Bliss Care And Training Ltd - Barnet

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.

The provider was previously in breach of the legal regulation in relation to not always providing safe care and treatment to people. Improvements were found at this assessment and the provider was no longer in breach of this regulation.

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. 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 effective system of monitoring and evidencing the actions taken when an accident, incident, and allegation was made. Staff were informed of lessons learnt at team meetings to share what needed to be improved. Improvements had been made following the last assessment, showing the provider had a culture to learn and make improvements when shortfalls were found.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed and monitored. They made sure there was continuity of care, including when people moved between different services.

We found safe systems to ensure people did not have any missed care visits. Reviews of people’s needs took place routinely. When staff reported people needed further time and had additional care needs from what was initially identified by social services, actions were taken to seek social services agreement to make these changes.

The provider did not always work well with people and healthcare partners to understand what being safe meant to them and how to achieve that. They did not always concentrate on improving people’s lives or protecting their right to live in safety, free from abuse and discrimination.

Staff were not knowledgeable about the potential different types of abuse which can occur. They were not open to the potential of people being harmed by others, despite completing training on safeguarding. Staff did not know who to report concerns to outside of Bliss Homecare. Staff were also not familiar with the concept of discrimination. No one had come to harm as a result of this, but further work was needed to ensure staff were knowledgeable and open to these issues.

When concerns were raised by the local authority by a third party the management team took appropriate and timely action to investigate these concerns.

The provider did not always work effectively with people to understand and manage risks. Staff did provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Improvements had been made with how key risks were identified and explored for people. However, those people at greater risk due to their health needs and the lifestyle choices they made required further work, to fully explore the risk, to enable the safer management of risk. Staff were not always fully briefed on the risks people faced. It was not always clear when the providers responsibility ended in relation to the management of high risk. There were missed opportunities to revisit high risks at reviews. No one was harmed as a result of these shortfalls but there was a risk they could be. The management team manager and provider responded positively to this feedback and said they would revisit this work as a priority.

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

A full environmental risk assessment was completed before care visits started. In these risk assessment relevant aspects to people’s safety was considered, like the use of equipment such as hoists, fire risks, and staff safety.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. But there were shortfalls with an aspect of staff recruitment checks.

The provider had ensured they had enough staff to provide a person centred care experience, of people seeing regular staff at times they were happy with. The provider had improved their system of monitoring to ensure staff were doing this. As one person told us, “I get a regular excellent carer and a cover is also very good. Time keeping is very good. They [staff] stay for the time and ask if there is anything else they can do.”

Staff received training including more specialist training in order to meet some aspects of people’s health needs, such as those who needed specialist equipment to have the nutrients and fluids. Staff checks were completed to ensure their practice in key areas was sufficient.

Recruitment checks were taking place to help ensure the right staff were recruited to keep people safe. However, the provider had not ensured they obtained a full employment history. The registered manager said this would be corrected moving forward.

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.

Staff had a good understanding of good hygiene practices. People reported staff wore personal protective equipment when they provided care to them. The provider had arranged checks on staff practice to confirm this was happening.

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 appeared to receive their medicines correctly. The medication administration records reviewed were correctly completed. The provider had a system to monitor if a medicine administration was not recorded, staff would be contacted that day to check this, if this happened. People spoke confidently about this part of the care staff provided.