Caring Partners Healthcare 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 remained 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.

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.

The provider did not always have a proactive and positive culture of safety based on openness and honesty. Lessons were not always learnt to continually identify and embed good practice.

At our last inspection we found systems had not been implemented to review incidents and accidents to make sure action was taken to prevent recurrence. At this inspection we have found some improvement has been implemented, however, further improvement is required.

Incidents and accidents had been recorded on the provider’s electronic care planning system. Good details were provided of what had happened and what immediate actions staff had taken to make sure people were safe. However, the management review of all incidents was inconsistent and there was a lack of detail available on follow up actions or risk mitigation. For example, one person had experienced a number of falls. The registered manager told us the actions they had taken such as liaising with the person’s GP, but these conversations had not been recorded. Another person had an incident as they stood up when using a specialist chair, which put them at risk of falling. There was no record of the management review of this incident, or details of actions put in place to mitigate risks. Staff told us they knew what action to take as management had shared this, however, there was no record of these conversations.

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.

The provider had a policy to give staff guidance on how to support people safely in the event of admissions to hospital. The registered manager told us if people were in hospital for a period of time, their needs would be re-assessed before care was started.

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.

Staff were provided with training on safeguarding adults and children. Staff we spoke with understood their responsibilities to report any concerns. Management had completed safeguarding for managers training and understood their role in keeping people safe.

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

At our last inspection we found a breach of regulation for safe care and treatment as the provider had not assessed risks to keep people and others safe. At this inspection we found improvement had been made so the provider was no longer in breach of this regulation. However, further improvement was required in some areas.

Risks to people’s safety had been identified and there were risk management plans providing staff with guidance on supporting people safely. However, some plans lacked detail and needed more personalised information. For example, one person required a modified diet and whilst there were some details recorded about how to prepare meals, further information was needed. There was some information in this person’s risk management plan to help staff support behaviour. However, this also lacked detail and needed more information.

The registered manager told us they would review the risk management plans and add details without delay. Following our site visit the registered manager provided evidence that some risk management plans had been updated.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

Guidance for staff on using equipment safely was not always recorded. For example, one person used a specialist chair. There was no guidance for staff on how to use this chair safely. Staff we spoke with knew the person and were aware of what they needed to do, however, the instructions were not recorded. For another person we found staff had guidance on using a wheelchair to support their mobility. There were no further details on what type of wheelchair this was or the type of support staff needed to provide.

The provider had an environment risk assessment for people’s homes which assessed hazards people faced. For example, details of the fire exits had been located and recorded.

At our last inspection we found a breach of regulation for recruitment of staff. At this inspection, we found this had improved and the provider was no longer in breach of regulations. However, further improvement was needed. For example, the provider had obtained employment histories for staff and obtained references before staff started work. However, for 1 member of staff we found a reference had been obtained from an employer not recorded on the application form. The registered manager said they would review the employment history with the applicant.

Staff had been provided with an induction which included training and shadowing more experienced staff. Staff had supervision and told us this was a good opportunity for them to talk with management about their work.

The provider carried out spot checks with staff to make sure they were working to the standards required. However, we found actions identified during the spot checks had not always been actioned. For example, a member of staff had been identified as needing more guidance on safe moving and handling techniques. Management had shared guidance with the staff member, but they did not have assurance the member of staff had read this guidance and understood what they needed to do. The registered manager told us they would follow this up with the staff member immediately.

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 had plenty of personal protective equipment (PPE) and had been provided with training on infection prevention and control guidelines. People and staff confirmed PPE was being used appropriately when staff were working in people’s homes. People told us staff kept their homes clean and tidy whilst they were carrying out their visits.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. People’s medicines care plans did not always reflect the levels of support staff were providing. For example, staff was prompting one person to take their medicine, but this was not recorded in the medicines care plan. There was also specific action to take to help this person store their medicines safely, but this also was not recorded. Staff we spoke with knew what to do to support this person safely, however, medicines care plans should give details on levels of support required. This makes sure staff have all the guidance they need to provide safe support.

Staff had training on medicines management and staff said this prepared them to manage medicines safely. One member of staff said, “I did the training and I feel confident to administer medicines. We do tests after the training and that was thorough. Before you administer medicines you check the [electronic system], it tells you everything you need including the colour of the tablet.”

Whilst staff were provided with training to administer medicine the provider had not always assessed staff competence in a timely way. When carrying out spot checks if there was medicine being administered management carried out observations of staff practice. This system was not robust and did not capture newly trained staff consistently. The registered manager told us they would implement competence checks without delay.