Nucare Group 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 assessment we rated this key question requires improvement. At this assessment the rating has changed to good.

This meant people were safe and protected from avoidable harm.

This service scored 66 (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, 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. The management team were open and transparent and wanted to drive improvement at the service. Accidents and incidents were recorded and monitored for themes and trends. Where incidents had occurred, action was taken to learn lessons and mitigate any future risks. Learning from incidents was shared with staff through regular team meetings, communications and supervisions.

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.People’s needs were assessed before support commenced and this information transferred into their electronic care record. However, some care records required additional detail in some sections to guide staff and ensure effective information sharing with other parties. Communication between staff, people and families was timely and responsive. One relative told us, “We have a system of leaving messages. I can leave messages for them, and they will do the same.”

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 support provided by Nucare Group Limited. One person told us, “We have a laugh and a joke, and I feel safe. They always have a smile. I would recommend them to anyone.” Staff were trained and understood their roles in relation to safeguarding.Staff told us they knew how to raise a concern and were confident their concerns would be listened to and acted upon. One staff member told us, “I would document this and report this to my line manager. This would then get passed onto the relevant authorities.” Another staff member told us, “If I felt someone was at risk, I would firstly inform my care coordinator and raise a concern, even add a safeguarding (on the App). This would be followed up until we knew they were safe.” Records showed safeguarding concerns were reported promptly to the local authority and to CQC.

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. However, care records for some individuals needed additional detail or clarity to ensure staff had sufficient guidance to support people appropriately and mitigate risks. For example, one person had conflicting information in their care plan regarding pressure area care. Risk assessments were also not in place for people using paraffin-based products. This was a recording concern, and we found no evidence of harm to people. Any concerns raised were actioned immediately by the provider. Staff had completed a range of training to assist them in managing risk. One staff member told us, “One way to support people safely is to keep up with risk assessments, ensure care plans are up to date with any changes.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, and technology supported the delivery of safe care. Prior to support starting, the provider completed an assessment of the environment. This was regularly reviewed to ensure both people and staff were safe. Systems were in place to ensure checks of equipment were undertaken at regular intervals. The provider agreed to review some records to ensure service dates for equipment were also updated in care records once their service had been completed. Staff had received training in health and safety and were aware of risks associated with the environment. One staff member told us how they supported people to remain safe, “Ensure they are safe in their homes and that there are no risk factors to cause any danger.”

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. Recruitment procedures were in place, so people were cared for by suitably qualified staff who had been assessed as safe to work with people. However, it was noted that employment history for some candidates did not always provide sufficient detail or include all information from leaving school. Some of the systems for recruitment also needed review to ensure risk was fully mitigated. The provider actioned this immediately. People and relatives raised no concerns about call times, reliability or consistency. One relative told us, “I am very happy with the care, no problems at all, they are always on time, and I know every single one of them. [Name of relative] gets continuity and [person] looks forward to them coming.” Staff expressed no concerns about staffing levels, although some raised that additional time for travel between some calls would be beneficial. The provider agreed to keep travel times under review. We reviewed the electronic records of support provided and queried some call information with the provider. Documentation was provided which explained the issues noted and evidenced call monitoring was completed. Staff told us they received a comprehensive induction which included training and shadowing. This also included specific training to meet individual needs, such as specific health conditions and training around learning disability and autism. Training was refreshed at regular intervals in line with good practice guidance. Staff told us they felt well supported and were receiving regular supervision and support with their wellbeing.

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. Staff received training in infection prevention and control (IPC) and policies were in place to manage the risk of infection. No concerns were raised by staff, people or families about the availability of personal protective equipment (PPE) or the management of infection.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. However, some medication records for timed medications did not show the actual administration times, making it unclear whether doses were given in line with prescribed guidance. For example, medicines to be given half an hour before food. Guidance for staff on administering medication for people with a PEG (Percutaneous Endoscopic Gastrostomy) also required further clarification to ensure safe and consistent practice. These were recording issues, and we found no evidence of harm to people. Risk assessments for paraffin-based creams were also required to address the potential hazard of these products transferring onto clothing and increasing flammability. The provider acted promptly to address all these issues. Staff were trained in medicines administration, and their competency had been assessed. People were supported by staff who followed systems and processes to administer, record and store medicines safely. People and their families told us that they received their medicines as prescribed and on time. One relative told us, “They see to [person’s] medication which is arranged daily in packs to ensure it is safe.” Another relative told us, “The timing of [person’s] food is so important as [person] has to have insulin 20 minutes before. The insulin arrives at 5.45 so they come in at 6 for [person’s] tea visit and it works.” The provider had a medicines policy, and this included the principles of STOMP (stopping over-medication of people with a learning disability, autism or both). People were supported with their medicines in line with the policy.