Prime Care at Home Limited

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.

This service scored 75 (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 we spoke with were confident to report any accidents, incidents or near misses. Records showed these were reviewed by leaders to check that all appropriate actions had been taken and to identify if anything could be done to make further improvements.
If something had gone wrong with a person’s care, the registered manager contacted them to inform them and apologise. Records showed any issues were discussed openly and honestly with people and their relatives, and actions were taken to ensure any problems would not happen again. This helped to demonstrate leaders had developed a learning culture that worked well to help promote people’s safety.
 

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.

Records showed staff supported people to make appointments with their GP, liaised with the pharmacy regarding people’s medicines and worked with hospital teams to ensure people had the equipment and supplies needed when they were discharged from hospital. People’s care records were updated when district nurses had visited people and if any actions had been taken, for example, if antibiotics had been prescribed. These actions showed staff worked well with other healthcare professionals involved in people’s care to ensure they received the care they needed.

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.
People and relatives told us they felt safe and were happy with the care provided by Prime Care at Home Limited. One relative told us, “I like all the carers, and I am happy for them to care for [my family member].”
Staff we spoke with had been trained and were knowledgeable on what actions to take if they noticed any safeguarding concerns. In addition, staff understood how to report any concerns under ‘whistleblowing’ legislation. This is legislation that protects staff from being treated unfairly by their employer if they have raised genuine concerns about a person’s care.
People understood their care choices however, the provider had policies and procedures in place should decisions be required to be made in people’s best interests. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to make particular decisions, any made on their behalf must be in their best interests and be as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. For people living in their own homes, this is usually through MCA application processes made in the Court of Protection.
 

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.
People and relatives felt staff involved them to help reduce and manage risks. For example, one relative told us how staff had arranged for more help to be able to safely assist their family member to transfer. They told us, “[With their health condition] some days are better than others…[staff] bought forward the next shift so there were two carers available to help.”
People were involved in managing any risks that may occur during support. Risk assessments helped to identify and manage risks in relation to people’s care. Staff told us they felt the risk assessments contained enough details and were able to describe practical steps taken to help ensure risks were reduced. For example, they told us the registered manager would visit the person’s home with them and explain how to use any new equipment people had. Additionally, staff checked to ensure people had access to their personal alarms, if they used these, when leaving their care calls. These alarms allow people to raise an alarm should they fall or have a medical emergency when they are at home alone.
 

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 risk assessment had been completed to check for any risks in people’s homes prior to staff supporting them, and staff were prompted to check the environment was safe at each call. Where potential safety issues were identified, actions were taken to help reduce these. For example, staff had helped to make a referral to the local authority so a ramp could be installed to make it easier for the person to use their wheelchair.
Staff had been trained in areas of care that helped to support a safe environment for people. For example, in risk assessment, health and safety, fire safety and food safety. Staff told us they used key safe systems to keep people’s homes secure in-between their care calls. All these actions helped to maintain a safe environment for people.
 

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 and relatives spoke highly of the staff team that cared for them. One person told us, “I am very happy with them. The carers are regular and I always have the same carers. They know me and I get my rota on time.” Another relative said, “We get sent a rota at the weekends and the staff come exactly on time, and we know who they are going to be. [My family member] only has 4 or 5 staff and if there is anyone new, they get sent along with regular staff until we all feel okay with them; we really value that.”
Staff told us they never felt rushed and were given enough time to travel to their next call. They said if they were ever delayed and were running late, they would call the next person to let them know.
Staff spoke highly of their training and praised it for being relevant to the people they supported. One staff member said, “When I started supporting a person with a catheter, I had catheter training. We’ve also had training for a specific client’s [health condition], and it was very helpful.” Another staff member told us, “We do our moving and handling training and when joining the company, you shadow and get training that way too.” Staff training was kept up to date and covered a wide range of areas relevant to people’s care needs. Staff were supported and developed through meetings with the registered manager and received feedback on how they performed and cared for people.
The registered manager completed checks when they recruited new staff. These included checking previous employment history, obtaining references and Disclosure and Barring Service (DBS) certificates. DBS certificates provide information including details about convictions and cautions held on the Police National Computer. The information helped the registered manager ensure they were employing staff who were suitable to work in care.
 

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading.
Staff received specific training on infection control and confirmed they had sufficient amounts of personal protective equipment (PPE). Risk assessments were in place where needed, to help identify and mitigate any infection risks. Relatives told us staff managed people’s personal care well and would always ensure people’s hygiene was maintained.
 

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.
Where staff helped people with their medicines care, people told us they were happy with how this was completed. One person said, “Staff do my skin creams and they are always done.”
Any care that people needed with medicines had been clearly recorded. Staff used electronic medicines administration record (MAR) charts to record when people had been given their prescribed medicines. Clear instructions were in place when people had any transdermal medicines (where medicine is given by a patch placed onto the skin), for example, for staff to first remove the old patch and how to rotate the position of the new patch to prevent any skin sensitivity. Records showed the registered manager audited medicines records and had taken action if they identified any issues.