Aamevol Home Care 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 changed to inadequate. This meant people were not safe and were at risk of avoidable harm.

People were not always safe using the service. We found breaches of regulation in relation to safe care and treatment, staffing levels and the safe recruitment of staff. Processes were not in place to help make sure people using the service were kept safe. Staff did not have a good understanding of safeguarding and processes were not in place to monitor incidents and put measures in place to improve safety. People’s risk assessments were not detailed. Staffing levels were not being effectively monitored, and staff were not being recruited safely. People were not always supported safely with their medicines.

This service scored 38 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There was not a proactive learning culture in the service. Audits were not effective in monitoring the safety of the service and people’s experiences. There were no systems in place to monitor all incidents and accidents so effective actions could be taken if this was necessary. Staff were not always recording the care people received. These were not being reviewed to see if staff had recorded any incidents or recorded if people’s support needed changing. The registered manager told us staff had meetings and supervisions to discuss learning lessons from how they supported people. However, there was no evidence these had happened. There were no measures in place to collect meaningful feedback from people to see if there were lessons that could be learned. There were no service improvement plans in place to help improve the service and people’s experiences.

Staff told us they had meetings as a team, however, were not sure how often these were or whether meeting minutes were recorded so they could be referred to later on. People and relatives told us staff made changes if things were not working. One relative said ‘‘If we want something changed, we just let the staff know.’’

The service did not always maintain safe systems of care to manage risks people could experience or be exposed to. Although people’s needs were assessed before they started using the service, these assessments were not always detailed about the risks people faced or their support needs. Staff told us they would contact other services such as paramedics if people needed support in an emergency. However, they were unclear what information to share with other professionals to support people to transition to other services safely. If people saw other professionals, this was always effectively recorded in their care records.

Staff told us they spent time meeting people before they supported them so they could help them transition safely to the service. People and their relatives were positive about their experience starting to use the service. One relative said, ‘‘When we first started, we had lots of communication with the management team and the experience was very good.’’

People were not always safeguarded from potential abuse because there were limited processes in place to monitor and audit most aspects of the service. Incidents were not being effectively reviewed to see if there were potential safeguarding concerns that needed further investigating. Staff had safeguarding training, however their competency after this training was not being checked. Staff did not know who to report safeguarding concerns outside of the service to partner such as the local authority or CQC.

However, people and their relatives told us they felt safe using the service. One relative said, ‘‘The staff all act professionally and I know they keep [family member] safe.’’

The service did not always plan care to meet people’s needs safely. are plans listed people’s support needs but did not give staff members guidance about how to fully support them with these needs. Staff were not consistently completing daily care records, and these were not being reviewed to help make sure risks were being identified and mitigated. Staffing rotas and visits were not being effectively monitored to help make sure risks to people were being supported by the correct staffing levels. In some cases, the management team had not checked to make sure staff were competent to support people following their training. This included in areas such as supporting people with moving and handling and using equipment such as hoists. Staff could not tell us how to support people in line with their risk assessments such as using hoists or supporting people to eat and drink.

People and relatives told us they were not always involved in discussions about managing risks. One relative told us, ‘‘We had a chat at the beginning but haven’t really spoken about the care plans since then. I think it would be good to check through every now and then.’’ There were no records to show how or if people and relatives had been involved in discussing their support and how to manage any risks they faced.

People and relatives told us staff respected their home environments and kept them safe. One relative said, ‘‘[Staff] are very respectful and will make sure everything is clean and tidy when they leave. They notice things and tidy up if anything extra is needed too.’’ Staff told us how they supported people to be safe in their environments, for example by removing items to make sure the environment was free from trip hazards. Risk assessments about people’s environments had been completed to help guide staff how to keep environments safe.

Measures were not in place to monitor staff deployment and suitability for their job roles to help keep people safe. People’s care visits were being recorded as being completed by staff at different times throughout the weeks and months, which were not always in line with their planned care times. The management team told us this was at the request of people, however there were no records to show this was the case. There was no evidence of any audits of people’s care visits to make sure they had the right level of staffing at the right times. This put people at potential risk of harm.

Staff competency checks were not always undertaken following staff being trained in supporting people with their medicines and their mobility needs. Staff were not receiving regular supervisions to discuss their job roles; training and any support needs they may have.

Required checks such as making sure full staff employment histories and references from previous employers were collected before staff started their roles, had not been completed. One staff member had worked for the service and had no recruitment checks completed. This meant people were at risk of being supported by staff who had not had their suitability to support them safely thoroughly checked.

Despite our findings staff told us they had their care visits at the correct times and the right number of staff supported them. One relative said, ‘‘Never had an issue with staff and they always arrive on time. They might be a few minutes late, but they always let us know.’’

People and relatives told us staff followed good infection prevention and control (IPC) measures and kept their houses clean. One relative said, ‘‘The staff never mind if the house is a bit untidy and will always clean to a good standard.’’ Staff told us they had the equipment they needed to follow IPC practices such as cleaning products and Personal Protective Equipment (PPE).

People were at risk of having potential medicines errors not identified. Audits were not in place to monitor whether staff were administering people’s medicines safely. Whilst staff were trained to administer their medicines, competency checks were not always being completed to make sure this was effective.

Staff told us what they would do in certain scenarios such as medicines running out or a person refusing their medicines. We reviewed medicines records and did not see any errors. One relative told us, ‘‘[Staff] know what they are up to with the medicines and always make sure they are administered correctly. They are very thorough.’’