relation to how safe they felt. One person said they was “happy and felt safe, has a key safe and never had a problem”. However, other people’s relatives described care that was unsafe relating to poor care, risk management and medicines and amounted to allegations of abuse or neglect which we had to raise as safeguarding referrals to the local authority.

Staff knowledge around safeguarding was mixed. Whilst some staff were able to confidently talk to us about safeguarding processes, we found this was not consistent. We found examples where staff and management had not made safeguarding referrals as required, and these had to be raised by CQC.

People told us they did not always feel risks were appropriately managed. We were given example of poor risk management including poor practice around managing peoples PEG feed and also how staff did not always safely manage people’s key safes, which posed potential risks to people using the service. One relative we spoke to told us that she and her mother was “stressed with the service”.

Staff raised numerous issues about risk management including lack of training.

We found some elements of care plans were conflicting or missing necessary information. Risk assessments were not always in place in relation to people’s health conditions. We found examples where people had health conditions such as diabetes but did not have risk assessments in place. This meant staff may not always be aware of how to manage risk appropriately. One person was at risk of choking but had no risk assessment in place for this. When reviewing this person’s daily notes, we found they had consumed food that was not in line with the speech and language therapist recommendations. One person experienced distressed reactions where they posed a risk to themselves and others. They did not have an appropriate assessment to help staff understand triggers and de-escalation techniques. Some care plans contained conflicting information about medicines while this information was missing altogether from others.

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

People provided mixed feedback about staff, one person said, “there was a lack of training, with staff coming from other countries and young people who had not had training.” Whilst another said “the carer checks that they are up, washed, dressed, hearing aids in, eyedrops, and cleans her glasses.”

Staff told us they had completed a variety of training courses, but some staff told us they had not received training in specific areas such as PEG feeding, when they were supporting people with these needs. The manager scheduled necessary PEG feed training when we raised this. One staff member told us “There are no supervisions or planned appraisals.”

We had concerns in relation to the employment of oversees workers, however, as this is out of our scope of CQC’s regulations, we made a referral to the home office for them to investigate further. We could not determine if staff training was up to date as a completed staff training matrix was not available during our inspection. The registered manager appointed a staff member to create and update a tracker and gave us their progress to date, during the inspection. We asked for copies of supervision and appraisal records and the registered manager told us there was no records relating to this, we did see some evidence of spot checks and shadowing for new starters. We also found a person which required a call before 5 pm but on 15 occasions in one month period, visits were made after this time meaning care was not provided as required.

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.

We received mixed feedback in relation to medicines management. Whilst one person described the staff as “good and helpful checking that medication is taken and reminding you if it’s not” one relative told us there had been “some medication errors with night-time medication being given at teatime.” and “There were further medication errors resulting in the staff member being sacked but then came back again.” The registered manager has since disputed this member of staff had been sacked. Another relative told us “There had been some problems with catheter care and also with medication.”

We received mixed feedback on medicines training, some staff told us they had received training, whilst other raised concerns. One staff member said, “the service was under pressure this to take more sponsorship people, who weren’t trained and medication mistakes were being made.” The registered manager has since disputed that sponsorship staff were not trained. One staff member we spoke with told us they were delivering medicines to people. We raised some queries about this persons training when we were reviewing records, and the registered manager told us that as this person was only 17 and they were not delivering personal care or giving medication. On further review, we found this person was administering medicines and delivering personal care with incomplete training records around medication.