Minster 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

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 good. At this assessment the rating has changed to 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 regulations in relation to the recruitment of staff and the governance at the service.

This service scored 56 (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 did not always have a proactive and positive culture of safety and learning. Lessons were not always learnt to continually identify and embed good practice. Incidents, accidents and safeguarding concerns were identified and recorded appropriately. These were analysed to look for trends and identify learning, but there were some gaps in this analysis which had not been identified.

The quality of the service had declined since our last inspection. Effective quality assurance processes were not in place to support continuous learning. However, the provider and new manager were responsive to feedback. They were committed to learning from the findings of the assessment and from their own recent reviews of the quality of the service. During the assessment process the provider created a comprehensive action plan, and the new manager implemented multiple changes including audits to support improvements. Learning was shared with staff in various ways such as meetings, one to one supervisions, and staff quizzes.

The provider did not always have effective systems in place to make sure there was continuity of care, including when people moved between different services.

Staff were not always provided with full information about people’s care and treatment. For example, information and risks about medicines administered by district nurses were not always documented for staff to be aware of. Not all information from other professionals’ assessments of people’s needs was clearly and consistently recorded for staff. We found no impact and the service was in the process of reviewing and updating all care plans and risk assessments to ensure all relevant information from other professionals was incorporated.

The new manager was in the process of implementing emergency health passports for all people using the service. This document contained all relevant information to support the safe transition of people between services. The provider had an on-call system in place to aid effective communication across the service at any time, including if people were to access other healthcare services during the evenings and weekends.

The provider generally worked well with people and healthcare partners to understand what being safe meant to them and how to achieve that. Although safeguarding concerns were generally identified and actioned appropriately, the provider’s oversight of the management team had not identified gaps in safeguarding analysis or concerns with the management of the service.

There were some gaps in people’s support plans around risk and ensuring their safety. However, there was no evidence of harm or impact identified during the assessment, and the new manager was in the process of reviewing all care plans and risk assessments.

Staff had received safeguarding training and understood how to recognise potential concerns and what actions to take. One staff member told us, “I understand safeguarding to be about protecting people from harm, abuse, or neglect, and I would not hesitate to report any concerns immediately to the manager or safeguarding lead."

The provider did not always work well with people to understand risks and how to manage these. Risk assessments were generally in place where required, however, these were often generic and not always person-centred. They often contained information which was not relevant to the person. This could potentially cause confusion for staff. It was not clear how people were involved with their risk assessments to ensure they were centred around each individual person. We found no evidence of harm and the provider was in the process of reviewing and updating all support plans and risk assessments.

The provider detected and controlled potential risks in the care environment. The provider carried out environmental risk assessments before the commencement of any care package to ensure the safety of staff and people. Staff completed fire drills and knew what to do if there were any issues in the environment such as with water, gas and electrics. Key information was provided to staff within support plans and within people’s homes.

The provider did not have a fully robust recruitment process in place to ensure that all required information about potential employees was obtained. For example, information required by regulation was not always gathered, such as potential employees’ full employment histories and qualifications. We found no evidence of impact from these omissions and people told us the staff were competent to meet their needs. One relative told us, “We are comfortable with the staff, and they are well trained.” The provider did carry out the necessary police and Disclosure Barring Service (DBS) checks. The provider amended their recruitment procedures to ensure they were in line with regulation going forward.

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. The provider had an up-to-date infection prevention and control (IPC) policy in place and staff had received appropriate training and understood their responsibilities. Staff consistently told us they always had access to the necessary PPE to enable them to carry out their roles safely in line with the IPC policy.

Medicines were generally managed safely, however, we found one example where staff were not always able to administer time-critical medicine due to the timing of the care calls. This had not been identified in audits. The provider addressed this following our feedback.

Staff were trained and assessed as competent to administer medicines and support people with their medication needs. They had access to a comprehensive policy and support from senior staff. Medication administration records had been completed accurately and where medicine had not been given for any reason this was recorded, including where people refused. Care plans included risk assessments relating to medicines and information about people’s choices. Where people were prescribed medicines ‘when required’ protocols were available for staff to follow.