Care 24-7 Limited

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 63 (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. Staff did not always listen to concerns about safety and did not always investigate and report safety events. Lessons were not always learnt to continually identify and embed good practice.

The provider did not have robust systems in place to identify emerging patterns and trends. For example, auditing and oversight tools, team meetings and learning from incidents were in place and trends were identified however, it was not always clear what actions had been taken. Key information was missing was missing from the records such as mitigating actions taken to minimise risk. As a result, information used to identify learning trends was not consistently robust. However, staff told us there was a positive culture of learning in the service.

The provider did not always work well with people and healthcare partners to establish and maintain safe systems of care. They did not always manage or monitor people’s safety. They did not always make there was continuity of care, including when people moved between different services.

The provider did not always fully document information regarding key professionals or information to ensure safe oversight and monitoring of people's care. For example, where people had mental health needs, they had care plans in place which were contradictory such as how to support periods of distressed or agitated behaviours. There was a lack of relevant escalation information to minimise risk. Professionals advised us the service generally worked well with other professionals, however, there was a lack of staff consistency. , The service did work well with other services to ensure people received appropriate care, but this was not always fully documented.

The provider worked well with people and healthcare partners to understand what being safe meant to them and how to achieve that. They concentrated on improving people’s lives or protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

There was a safeguarding policy in place. The provider escalated concerns to appropriate agencies when required, such as the local authority, and took mitigating actions to manage safeguarding concerns. However, at times, lacked important details as to how risk had been mitigated.

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

The provider escalated risk to appropriate services such as GP or emergency services. The service worked with local services such as the dementia team and reablement. However, this partnership working was not always clearly documented. For example, to support with choking risks the provider did not maintain clear records of recommendations and guidance provided by the speech and language teams. This put people at risk who had choking risk management plans in place would not be provided the correct support. One professional told us, "Care 24/7 work closely with the local GPs, pharmacies and district nurses, to manage any risks".

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 provider completed thorough environmental risk assessments and safety checks for people using the service. For example, arrangements regarding fire safety were well documented.

The provider did not always make sure there were enough qualified, skilled and experienced staff. They did not always make sure staff received effective support,

supervision and development. They did not always work together well to provide safe care that met people’s individual needs.

The provider had safe recruitment practices in place, and staff were supported to have regular supervision and appraisal. Most staff had received relevant training. However, there were some areas of training which were significantly outdated, for example, infection control training, which increased the risk to people who were supported by those staff members. Staff did not always have a full understanding of key policies and legislation important to their roles, for example, the Mental Capacity Act (MCA,2005). People we spoke with told us at times, they had to retell their story to staff, in order for them to get the right support.

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 infection, prevention and control policy in place. Arrangements to support infection prevention was well documented, including the use of personal protective equipment (PPE). People told us staff wear appropriate PPE. One person told us, " Yes, they [staff] wear gloves and aprons."

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

Medicines were not always managed safely. There was at times contradictory or missing information in care documentation regarding management of people's health needs involving medication. For example, with the use of prescribed creams. People’s personalised care plans advised they required prescribed creams to support with skin integrity, however, people’s assessments advised there were no issues with skin integrity, and no support required. We reviewed “as and when required" (PRN) documentation which lacked important details, for example, when escalation to the GP would be required. A medication policy was in place, and people did receive their medications when they needed them, and staff were appropriately trained.