Absolute Care Agency (EM) Limited - Quorn

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 good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 69 (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, and these were shared with staff. Robust records were kept in relation to the actions the provider took in response to safety incidents, and these demonstrated appropriate actions had been taken. For example, referrals to external agencies following falls or requests for reviews of equipment where staff felt these no longer met people’s needs safely. A staff member told us, “The management team are very good at listening to us when we raise concerns. I can contact the office or on-call, and they give me the guidance I need.” This support and learning culture enabled staff to have the appropriate knowledge they needed to keep people safe.

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 procedures in place to ensure people’s transition to and from other services was well-managed, involving people, their families, and relevant healthcare professionals. Relatives described how the managers undertook in-depth assessments of people’s needs and wishes before providing a service. Their comments included, “We all sat together and went through a plan of what we would like to see happen” and “Staff came and did an assessment visit and we went through [Name’s] needs and [Name] as a person. They made sure they could commit to the time to give [Name] the care they need.”

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 and their relatives told us people felt safe with staff. A relative told us, “[Name] does feel safe with staff. I find it reassuring that I can look at care notes on the app (digital care plan).” The provider had policies and procedures in place that supported effective and timely safeguarding. Staff demonstrated they understood abuse, potential symptoms and what they would do should they suspect abuse had occurred. A staff member told us, “If I had concerns, I would contact the office immediately and I know they would respond. I would back this up with an email and let the family know if appropriate.”

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. Relatives told us, “I do feel staff manage risks well. If there are any concerns of any kind they will call me. [Name] had a bed sore in the past and staff managed this along with the district nurse” and “At the beginning, staff assessed what [Name] needed to be safe. Everything is in place now and staff know how to use the equipment.” People had assessments in place that identified risk and actions to mitigate these. However, we found some risk assessments required further development to ensure they were not generic but specific to each individual person. The registered manager told us they would address this following our site visit.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People’s care plans included information for staff regarding potential environmental risks, such as location of emergency utilities and any known risks, including pets and access to people’s homes. Relatives told us staff accessed and left people’s homes safely. A relative said, “Staff access the home via the key safe and always leave the key back there.”

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. However, several people and relatives expressed concerns around the lack of consistent staff and late visits, and this was confirmed in our review of records. Whilst the provider made efforts to inform people of their lateness, this meant people were not always receiving care at consistent times and could not guarantee support would happen when they wanted it. References made by people and relatives included, “There hasn’t been a time where staff miss a visit, but there has been a pool of late slots. Staff don’t communicate if they are running late,” “There has been times when staff have had a lot of sickness and they come too late. For example, sometimes staff are late and they don’t always let us know and then that means [Name] can miss medication and a meal for that time” and “I feel like they get stretched at times. There was one occasion when staff didn’t get [Name] out of bed until 11:30am. There is the odd time when they are late. However, they do stay for the visit time, and I don’t feel they rush [Name].” The provider had completed their own analysis prior to our inspection and had recognised the need for improvements around staff consistency and timely visits. They had started to take action to address this including reallocation of staff, changes to travel times and recruitment of more staff. These improvements were not fully embedded at the time of our inspection. Staff provided positive feedback around training and support. They told us, “My training was very good, and I learned a lot from it which I use in my role” and “The service has an exceptional training programme, and the office are always on hand to help. We have regular supervision and support”. Staff were recruited safely. We saw documents to confirm that Disclosure and Barring Service(DBS) checks were part of the recruitment process along with the necessary references and right to work checks. DBS checks provide information about convictions and cautions held on the police national computer. The information helps employers make safer recruitment decisions.

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 and relatives felt staff were skilled at protecting them from the risk of infections. They told us, “Staff always leave the home tidy. They wear gloves and aprons to help prevent infection.” A relative described how they had requested staff to wear face masks due to an escalation of respiratory viruses to help protect their family member. We saw staff had complied with this request and the person’s care plan had been updated to reflect this.

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. Staff were trained in medicines administration, and their competencies were regularly assessed. People’s care plans included detailed information and guidance for staff to follow when supporting people to take their medicines, including any specific risks or potential adverse effects. The registered manager had completed audits to ensure medication administration records (MARs) were accurate and medicines were given on time. People and relatives felt staff supported people to take their medicines safely. Comments included, “Staff manage medication well. [Name] receives it when they need it and staff make sure they have eaten before they take the medication, which is a requirement” and “Staff prompt me to take my medicines at the time I need to.”