CareTech Community Services Limited - 82 Chaucer Road

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 inspection the rating has remained 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 a legal regulation in relation to safe care and treatment at this inspection. The provider did not always ensure known issues with the environment were made safe in a timely manner. The service was not always kept clean and free from IPC concerns. People’s risk assessments and care plans were not always specific to people’s needs or updated in a timely manner to reflect their current needs. Some aspects of how people were supported with medicines was not safe. However, staff were trained and knew how to notice and report safeguarding concerns. There were enough staff to support people with all their support needs and staff were recruited safely.

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 did not always have a proactive culture of safety. Lessons learned were not always clearly evidenced to identify and embed good practices and care plans and risk assessments were not always updated to reflect changes in individuals' support needs. Although staff understood the need to report incidents and told us these were discussed, it was unclear how these were monitored for learning opportunities. For instance, they adapted their support for one individual who felt anxious at certain times.

People and relatives told us staff learnt from incidents an changed their practice if necessary. A relative said, ‘‘[Family member] has been at the service for a long time but the staff always make sure they stay on top of anything that changes. They adapt quickly.’’

The provider and registered manager did not consistently ensure safe transitions for people between home and external health services. While individuals were supported to see professionals for their needs, such as mental health and skin care, the advice from these appointments was not always communicated to the staff team. Care plans and risk assessments were often not updated promptly, which could put individuals at risk of unmet support needs. However, staff did support people during appointments and care plans were in place to inform professionals about their needs. One relative mentioned, "I know [family member] has needed help recently, and the staff deal with all of this and keep me up to date."

People and their relatives told us they/ their family member were safe at the service. One person said, ‘‘Yes I do feel safe, yes I do. Staff are good like that.’’ A relative said, ‘‘I am 100% confident [family member] is safe living at the service. The staff know what to do in any circumstance.’’ Staff were trained to recognise where people might be unsafe or at risk of abuse and knew how to report concerns appropriately. Processes were in place to investigate potential safeguarding concerns and take action to keep people safe if necessary.

Risk assessments for individuals were in place but were not personalised. We found examples where these contained other people's names and lacked specific details about individual support needs. This limited staff's ability to effectively mitigate risks. Staff members and the registered manager could not consistently tell us who needed to be supported with physical interventions when they were upset or anxious. In response to our concerns, the registered manager began updating risk assessments. However we could not be sure this would have happened if not for our inspection.

However, staff knew people well as individuals and whilst risk assessments were not specific to people, staff were able to tell us how they supported people to be safe in line with known risks. The registered manager involved people and their relatives in 6 monthly discussions about risk assessments to ask them for their thoughts and feed back. People and relatives felt staff supported them well with their risks. One person said, ‘‘[Staff] help me when I want to go out and keep me safe.’’ A relative told us, ‘‘We have regular discussions about risk assessments and as far as I can tell they cover everything [family member] needs help with.’’

The provider did not consistently manage potential risks in the care environment. During our inspection, we identified safety issues such as a broken window restrictor, a fire door not complying with regulations, and en-suite bathrooms with missing radiators, protruding nails, and mould. Although staff and the registered manager had reported ongoing concerns about the environment, including lighting issues and malfunctioning fire doors, the provider had not addressed these promptly. After our first inspection day, the provider acted to resolve these concerns. However, we observed a hazardous wood and nail plank found in one bathroom during our following visit. While checks on health and safety were conducted by staff, identified concerns were not always managed effectively. Staff completed health and safety checks, including fire safety checks of the environment to help keep people safe. They reported concerns that needed addressing and fixing in a timely manner. The registered manager audited these checks to try and make sure actions were taken to keep the environment safe. People and relatives told us the environment at the service was safe. One person using the service pointed to the fire alarm at the service and happily laughed and smiled when we asked them if they practiced fire drills. A relative said, ‘‘The building is old and needs a bit of work I think but I would not say it is unsafe.’’

There were enough staff to support people safely. We observed staff to always be available to support people when they needed it. One person said, ‘‘There is always someone to see me if I need help.’’ A relative told us, ‘‘I have never had a problem with the staff team. There have been a few changes but I think this has been for the better. They all seem to really love the job and care for [family member].’’

Staff had training in areas relevant to their job roles such as supporting people living with a learning disability and safeguarding. They told us this training helped prepare them for their job roles and helped them understand how best to support people. The registered manager was sourcing more training for staff on a regular basis and spoke about training with staff in 1 to 1 supervision meetings. One person said, ‘‘I think the staff are well trained to support me.’’

Staff told us they felt there were enough staff to support people. Staff also advocated for people to make sure they had enough 1 to 1 support hours from staff to help them with what they needed. The registered manager monitored peoples support needs and rotas to help make sure staffing levels at the service were safe. Staff were recruited safely in line with legislation.

The provider and the staff team did not always assess or manage the risk of infection. During our inspection, we noted several areas of the service that were visibly dirty and had malodours. In 1 bedroom a large brown stain was on the wall. We informed the registered manager of these concerns, who agreed there had not been an acceptable level of cleanliness. Although the service made some improvements following our feedback, not all of our concerns were addressed. For example, stains on walls remained. Staff were also not labelling food items, which they froze on the day of purchase. This increased the risk of people eating food that had been frozen past recommended guidelines. However, people and their relatives told us they felt the service was kept clean. One person said, ‘‘Everything is very clean here- spick and span.’’ A relative told us, ‘‘Whenever we visit the service, everything looks clean and very homely.’’

The provider did not always make sure that medicines and treatments were safe and met people’s needs. 1 person was supported with an as an when required (PRN) medicine to be administered when they were feeling upset or anxious. This had recently changed, and the old medicine had been disposed of. However, this was done before the new medicine was available for the person. This left the person at risk of not having a medicine they needed available to them. Another person had a new medicine prescribed, however this was not updated and added to their medication care plan, so staff may not know what the side effects of this medicine could be. People’s PRN protocols detailed staff should administer medicines if people were showing signs of pain, but did not go on to say what these signs were. This meant staff may not know when people needed support with PRN medicines. The registered manager took action and resolved these issues immediately during our inspection.

However, staff were trained to administer medicines and had their competency to do this checked. They administered medicines in line with people’s preferences. Audits were effective in monitoring that medicines were being administered correctly. One person said, ‘‘Staff help me with the medicines. It is all good.’’