Care 4 U Care 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 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 legal regulation in relation to safeguarding.
 

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.

There was some evidence of learning culture within the service, but also areas that required further development. The service had undertaken a programme of improvement, implementing new record keeping systems, auditing and governance and feedback processes. Managers and staff spoke positively about the impact these changes had on the service, however records evidenced that enhanced supervision, training and spot checks had not yet been achieved with all staff. Managers did not have a finalised plan of how often these should take place. Feedback surveys had been gathered from people who use the service, the provider was in the process of finalising how to use this information.

The provider worked with people and healthcare partners to establish and maintain 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 initial assessments prior to the commencement of care and care records were available within peoples own homes should there be a requirement for records to travel with them, for example to hospital. Records evidenced that when information and advice was provided from health and social care professionals, this was documented.

The provider did not always work well with people and healthcare partners to understand what being safe meant to them and how to achieve that. They did not always concentrate on improving people’s lives or protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider did not always share concerns quickly and appropriately. Staff were provided with safeguarding training and staff told us they would feel comfortable raising concerns. However, records evidenced a safeguarding concern that was raised to the service was not shared with the Local Authority safeguarding team or CQC in line with expectations. Managers at the service undertook some steps to investigate concerns but did not proactively conclude the investigation or identify areas for concern without prompting to do so.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was supportive and enabled people to do the things that mattered to them. People and their relatives told us they were involved in the planning of their care and kept informed of any changes. A relative told us, “Someone came round and sat with us, and we talked at length about what [relative] wanted.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The provider assessed the care environment to identify and address potential risks to people and staff within the care environment. Where people had equipment in their homes to support with care delivery, the provider kept records of servicing dates to ensure equipment remained safe to use.

The provider did not always make sure there were enough qualified, skilled and experienced
staff. They did not always make sure staff received effective support, supervision and development. They did not always work together well to provide safe care that
met people’s individual needs. Recruitment was not always completed safely with required checks to ensure people were suitable for their roles. Records evidenced that a member of staff did not have a Disclosure and Barring Service (DBS) check or suitable risk assessment undertaken prior to their commencement of work, a risk assessment was completed retrospectively in response to concerns raised by CQC. Training was available to staff however multiple training areas were covered in one day. Managers advised that the intention was to strengthen training at the service.
 

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. Staff had access to sufficient stocks of Personal Protective Equipment (PPE) and could collect this from the office as required. Staff received training in how to manage Infection Prevention and Control (IPC).

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. Medicines administration records were completed by staff and audited by the management team. Systems were in place to alert staff and managers if medicines were not administered in line with agreed plans. Managers demonstrated an understanding of when to seek support for medicines, for example where a medicine was consistently declined this information was provided to prescribers. Staff received training in medicines administration and records evidenced that their competence in this area was monitored.