Caremark (Barnsley)

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.

At the last assessment the service was in breach of legal regulation in relation to staffing. At this assessment, enough improvements had been made, and the service was no longer in breach of regulations.

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. Staff recorded accidents and incidents via an online system. Accidents and incidents were reviewed during governance meetings. Lessons learned were discussed with staff during team meetings and communication apps. However, whilst we found appropriate action was taken following incidents, such as contacting emergency assistance and informing relatives, some improvements could be made to how logs were kept. The registered manager had recognised this and planned to implement more robust logs, to ensure they could easily have oversight of incidents which occurred.

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 received assessments of their needs prior to being supported by the service. People were consistently supported when they were distressed. Care plans were in place to support people to have a good day, and strategies were in place to prevent distress. Where required, people had been referred to external professionals, such as occupational therapists and speech and language therapists, to ensure their health needs were met. Staff had recently changed their care hours, to support a person to attend an emergency dental appointment. Records evidenced positive feedback from professionals about the service and how staff worked with them to meet people's needs. For example, a professional had said, ‘The care package is going well, staff have provided person centred care, and the person is happy as they have been receiving the same staff.’

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. For example, procedures were in place and staff worked closely with external professionals to ensure a person was protected from the risk of financial abuse. People were supported to develop skills to protect themselves from harassment and abuse in the community in a way that didn’t infringe on their independence. The provider shared concerns quickly and appropriately. Staff were trained and understood their roles in relation to keeping people safe. A staff member said, “I've received training on recognising signs of abuse, reporting procedures, and prevention strategies. I feel confident to report concerns to my manager.” People told us they felt safe receiving support and staff cared for them well. One person said, “I feel perfectly safe, they just feel nice. I have never felt unsafe with staff. They know what they are doing.” A relative said, “[Name] is very safe, staff are very attentive, they are good to [name].”

The provider did not always work well with people to understand and manage risks. Some improvements were required to ensure records appropriately reflected people’s current needs and risks posed to them. We found no harm to people, and this was found to be a recording concern. For example, some people's care records did not contain enough information about their mobility, diabetes, environmental risk and falls risk. We also found daily logs did not always contain enough information about people’s specialist dietary intake. The registered manager had recognised this and was working through and reviewing people's risk assessments and care plans at the time of our inspection. This was also included in an ongoing service improvement plan and record keeping was a key focus in staff development.

People were supported by staff within their own homes. Care records contained some information relating to staff safely entering and exiting people's properties, including security checks. Some improvements were required to ensure a robust risk assessment was in place for each person's property, to identify any potential dangers from the environment. Staff received health and safety training and told us how they kept themselves and people safe in their homes. A staff member said, “The individuals we support are cared for in a safe and secure environment.” Where there were risks outside of the provider’s control, for example, a poorly maintained environment, the staff and leaders escalated this to the relevant agencies and reviewed how they were able to keep people safe whilst they were supporting them.

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 were supported by staff at their allocated call times. People told us staff arrived on time and stayed for the allocated time periods. A relative said, “They tell us who is coming, they come at the right time and stay for the allocated times. [Name] needs 2 staff, and they come together. We have the same staff, unless someone is off.” Staff were trained in a range of subjects to carry out their roles. This included specific training related to supporting people with learning disabilities, dementia, diabetes and catheter care. The service had in-house trainers, to enable some face-to-face training, such as moving and handling and first aid. Staff received regular supervision and told us they felt supported in their roles. A staff member said, “I’ve received the required training for my role and am confident that additional training would be provided if needed. In the past year, I had 1:1 supervision and receive a written record after each session. I also have an annual appraisal to review my progress. My Care manager is very approachable, fair, and always ready to offer support when needed.” Staff were mostly recruited safely; we identified some recruitment records gaps which were discussed with the registered manager on the day of our inspection. Staff received a police records check before commencing their role and received inductions and shadowing opportunities.

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. Policies, systems and processes were in place to protect people from the risk of infection. Staff were trained in relation to infection, prevention and control and staff spot checks were in place to ensure staff were adhering to safe infection control practices. People told us staff wore PPE and kept their homes clean and tidy. A person said, Staff wear aprons and gloves and wash their hands.” A relative said, “The first thing they do is put their gloves on, they wash their hands when they have finished (providing care).”

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Medicines were mostly managed safely. However, we found some recording concerns. Staff completed medicines administration records; we found some incorrect codes used on records when people had either refused or stopped medicines and some people required a more individualised medication profile, which details people’s preferences about how they like to take their medicines. Staff training and competencies were assessed prior to administering medicines to people and medicines errors and/or learning events were thoroughly investigated, reflected upon, and discussed in staff meetings and supervisions. Some medicines audits were also overdue a review. This was being worked through by staff at the time of our inspection. People told us they received their medicines as prescribed. A person said, “My medication is kept in a safe, staff give it to me on time every day and document it.” A relative said, “Staff do the medication and follow the list. They give it to [name] and make sure they take it.”