Biliv Care 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. This is the first inspection for this service. This key question has been rated 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 regulation in relation to safe care and treatment.

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 had a positive culture of safety based on openness and honesty. The provider had systems and processes for staff, people and their loved ones to report any concerns, incidents, accidents and complaints. The system recorded events and the registered manager investigated them. The registered manager would apologise and recognise where improvements could be made. However, learning from incidents and complaints was not always clear to demonstrate what actions had been taken to minimise the risk of them happening again. Staff understood the importance of reporting safety concerns and told us the registered manager was always quick to respond and very supportive when dealing with any issues that were raised. People and their relatives knew who they needed to contact if they were unhappy or had any concerns about people’s care. A relative told us, “We are always informed of any health issues or concerns relating to my family member.”

The provider worked with people, their relatives and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was a continuity of care, including when people, for example, were admitted into hospital and discharged back to their home. One person told us, “Last year [staff] was absolutely lovely and phoned for an ambulance and good job he did I had an awful infection and was there (in hospital) for 2 weeks. I had to have rehabilitation first for 6 weeks (when discharged) then when I could have a proper company and who I liked, I asked for Biliv again and was very happy I got them back.” Systems were in place to support the continuity of care, with information obtained from people and others involved in their care. This was used to develop individualised care and risk management plans to ensure people received safe and appropriate 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 the quality of 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 with the local authorities.

People told us they felt comfortable with the staff coming into their homes and relatives told us they felt their loved ones were safe. One person told us, “Oh goodness, most definitely I feel safe.”

The provider shared concerns appropriately with the relevant agencies. Staff had received safeguarding training and knew how to report any safeguarding concerns they might have. One staff member said, “When it comes to safeguarding, if I saw any form of abuse I would make sure I would raise with the management and I'd tell my supervisor. I'd document it and follow up through my supervision to make sure it has been looked at and if it wasn’t, I would report my concerns to the CQC.”

The provider had a safeguarding policy.. Safeguarding concerns and complaints had been fully investigated and responded to. Though the provider was not aware of their legal obligation to submit required statutory notifications to CQC, these were submitted in response to our assessment.

The provider worked with people to try and understand and manage risks by thinking holistically. However t risks associated with some specific medical and health conditions were not always understood, assessed or managed. For example, there were no risk assessments or clear instructions for staff to manage risks related to diabetes,, Parkinson’s, stoma, catheters, dyspraxia and people who had experienced a stroke. Care plans lacked information to , provide staff with the relevant information and guidance to follow to support people safely.

Two care plans referred to staff supporting people with glucose readings and monitoring sugars. However, there were no risk assessments or guidance for staff on how to do this. This increased the potential risk of staff not understanding or misinterpreting what the safe levels were for people and what action should be taken in the event of levels falling below or above what was safe for people.

People told us the care they received supported their needs and staff we spoke with were able to tell us how they cared for and supported people safely.

The provider had processes to detect potential risks in people’s home environments. The provider helped people ensure equipment used in their homes had been serviced and contacted relatives when equipment was not working or damaged.

The provider completed an environmental risk assessment before people started using their service. This included potential risks related to using equipment, slips, trips and falls risks. The assessment would also include outside the person’s home including car parking and street lighting.

Staff were not always recruited safely. Information relating to past employment records for 1 member of staff was not accurate. A reference was received for them from an employer that was not listed on their application form. On 2 staff records it was not always clear if the police checks (DBS) had been completed prior to the staff starting their employment. Staff shadowing and induction records for 2 members of staff were not consistently signed or dated by a manager, so it wasn’t clear whether they had completed their induction successfully before providing support to people.

Staff told us they received training which provided them with the knowledge they needed to deliver safe care. However, training for specific medical and health conditions had not been offered or completed by staff.Some staff had not updated their training since 2023 and there were discrepancies in training and competency completion dates. This meant we were not assured staff training was up to date and that their competencies were assessed. In response to our assessment, the provider took action to prioritise improvements to staff training and their recruitment process.

The provider made sure there were enough staff on duty to support people. People told us they would usually receive support from the same staff, demonstrating some consistency, which they liked. One relative told us, “[Person] has regular carers and there are no issues with their timekeeping. They are very good, they schedule their visits to fit in with [person] schedule so they come at the best time for [person] to have the support they need.” People told us they were not rushed and staff had enough time to provide the care and support people needed.

The provider assessed and managed the risk of infection. They controlled the risk of it spreading by providing staff with a sufficient supply of appropriate personal protective equipment. All staff were trained in infection control and effective hand hygiene. People and relatives did not have any concerns regarding the infection control practices carried out by staff.

The provider had processes that supported people to take their medicines and treatment in a safe way that met their needs, capacities and preferences. People told us they were involved in planning, including when changes happened.We found people’s day to day medicines were well managed with the provider completing regular medication audits and completing spot checks on staff.