Mayfair Homecare - Barnet

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 requires improvement. At this inspection the rating has changed to good. This meant people were safe and protected from avoidable harm.

During our last inspection the provider was in breach of the regulation in relation to safe care and treatment. We saw improvements had been made during this inspection, and the provider was no longer in breach of this regulation.

This service scored 72 (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 had a proactive and positive culture of safety. There was a process for reporting and recording incidents or accidents such as those involving people coming to harm.Procedures for investigating incidents, such as falls or medicine errors, included what action was taken to keep the person safe. Records showed staff and managers listened to concerns about people’s safety and followed processes to report and investigate incidents. Lessons were learned to continually identify and embed good practice. Incidents were reviewed by the registered manager and used to support regular discussions with staff so that improvements were made.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Information was collected before people started to use the service. The management team had experience of working with external professionals and partner agencies to ensure there was continuity of care for people, including when they moved between different services. The provider worked closely with professionals to ensure people’s preferences and wishes were understood and respected.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. People told us they felt safe when staff were present and did not feel they were at risk. A person said, “I am definitely safe with the carers.”

The registered manager reported safeguarding concerns to local authorities. Staff understood how to protect people from the risk of abuse and received training in safeguarding people. There were clear and up to date safeguarding systems and processes in place that considered the protection of human rights and protecting people from abuse, neglect and discrimination.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Assessments were undertaken to identify risks to people’s safety and determine the level of care they required. Risk management plans were in place to support people and mitigate risks to their safety. These covered areas such as medicines, mobility, nutrition, skin integrity, choking, personal hygiene, incontinence and risks related to long term health conditions.

People and their relatives told us they were satisfied with how the service worked with them to protect them from coming to harm. They confirmed they had been involved when discussing risks to their health and felt staff knew how to keep people safe. A person told us, “The carers are well trained and the service they provide to me is high quality.” A relative said, “The company completed a comprehensive care plan and risk assessment.” Another comment from a relative was, “They check [family member’s] oxygen levels and temperature.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The service carried out an assessment of environmental risks in people’s homes during the initial stages of the person’s assessment to check if it was safe for staff to work and carry out tasks. This included fire safety and environment hazard checks.

There were systems in place to ensure staff were deployed effectively across the community. Staff received rotas in advance and were clear about where they needed to be and when. They confirmed they had sufficient time to travel between visits, which helped them arrive punctually and maintain continuity of care. A staff member explained, “I work in a three-mile radius so I can travel fairly easily, either walking or taking transport.” People confirmed this, describing staff as punctual and considerate. A relative told us, “They are fairly prompt with their arrival times and [family member] doesn’t feel rushed.” Another person said, “The carers arrive on time. If they are going to be late, they call me.”

However, some people and relatives felt staff were occasionally rushed due to their busy schedules. A person commented, “They are very kind, but it is a shame they are always in a rush,” while another person said, “They do their job even if they are a bit rushed.”

We reviewed completed staff calls and schedules and found that, overall, staff were punctual and had adequate travel time between visits. However, we noted inconsistencies in logging practices, with some staff failing to log in and out of visits, and some calls being shorter than planned. The management team acknowledged these issues and provided assurance that staff performance was monitored. Where concerns were identified, such as lateness, incomplete logs, or rushed care, managers worked with staff to address these and improve practice.

The provider made sure there were enough qualified, skilled and experienced staff who received effective support, supervision and development. Staff were recruited safely, although we noted that staff references were not always easy to find or were not filed in hard copies of individual recruitment files. The registered manager took action to resolve this during our inspection.

Staff received an induction and training and were recruited safely. They had the opportunity to shadow other staff supporting people to help them get to know them and become familiar in practices and procedures. Staff told us they were supported by the registered manager and that their health and well-being was considered at all times.

They received training to equip them with the necessary skills to support people. This included training in areas such as safeguarding adults, moving and handling, infection control and person-centred care. Training in some specialist care topics was also provided where required.

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. Infection prevention and control procedures were in place. Staff received training to help them maintain good standards of infection control. Staff had access to sufficient supplies of personal protective equipment (PPE). A staff member said, “We have PPE and we follow procedures and have had infection control training.” A person said, "The staff always wear PPE and wash their hands.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened.

At our last inspection we found the provider had not always managed medicines safely. At this inspection we found improvements with medicine management.

The provider had policies in place to manage the safe administration of medicines. People’s medication administration record (MAR) charts were completed appropriately and regularly audited and reviewed by senior staff or managers.Staff told us they received medicines training and felt confident they could support people with medicines. Information about people's medicines was included in people’s care plans. Protocols for PRN (when required) medicines were in place.

Staff competency checks were carried out for staff who supported people with medicines. Some people did not require support with medicines but where they did, they told us staff were helpful. A person told us, “I take my own medicine, but the carers always ask me if I have, so they check up on me.”