Candlelight Homecare Service Limited (East Sussex)

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 66 (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.

There was a system for reporting accidents and incidents. These described what had happened, any investigations that had taken place and actions taken. Staff understood how to identify and report safety concerns. Some incidents were related to staff whilst at people’s homes. There was evidence of measures that had been implemented to reduce the risks. Staff were updated when any risks or concerns were identified.

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 sure there was continuity of care, including when people moved between different services.

Before people started using the service an assessment was completed to ensure their needs and choices could be met by the service. This included preferred times of visits, staff knowledge, and skills and to ensure there were enough staff to support the person.When people started using the service were, staff who would be supporting the person were informed about changes to their schedule. There would be first visit information of what support the person needed and a general information about the person their needs, preferences, and choices. As staff got to know people a more detailed care plan would be completed to guide staff.

However, the registered manager told us that during 2025 the provider had purchased another company which was to be run from Candlelight Homecare Service Limited (East Sussex). This included an increase in the number of people who required support and the amalgamation of staff from both Candlelight Homecare Service Limited (East Sussex) and the purchased company. This transition had not been a success and had caused distress to some people, their families, and staff. At the time of the inspection these issues had generally been resolved. Whilst the registered manager and nominated individual spoke about their learning from this transition, we did not see evidence about understanding at the provider level which would reduce the likelihood of reoccurrence.

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.

There were systems in place to ensure people were protected from the risk of harm, abuse, or discrimination. There was a safeguarding policy which was accessible to staff. Staff received safeguarding training and this was updated regularly. Staff understood the importance of safeguarding. They knew how to identify and report any concerns. Staff told us in the first instance they would contact the staff in the office. If this was not appropriate, they would contact the local authority safeguarding team. One staff member told us of their experience of witnessing abuse. They said, “I saw it and so I reported it straight away.” Where safeguarding concerns had been identified, the registered manager had taken action and worked with the local authority to support any investigations and outcomes.

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.

People and their relatives told us they felt safe with the care and support provided. One relative said, “I feel [name] is safe with them, they both communicate well and the carers flagged up that [name] needed an additional [safety equipment] to make it safer for him.” One person told us, “I certainly feel safe and get on well with the [staff].”

Staff knew people well and understood the risks associated with their care and support. Staff told us how they supported people safely. They were able to tell us how risks to people were managed in relation to skin integrity, mobility, personal care, and nutrition. However, this information was not always in people’s care plans and risk assessments to ensure people’s care was safe and consistent.

Care plans and risk assessments did not include all the information staff may need. People received support with personal care but there was limited information in care plans and risk assessments about managing their skin integrity. Care plans and risk assessments did not identify if people were at risk of developing pressure damage. There was no detailed information within daily notes to demonstrate people’s skin remained healthy.

There was a lack of evidence of how one person was supported to manage their constipation. Records showed that a laxative was offered and sometimes taken other times declined. Daily notes did not state why the person had declined the medicine or what the person’s constipation status was. This could leave them at risk of poor health if their condition was not managed safely. The registered manager and nominated individual told us they would work with staff to help improve and develop care plans to fully reflect people’s needs.

However, staff told us a small team of staff visited each person regularly. This helped ensure people received consistent care and helped to mitigate the risks to them. One staff member told us, “I always check people’s skin integrity, it’s the first thing I do when I go to someone. It also shows if they are in danger of abuse from bruising.” Another staff member said, “I always look, it’s something you just do.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Staff completed an environmental risk assessment before care and support was provided. Staff told us as part of the assessment process they would ensure people’s homes were a safe place in which to provide care. This included external access to the home and how staff would gain entry. Checks were made externally and internally for any hazards, such as trip hazards or any animals that staff would need to be aware of. Where possible changes were implemented to mitigate risks as much as possible whilst also respecting people’s individual preferences. Checks were made to ensure smoke detectors were in place and people offered the opportunity for a referral for fire safety checks.

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.

We had been made aware of concerns related to staffing numbers, including late or missed calls. Most people told us they received the support at the times they needed it. One relative told us, “[Name] really appreciates the carers, but they do seem very short staffed since the merger.” One person told us, “Timekeeping can be a bit odd but it’s OK most of the time, and generally I will get a call if they are going to be late from the carers but not the office.”

At the time of the inspection there were enough staff to support people safely. The registered manager told us that following the merger, there had been staffing issues. This was due to an increase in the number of people requiring support and a number of staff leaving the service. Whilst this had now been resolved, there had been an impact on both people and staff.

There were processes to ensure staff were recruited safely. This included references, employment history, appropriate checks for staff from overseas to ensure they had the right to work at the service and Disclosure and Barring Service (DBS) checks. DBS checks provide information including details about convictions and cautions held on the Police National Computer. When staff started work at the service, they completed a period of induction, and they commenced their training. This included a period of shadowing where they worked with more senior staff to understand the day to day running of the service and meet people who they would be supporting.

There was a training program which staff completed. This was face to face training but was moving to an online platform. Staff told us they valued the face-to-face training as it was able to truly reflect the people they supported. Some training was continuing to be provided face to face. This included moving and assistance, medicines, and basic life support. This was provided as a group or one to one as required. In addition to the providers mandatory training staff received further training that was relevant to the people they supported.

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 protected them from the risk of cross infection. One person said, “They always wear uniforms and use the correct aprons and gloves.” Staff received infection prevention control training and had access to essential personal protective equipment (PPE). Staff told us there was always plenty of PPE available. Contingency measures that were in place in case of any future outbreaks. There was observation of staff practice in relation to their individual practice, this included the use of PPE and hand hygiene.

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

People told us their medicines were managed safely. One person said, “We are happy with the way they give and supervise the medications – we haven’t had any mistakes.” Where medicine errors had occurred, these were addressed by the registered manager and included further training for staff.

Some people had been prescribed medicines to take ‘as required’ (PRN), for example, pain relief. There was limited guidance about when, why, and how often this medicine may be required. There was no information about what actions to take if it was not effective and records did not show if the medicine had been effective. We raised this with the registered manager as an area to be improved. Despite this staff demonstrated they understood PRN medicines. They were able to tell us when and why they would give the medicine. One staff member said, “I will ask and look at person, check their capacity and follow up at the next visit.” Another staff member told us, “I always check what medicines have been given previously before I give the next dose.” For people on medicines which required regular monitoring we saw these checks were carried out to ensure medicines were dosed appropriately.

Staff were knowledgeable about people and their medicines. They were clear about their roles and responsibilities. One staff member said, “With medicines, I check and double check.” This helped ensure people received their medicines safely.

Systems were in place to ensure medicines were managed safely. Staff received medicine training and were assessed as competent before they supported people with their medicines. Staff competency was regularly re-assessed. There was information for staff about why medicines had been prescribed and when and how they should be taken. Medicine administration records (MAR) were completed when people had taken their medicines.