The Recruitment Partnership Also known as Total Care UK

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.

This the first assessment for this registered service. This key question has been rated 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.

The service was in breach of legal regulation in relation to the way people’s medicines were managed and recorded.

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.

Improvements were needed to ensure effective systems were in place to support a culture of learning and continuous improvement.

Whilst the registered manager demonstrated an awareness of individual incidents and took action in response, such as sourcing appropriate footwear for a person who frequently tripped, there was no formal audit process to consistently review and analyse incident and accident records. This limited the provider’s ability to identify patterns, learn lessons, and embed good practice across the service. Without a structured approach to auditing, there was a risk that opportunities for improvement could be missed, and learning not consistently shared or sustained.

People and relatives, we spoke with confirmed they were able to raise concerns with staff, and they acted on any concerns to make improvements to the care provided. One relative told us, “I’ve raised a safety concern, I phoned the office and spoke with the carers who made the mistake. The manager spoke with the staff, and we got it sorted.”

Staff told us they felt confident raising concerns on behalf of people or their relatives and were assured these were addressed by the registered manager. Staff also said they could approach the registered manager with any staffing concerns or suggestions for improvement, and these were listened to and acted upon.

The provider did not always maintain safe systems of care. They did not always manage or monitor people’s care and records, which meant there was a risk inconsistent care when people moved between different services.

People’s daily care records contained details of advice received from health and social care professionals. However, the information within the care plans had not always been updated when people’s needs changes, which meant there was a risk of inconsistent care and support when people moved between services.

People and their relatives told us staff raised concerns with health and social care professionals when required. One person said, “They [staff] will call GP for me if I need them to or the pharmacy.” Staff confirmed they sought and followed advice from external professionals to ensure support met people’s changing needs.

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 quickly and appropriately.

People and their relatives told us they felt safe with the staff who provided their care. One person said, “The carers are good, and I feel safe with them.” A relative told us, “[My family member] loves the care, I can’t fault it. [My family member] feels safe with the carers.”

Staff demonstrated a clear understanding of their roles and responsibilities in safeguarding people from harm. They were able to identify signs of potential abuse and were familiar with the procedures for reporting concerns, helping to ensure people remained safe.

The provider had established systems and processes to safeguard people from the risk of harm, which were consistently followed by staff in practice. The registered manager demonstrated a clear understanding of their safeguarding responsibilities, including the appropriate procedures and external agencies to contact in the event of suspected abuse.

Improvements were needed to strengthen the provider’s systems and ensure risks were effectively managed and recorded to protect people from unsafe care.

Although staff demonstrated a good understanding of individual risks, the electronic care planning system did not contain current risk assessments. The service transitioned to a new electronic monitoring system in October 2024, and previous assessments were uploaded as non-editable documents. This limited the provider’s ability to review and update risk information in line with changes to people’s needs and increased the risk of unsafe care.

Concerns were shared with the registered manager and provider, who responded promptly by implementing editable electronic risk assessments for all individuals receiving support. The effectiveness of this improvement will be assessed at the next inspection.

People's risks were managed and mitigated to keep them safe. People and relatives told us they were involved in their care and how they wanted to be supported to manage their assessed risks. One person said, “My regular carer [staff name] is very good they know exactly what I need help with.” One relative said, “That’s why they have 2 carers come as [my family member] isn’t good on their legs. I am involved in all decisions made about my [family member’s] risks.”

Staff understood people’s individual risks and how they needed to support people to remain safe. One staff member said, “I look at the care plan, so I know what the person needs support with, and I also ask them each time I visit too.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Environmental risk assessments of people’s homes were completed prior to staff delivering care and support. This process helped to identify and mitigate potential environmental hazards, promoting the safety and wellbeing of both people using the service and staff.

The provider made sure there were enough staff available, who received effective support and supervision. They worked together well to provide safe care that met people’s individual needs. Some improvements were needed to ensure the training and development provided for staff was consistently effective.

Staff told us they received an induction prior to delivering care, which included training to support them in their roles. However, we found improvements were needed to ensure training was effective in providing staff with the necessary skills and knowledge. For example, staff told us they had completed online manual handling training but felt practical training would be more beneficial. Staff we spoke with had limited understanding of the Mental Capacity Act 2025 and their responsibilities under the legislation.

People and relatives told us there were enough staff to provide support at the time they preferred and confirmed they had a consistent staff group providing their care. One person said, “I think there are enough staff, I have a regular time, and they [staff] stay for as long as needed.” Staff told us they had enough time to support people in a calm and unhurried manner. The provider had systems in place to maintain continuity of care during periods of staffing change, helping to ensure people continued to receive the support they needed.

Staff told us they felt supported in their role and received supervisions to ensure any issues or areas of development were discussed. One staff member said, “I have regular supervision and spot checks carried out, which I find okay to discuss any issues I may have.”

Staff recruitment records demonstrated the provider had carried out the necessary pre-employment checks. This helped to ensure staff employed were safe and suitable to support people using the service.

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.

People and relatives told us staff used aprons and gloves when they provided support. One person said, “They [staff] always wear gloves and aprons when they support me.” One relative said, “The staff wear gloves and aprons as I see them in the bin when I visit my relative.”

Staff followed infection control guidance to help keep people safe. Staff told us and the records confirmed they used protective equipment such as gloves and aprons when they provided care. and they told us there was always enough available to them. This helped reduce the risk of spreading infections.

The provider had an infection prevention and control policy in place, which outlined procedures for reducing the risk of infection. This included guidance for staff on the use of personal protective equipment (PPE) and maintaining hygiene standards when delivering care.

Medicine administration was carried out safely and in line with people’s needs. However, improvements were needed to medicine risk assessments, audit accuracy, and PRN protocols to ensure consistent and safe practice across the service.

While people said they were happy with how their medicines were managed, improvements were needed to ensure safe practice. Staff could identify when PRN (as required) medicines were needed, but no written guidance was available to support this. This posed a risk of inappropriate administration by unfamiliar staff.

Risk assessments for emollient creams and fire lacked a holistic approach. For example, one assessment noted a person who used emollient creams was not at risk due to not smoking but failed to consider other hazards such as open flames or gas appliances. This meant risks were not fully identified or mitigated.

Medicine audits were completed but were not consistently accurate or effective. Some audits did not reflect the actual support provided or identified incorrect information, such as medicines people were not prescribed. This limited their reliability in identifying and addressing risks.

The provider took immediate action to put a plan in place to introduce PRN protocols where needed, review medicine-related risks, and improve the accuracy of medicine audits. The proposed actions will be reviewed at the next inspection to ensure they have been implemented and embedded into practice.

People told us they were supported with their medicines and creams as prescribed. People and relatives confirmed staff understood how and when they needed their medicines and creams. One person said, “They [staff] give me my medicine with water, they know what I need. If I’m in pain they know what tablets I need and make sure I lie down, it’s very good care.”

Staff received training in medicine administration and had their competencies assessed to ensure safe practice. Medicine Administration Records (MARs) were used to document support with medicines and topical creams included guidance for prescribed items. Staff knew people well and were able to describe how they supported individuals with their medicines and creams