Radfield Home Care Leicester East, Groby & Oadby Also known as Amison Wellbeing Services 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. This is the first assessment for this service. This key question has been rated 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 an incident reporting system that staff understood and followed. Staff knew when and how to report falls, accidents or any changes to the person’s wellbeing. Staff maintained records of incidents so follow up action could be taken to reduce further risk. When asked about incident reporting following a person having a fall a staff member told us, “Firstly I make sure they are ok, if they are not then I call an ambulance or 111, inform the office and fill in an incident form." They knew what information was required to be recorded to support learning and improvement.

The provider maintained an incident log and recorded what happened, and action taken to reduce further risk. Records showed people and or their relatives were consulted and involved in the consideration and implementation of further risk reduction interventions.

The provider analysed all incidents, accidents, complaints and safeguarding referrals. They looked for trends or patterns contributing to these risks.

Quarterly reports were produced with data of all accidents and incidents along with the learning outcomes and how these would be shared. For example, recording errors for medicine administration were identified (though no harm or missed medicines had occurred). Changes were made and these were communicated to staff through team meetings, individual staff feedback and weekly operational meetings. This action resulted in fewer recording errors and improved staff practice.

A ‘lessons learned’ template document was used to review individual incidents or accidents. This facilitated a review of what worked well and what did not. An ongoing action plan reduced any further risk.

The provider attended monthly meetings with the franchise group partners and compliance managers to discuss learning from incidents and best practice within the wider sector.

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 told us they received care and support from a consistent staff team who knew them well and understood their needs. People and their family members (where appropriate) were involved and consulted at assessment, care plan development and review. People’s family members were kept up to date about any changes. They told us communication was good.

When people began using the service, staff had access to care plans and information about risks and safety before visiting them. They were accompanied on the first visit by an experienced staff member, so they could be introduced and trained about the person’s needs and preferences.

The provider had electronic systems for monitoring calls attended and care and support provided. Systems alerted the office team to any missed calls, missed medicines or activities so action could be taken quickly to ensure people were safe and had their needs met.

The provider ensured staff understood policies and procedures designed to keep people safe through training, supervision, staff meetings and policy updates. Staff understood professional boundaries and the limits of their role. They only provided care and support they were confident and trained to deliver. Staff requested and received support from managers when they needed it. They told us they were encouraged to do so.

External professionals gave positive feedback about the service. They told us communication was good. They gave examples of how the service had positively impacted a person with increasing mobility needs. They worked with the person and supported them through the changes with emotional support. An occupational therapist said, “We worked jointly to analyse moving and handling processes and agree to changes in equipment and levels of care”

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 told us they felt safe. One person said. “The carers are all delightful. I feel absolutely safe”.

The provider had a policy in place about protecting people from abuse and avoidable harm. Staff had training about safeguarding and understood their responsibilities. They knew how to recognise the signs of abuse and what action to take. Staff were confident their managers would take immediate and appropriate action if they raised a concern.

A staff member said, “It’s about making sure the person is protected and safe in their environment. If there’s any concerns, then we action that and take it higher in their best interests.” They gave us an example of when the service made a referral to the local authority safeguarding team when a concern was identified.

Protecting people from abuse and how to raise concerns was an agenda item at every staff supervision session.

People were supported to understand their human rights, rights under the Mental Capacity Act 2005 and their rights under the Equality Act 2010. These were promoted and protected.

The Mental Capacity Act is the law in the England and Wales that protects individuals who lack the capacity to make specific decisions regarding their care, finance or treatment. It gives people an opportunity to make their own choices where possible.

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 and their family members told us staff were alert to risks. They took appropriate action to keep people safe while also respecting their freedom and choices. A relative told us how staff used equipment in a safe way.

Risks were assessed when people began using the service and were reviewed during visits, care and support reviews and staff competency checks. People and staff were involved, consulted and listened to. Where risks were identified, risk management plans were developed for staff to follow. Records showed staff followed these plans and consulted with appropriate healthcare professionals such as occupational therapists or other professionals as required.

In the event of an accident or near miss, people’s views and preferences were taken into account and used as part of care planning. For example, care plan reviews were carried out where a person’s mobility was decreasing, so additional or alternative support methods could be explored. These included consulting with people’s family members (where appropriate) and with healthcare professionals such as occupational therapists.

Managers had a clear oversight of risk, peoples changing needs and new emerging risks. They took swift action and kept people and staff updated. Staff were updated through meetings and care plan updates. Staff were also updated via email about any immediate changes they were required to be aware of or respond to.

The provider gave us an example of action they took following identification of unsafe moving and handling they identified during an assessment. They consulted with the person and their family members and with healthcare professionals to ensure the correct equipment was provided to promote the person’s comfort and safety

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 carried out before any care and support was delivered. These were recorded with a risk rating and agreed actions for staff about how to manage risks.

Where people used mobility equipment, referrals were made to an occupational therapist.

Records showed action had been taken after consultation with people and or their family members to increase environmental safety such as replacing furniture or requesting mobility support equipment.

Each person had a fire risk assessment setting out any hazards to consider and what action staff should take in the event of a fire.

Health and safety risk assessments were reviewed at least every 3 months.

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.

People told us they had confidence in the staff who supported them and described them as competent, reliable and skilled. One person said, “Their skill levels are very high. All of them are good company and quite happy to help.” A relative told us, “They have never missed a visit. If they’re going to be late, they keep me posted. It was only once due to road traffic. Usually, they are on time. They absolutely stay and get everything done. I’m not rushed by them.”

The provider had effective systems in place to monitor call times. Staff were required to log in and out of each visit using an electronic recording system. This enabled managers to identify any calls that over or under ran and investigate why. Information from this monitoring was used to ensure people continued to receive the right amount of time to meet their needs safely and appropriately. There had been no missed calls in the last 12-month period.

Staff told us they had enough time to spend with people and to travel between calls. They received the training and support they required. A staff member said, “I feel supported, they are always there if I've got a problem or I need a problem solving. They come out every few weeks to check things such as using personal protective equipment properly. We have supervision in the office, but we can go into the office any time we need help."

Staff received induction training when they first commenced employment, and ongoing training to equip them for their role. They had supervision with their line manager to discuss any training or support needs. They had their competency checked to ensure their practice was safe and they were following the provider’s policies and procedures.

New staff shadowed experienced staff until they had the confidence and competence to work independently. A newly recruited member of staff spoke positively about the training provided. They told us the training was well organised with a mixture of online and face to face. They said they were learning a lot and felt equipped to meet the needs of people using the service.

A rota to cover last minute staff absence was in place. The provider sent us their analyses of call times planned and attended for the last 3-month period. This showed staff attended calls at the planned times or within 15 minutes and stayed for the expected duration. Any deviations such as staff staying for less than or more than the planned time were closely monitored and investigated for reasons and consideration of review of the person’s needs or preferences.

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.

People told us staff took action to prevent the spread of infection and maintained good hygiene routines. They wore appropriate personal protective equipment (PPE) and practised good hand hygiene.

A person told us, “Staff wear aprons and gloves every time. They change them and wash their hands. They put used things in a bin and put it downstairs to take to the main bin. They are good at hygiene and clean the shower.”

Another person said, “They wear an apron over their uniform and plastic gloves as well. They keep my place dusted and disinfected. Anything I ask, they do it. They do wash their hands and change their gloves. They put creams on their hands after washing them. They put used things in a bag and put it in the bin.”

The provider had policies about manging the risk of infection which met nationally recognised standards of good practice. Staff had training and understood their responsibilities.

A staff member told us they always had access to PPE. They said, “When I come in, I wash my hands, put PPE on after personal care after each cream and meds, and before and after administering medication, before starting to do food, between tasks, when taking rubbish out”. They knew how to safely dispose of different types of waste.

Staff were alert to additional safety checks and processes for a person with a compromised immune system. This was detailed in the care plan and staff knew how to recognise signs of infection and when to consult with healthcare professionals.

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.

People who required staff to support them with medicines told us staff did this well. A person said, “I take my own medicines. They (staff) give me water and check I’ve had the tablets. They record it.”

Another person said, “Yes, they help with medicines. They put them in an egg cup and give with water. They watch to see they’re taken and put it in their notes. In the evening, they give two paracetamols. They called the pharmacy and let me know if medicines are getting low. My blood pressure medication was updated after the Hospital informed us and them.”

Staff had training about safe medicines management and had their competency assessed. They told us they were confident and knew what to do. If they required additional support, they called the office and spoke with a manager.

The provider had good oversight of people’s prescribed medicines. The provider carried out weekly medicine audits to check people received their medicines as prescribed and in a safe way. Any errors in recording were discussed with staff during team meetings and through individual staff feedback so their practice could improve.

Procedures were in place for the event of a medicine error. Staff identified a risk a person may not be taking all their prescribed medicines at the correct time so additional safety measures were put in place.

Medicine records we reviewed were accurate and up to date. Staff recorded the exact time a medicine was administered to ensure they were given at the correct time and any required time intervals between doses were adhered to.

Body maps were used when topical medicines such as creams applied to the skin or patches containing medicines were prescribed. This meant staff knew where to apply these medicines correctly.

The provider had a medicine policy which adhered to best practice guidance and the principles of safe medicines management. Risk assessments were carried out to ensure the level of support provided by staff to ensure effective and safe management was correct. The provider’s medicine policy and procedures were comprehensive, included risk assessment, and promoted people’s independence.