Angels Domiciliary Care Limited Also known as Angels South East London

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. This is the first inspection for this service. This key question was rated 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 complete honesty. Staff actively listened to concerns about safety and thoroughly investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. People and their relatives told us they were confident that if they had to raise a safety concern it would be listened to and acted on appropriately to prevent reoccurrence. Safety incidents were reported on, investigated, and measures were put in place to prevent repetition. One example was when staff reported an incident of a person having a fall while being supported on a care visit. The registered manager reviewed the care plan with the person and discussed ways on how staff could keep them safe on visits and prevent further falls. An adjustment was agreed with the person to ensure staff were better able to keep them safe while mobilising. The incident was fed back at the next staff meeting and used as an opportunity for learning and prevention of future falls. The person had not experienced another fall within a year prior to our inspection. Staff told us they were confident in managing and raising safety issues with the registered manager and they were confident concerns raised would be suitably acted upon. The service had a robust accident and incident policy for staff to follow, which clearly explained accidents and near misses, and the importance of reporting both.

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. The registered manager was able to fully explain the usual process for referrals to the service. At the time of the inspection no people were moving between different services. However, the care plans and risk assessment in place had enough information to ensure any services people might need to be transferred to would be fully informed of their care and support needs ensuring people would have safe systems, and transitions if required.

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 with appropriate external agencies such as the local authority or CQC. All staff had received training in safeguarding adults and children. Staff told us they were confident in their ability to keep people safe from harm. One member of staff said, “We do regular checks on people, actively listen when people are speaking to us, or [we] look out for any unusual behaviours from people or family. Anything unusual we will report to the manager.” The provider had a robust safeguarding policy in place for staff to follow. The policy set out legal requirements to be achieved in relation to keeping people safe. Safeguarding was discussed at all staff meetings, and regular updates were sent to staff via email, texts or in newsletters. The registered manager contacted people regularly by phone to ensure they remained happy with the care they received, ensuring safeguarding was always at the forefront of care being delivered.

The provider worked well with people to fully understand and manage risks by thinking holistically. Staff provided care that fully met people’s needs and was safe, supportive and enabled people to do the things that mattered to them. People had care plans and risk assessments in place that had been put together with themselves, their relatives and the registered manager prior to staff providing support to them. The registered manger told us they ensured people’s voices were at the forefront of their decision making in relation to the care they received ahead of relatives. Feedback from relatives and people confirmed they were involved in the construction of care plans and risk assessments. Risk assessments were robust and covered all people’s care and support needs. These were reviewed on a regular basis with people and their relatives. People were able to request updates to their care plans and risk assessments in between scheduled reviews. The policy of the service was for people to allow 2 weeks for these changes to be implemented however, the registered manager strived to ensure these changes were implemented within 48 hours of the request being input and reviewed. People’s feedback confirmed requested changes were completed within 48 hours of the request.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Relatives told us staff maintained safe environments for people. One relative said, “[Person] needs to use equipment to transfer [through the home] and [staff] are well trained to use it. [Staff] enable me to have [person] living at home with me. They are a godsend to us.” The registered manager visited people and their relatives in their own homes to complete environmental risk assessments before support with care began. Risk assessments included fire safety and home security. This ensured staff were able to deliver care in an environment that was safe adn appropriate for both people and staff.

The provider made sure there were always enough qualified, skilled and experienced staff, who received thorough support, supervision and strong development opportunities. They worked together well to provide safe care that met people’s individual needs. The providers recruitment practices were robust, all staff had full employment histories, appropriate identification, DBS checks and right to work in the UK documents in place. Staff received an induction at the beginning of their employment. Staff told us the induction was helpful and helped them to do their job. The induction included training in unconscious bias, dementia care and manual handling. Staff had development opportunities to move into other roles such as care coordinators or management, and all staff were trained as care coordinators in the service. The provider ensured suitable staff were recruited into the service by having experienced staff members as part of the recruitment panel. People told us they felt staff were well trained. One person said, "[Staff] are really good, we have a good time with them, they are well trained. We use a battery-operated bathchair for [relative] and all [staff] are trained to use this.” The provider had robust disciplinary processes in place. One person said, "There were [staff] we were not happy with, and apparently other people had complained about them, the [registered manager] dismissed them." This was discussed with the registered manager who provided information of the disciplinary process and discussions which were had with the staff member in question before they were dismissed, ensuring people received safe treatment and felt safe. People told us staff always stayed for the agreed length of the visit.

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. The provider had a robust infection, prevention and control policy in place for staff to follow. The policy detailed the roles of the provider, the registered manager and staff to prevent the spread of infection across the home environment. Staff received training in infection control. People told us staff always wore personal protective equipment (PPE), and staff would continue to wear face masks when delivering care if that is what people requested. Staff told us they had no issues with obtaining PPE. Staff were also responsible for ensuring people had a good supply of PPE in their homes.

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. At the time of the inspection people were not being supported by staff to take their medicines as they had capacity to do this themselves or were being supported by relatives. However, care plans detailed medicines people were taking, and how and when they should be taken, so staff would be able to support people safely at short notice if required. Staff had received training in medicine management, so they were equipped to support people with the administration of medicines at any time.