Purple Skilled Healthcare - Main Office

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

We identified two breaches of the legal regulations. Risk assessments were in place; however, some risks had either not been identified or records lacked information about maintaining people’s safety and risk of harm. An effective call monitoring system was not in place and recruitment processes were not operating effectively to ensure the suitability and competency of staff. People told us they felt safe using the service. Staff followed appropriate infection control practices. There was a process in place to respond to accident and incidents. Best practice was relayed to staff to improve the quality of service being provided.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us they were able to speak to the registered manager and staff about any concerns or issues.

The registered manager told us there had been no accidents and incidents; however, they were aware that any lessons learnt would be used to improve the quality of service and relayed to staff to embed good practice. For example, records demonstrated that best practice was being relayed during staff meetings regarding falls management in people’s homes including prevention of slips, trips and falls, maintaining a safe environment and actions to take should a person experience a fall.

Systems were in place to respond and monitor accidents and incidents if and when they occurred.

People told us they were informed and involved in their care and support planning.

Care and support was planned and organised with people, relatives and relevant healthcare professionals in ways that ensured continuity and that risks were identified and managed to keep people safe.

Systems were in place to ensure continuity of care

People told us they felt safe using the service. A person told us, “They [Purple Skilled Healthcare] help me and it makes me realise I am safe in my own home, it is nice to have that safety.”

Staff had completed safeguarding training. The registered manager understood their responsibilities in relation to safeguarding and told us they would report any concerns immediately to the local authority and CQC.

There were systems in place to protect people from the risk of abuse. There were safeguarding and whistleblowing policies in place to report potential abuse.

People told us staff were aware of their needs and provided them with the support they needed to keep them safe from harm. A person told us, “She [staff] picks up things from the floor and makes it safer for me to walk.”

Staff were aware of people’s individual needs and helped ensure people were safe.

Risk assessments were in place which covered areas such as falls, medicines, nutrition and hazards in people’s homes.

However, some risks had either not been identified or records lacked information about maintaining people’s safety and risk of harm.

A risk assessment was in place for a person with mental health conditions. However, there was limited information about what the mental health conditions were, the triggers and signs which may cause the person to become anxious or experience deterioration with their mental health.

There was contradictory information in relation to the risk level of a person’s skin integrity. The care plan stated the risk was high, however the risk assessment stated ‘at risk’ only. The risk assessment had not been fully completed and stated ‘follow the care plan.’ This meant staff did not have the correct guidance in place to prevent and minimise the risk of potential pressure sores.

Records detailed a person was often in pain and staff were to assess the person’s pain by using a pain assessment tool. However, there was no further information detailing this was being used by staff to assess the person’s pain level and there was no risk assessment in place for this.

Records stated to prompt the person to take paracetamol to alleviate pains, however, there were no records to show if the paracetamol had been administered and no guidance which detailed how and when this should be administered

A person needed to be supported by staff to administer eye drops, however there was limited information in the risk assessment detailing how this was to be done safely.

A mobility risk assessment was in place as the person was at risk of falls and used a number of mobility aids. However the person used a stairlift. The risk assessment did not detail the risks associated or how to undertake safe practice to maintain the person’s safety whilst using the stairlift.

The person was also supported in the community and required the use of a scooter and wheelchair, however there was no risk assessment in place identifying the risks and support needed to maintain the person’s safety whilst out in the community.

People told us they were aware of hazards and were supported to keep safe in their home environment.

The registered manager had carried out an assessment of people’s home environment during the initial stages of setting up the care package. The assessments carried out involved health and safety checks including lighting, clutter, safe storage of mobility equipment and home security. This helped to support people in a safe environment.

Processes were in place to ensure risks within the environment were assessed and monitored.

There were enough staff deployed to meet people’s needs. People using the service told us they had no issues with timekeeping, there was flexibility if they wanted to change the times of their care visits, and this was accommodated for by the service when needed. A person told us, “Sometimes they stay over the hour, things are done slowly and calmly due to my condition.”

The registered manager told us there was an electronic monitoring system in place, however, this has been discontinued. The registered manager told us time monitoring was currently done by speaking to people and messages via mobile apps used by staff, however there were no records kept in relation to time keeping. This meant people were at risk of not receiving the appropriate care as any issues with timekeeping such as late, missed calls and staff not staying the allocated times for their calls could not be identified or monitored.

There was a lack of an effective call monitoring system in place. Recruitment and selection processes were in place and pre-employment checks including Disclosure and Barring Service (DBS) checks were completed. However there were instances where the recruitment process was not effectively implemented to ensure staff were suitable. The staff files provided to us did not contain all the relevant information required and information was not stored or filed in a manageable way. Therefore we could not be assured of how robust the recruitment process was. For example, for one staff member their employment documentation such as the offer of employment letter and contract of employment were not available in their files. There were also no interview notes to show assessment of suitability and competency for their roles. When reviewing the staff members application form, there were gaps in their employment history with no satisfactory written explanation of these gaps to ensure good character.

People were protected from the spread of infection. People told us staff always wore personal protective equipment (PPE) when supporting them with personal care.

Staff had received infection control training and implemented safe infection control practices.

The service had a process in place to prevent the spread of infections.

People told us they were supported with their medicines. People’s medicines support needs were documented in their care plan. Medicines administration records (MARs) showed people received their medicines as prescribed.

Records showed that staff had received training on the administration of medicines.

A medicines policy and procedure were in place to manage people’s medicines. Monthly medicines audits were carried out to ensure any issues were identified and actioned such as medicines refresher training for staff when needed.