Bowtree Homecare 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 75 (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 provider had systems in place review and investigate accidents, incidents and safeguarding concerns. The registered manager told us team meetings were used to discuss any areas they felt needed a lessons learned or improvement action. Staff said they would report any concerns and were confident the provider would act on their concerns. One member of staff told us, “I will always speak to [registered manager] or [care coordinator] if I have a safeguarding concern. If they can't help, they have taught me to contact CQC or Lancashire council safeguarding team.”

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 prior to them receiving a service. This ensured the service was able to provide the necessary safe care and support to people. One relative told us, “I was involved at the outset of care. That plan has evolved with minor changes, but I am comfortable that I can discuss at any time with the team if I had any concerns as well as being able to read the documents lodged at my mother’s residence.” The registered manager explained that people’s care plans would be available should they be admitted to hospital. They said, “Care plans will go to hospital with people. A hospital passport is in place in the file in people’s homes, this includes information on their medication and care 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 were supported by staff who had the knowledge and confidence to identify safeguarding concerns and act on them to keep people safe. One staff member told us, “I have no concerns with staff care practices. I can raise any concerns with the office staff for advice. I am confident they would take action if I raised any concerns. I haven’t had to raise any concerns.” Clear policies and procedures were in place to inform staff of the processes they needed to follow should they suspect abuse had taken place. Staff received training in the safeguarding of vulnerable adults and training records confirmed this. A family member said, “My mother is treated with a huge amount of patience given her frustrations at her condition, and I certainly do not concern myself about her safety in anyway with the care they provide.”

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.

People’s needs were assessed prior to them receiving a service. Care plans provided guidance for staff to ensure people received safe and responsive care and support. Risks were assessed and mitigated to keep people safe. Risk assessments were person centred and regularly reviewed. A staff member told us, “I feel very safe at work and the clients are kept safe by having person centred care plans and risk assessments in place. If ever I am not sure about anything I can ring [registered manager] or [care coordinator] and they will help me.” A relative told us, “The care and support provided by Bowtree has been first class and tailor made to meet my mother's needs. We feel that we can trust the staff of Bowtree and know they will keep my mother safe.”

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 were in place to ensure staff were safe whilst supporting people. Where people required the use of aids for safe moving and handling, risk assessments were in place to support staff to be able to use this equipment safety.

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.

There were appropriate staffing levels and skill mix to make sure people received consistently safe, good quality care that met their needs. Comments from people included, “My mother usually has the same carer on the same day each week and knows who will be coming. The staff are caring and friendly and the management team take particular care to provide a tailor made, personalised service.”

Staff received training appropriate and relevant to their role. Staff received an induction when they started working for the service and additional core training. Staff’s training was recorded and monitored by the registered manager and office staff to ensure they remained up to date with their knowledge and skills.

There were robust and safe recruitment practices to make sure that all staff were suitably experienced, competent and able to carry out their role. Disclosure and Barring Service (DBS) checks were carried out. These provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

Staff received the support they needed to deliver safe care. This included supervision, appraisal and support to develop and improve services. To support staff’s wellbeing the registered manager had introduced a wellbeing checklist to complete with staff and a space in the office for staff to be able to come and sit and catch up with each other or senior staff.

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.

There was an effective approach to assessing and managing the risk of infection, which was in line with current relevant national guidance. There was a policy in place and training for all staff. Unannounced spot checks were completed to ensure staff were wearing the appropriate PPE. Staff told us they had access to appropriate PPE (Personal protective equipment). One member of staff told us, “Infection control is managed by me being provided with the correct PPE. And assisting clients to maintain a clean clutter free environment. I will always dispose of my PPE in the correct way and in the correct bin. I will wear my gloves and apron. If my client wants me to wear a mask I will do. I am also provided with hand sanitiser. I can top up my PPE box when things get low. Bowtree provide all of my PPE.”

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

Appropriate arrangements were in place for the safe management of medicines. People received their medicines as prescribed. Staff received the necessary training and had their competencies assessed before being permitted to administer medicines. The provider completed regular checks to ensure people received their correct medication on time and in a safe way. Unannounced spot checks were completed to ensure staff were administering medication safely and correctly. One staff member told us, “It is in the care plan what medicines people have. We have a MAR (medication administration record) sheet we need to sign once we have given medication. I had to complete training before being able to give medication.”