Parry Healthcare 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. This is the first assessment for this newly registered service. This key question has been rated 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 the management people’s medicines

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.

The provider did not always have a proactive and positive culture of safety based on openness and honesty. Lessons were not always learnt to continually identify and embed good practice.

The provider had systems to report incidents and accidents, and staff knew and followed these systems. Staff told us they reported any incidents using the system and they informed the registered manager of any incidents. The registered manager assessed the incidents and implemented measures to prevent their recurrence. For example, medication reviewed was arranged for 1 person following 3 occasions of falls in a short period. Another person was referred to the fall’s clinic for support. Staff told us they used handovers and team meetings to share updates with each other about actions from incidents.

However, it was evident that staff had not developed or improved their use of the electronic monitoring system to accurately log their arrival and departure times during care visits. The call monitoring report revealed multiple instances where staff failed to sign in and out as required, consistently citing the same reason. Although the registered manager had previously reminded staff of the importance of this practice, non-compliance persisted.

Following our visit, the manager provided copies of warning letters issued to staff regarding their performance. However, this action was delayed, allowing the issue to continue for an additional two weeks. Given that electronic call monitoring systems offer real-time tracking and alerts—enhancing safety for both care workers and service users—the provider should have identified the recurring issue promptly and taken immediate steps to address it.

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 provider had systems they followed for accepting new care packages. The registered manager discussed people’s needs with them and made arrangements to ensure people’s needs were met safely. Staff told us that the registered manager accompanied them to meet new people for the first time. This gave them an opportunity to understand people’s care needs, learn how to use any equipment in place, and identify measures to ensure their safety and well-being maintained. When additional equipment was required, the registered manager told us they made appropriate referrals and arranged for its provision.

A member of the referral team noted that concerns were promptly raised at the outset of care delivery—such as the need for additional aids, equipment, or if the existing care package was inadequate.

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 told us they were safe with staff in their homes. One person commented, “The way they provide care makes me feel extremely safe and reassured.” Another person stated, “I feel safe and respected.” Staff demonstrated they had completed training in safeguarding. They knew what constituted abuse and neglect and knew how to report any concerns. One staff member told us, “I will inform the manager, and they will take it from there.” The registered manager understood their roles and responsibilities in ensuring people were safeguarded from abuse. The provider had a safeguarding policy and procedures.

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 told us staff worked with them to maintain their safety and reduce risks to them. One person mentioned, “The way the carers provide care makes me feel extremely safe and reassured.” One relative stated, “The manager came and completed a thorough risk assessment, covering the environment and the care tasks.”

Risk management plans provided detailed information to ensure people were protected from avoidable harm. For example, where people were at risk of developing pressure sores, their care plans stated actions for staff to follow to reduce the risk such as monitoring skin, applying prescribed creams and encouraging repositioning.

Risks associated with people’s medical conditions were noted in their care plans and actions for care staff to take to reduce of harm to them. One person’s plan showed the support they required from staff to reduce risk connected to their heart condition. Another person’s risk management plan reminded staff to make sure the person had their walking aid close by to reduce the risk of falls.

The provider assessed potential risks in the care environment. The registered manager conducted a risk assessment of individuals’ home environments where care was delivered to ensure safety. This involved assessing accessibility, fire safety and electrical risks. Records showed equipment used for care delivery were checked and safe to use. Care plans instructed staff to report any safety concerns and to help maintain a safe setting by keeping the environment clear of clutter and hazards.

The provider did not consistently demonstrate effective planning and management of care visits to ensure individuals' needs were appropriately met.

We received mixed feedback from people and their relatives about staff attendance and punctuality. One person stated, “They [staff] are usually late, but they never miss a visit. They always come even if they are late.” Another person told us, “They [staff] come generally within the time but can be up to 30 minutes late sometimes because of traffic. Kent is a rural area and getting about can be hard.” A relative commented, “They [staff] get here at the time agreed maybe 5 minutes late due to traffic. If they going to be more than 30 minutes late, they call to inform us.”

The provider had an electronic call monitoring system (ECM) used to plan, schedule and monitor care visits. Our analysis of ECM data for the 2-week period prior to our inspection showed staff had been late to calls by over 45 minutes on 40 separate occasions during that time. We also noted that on 60 separate occasions staff had not stayed the full duration of their visit and on 37 occasions record showed staff had logged in 2 different locations at the same time, and back-to-back calls without any time for travel.

Staff told us they received their work schedules/rotas electronically in advance, so they knew what calls they would be doing. Staff confirmed the provider gave them time to travel between visits, but the travel time was not always sufficient for them to get to the next person. They told us this was mostly a problem as some staff rely on public transport to travel and traffic in the area can be difficult.

The ECM records confirmed that no visits had been missed. Double-handed calls were successfully completed with overlapping attendance by two care staff in 76% of cases. In the remaining 24%, there was limited overlap.

Staff told us they felt supported in their roles and the registered manager provided training and feedback to them. One person commented, “The carers are good, they seem to know what they are doing. A relative mentioned, “All staff come across as professional and competent.” Records showed staff received induction, training and spot checks. However, these records were either not dated to show when they took place or not signed by staff to show they participated and agreed with the actions. Staff could not tell us how often they had supervisions.

The provider followed safe recruitment procedures. Staff had undergone appropriate checks before they started working with people. Recruitment records contained two references, criminal record checks, employment history, proof of identity, and each person’s right to work in the UK.

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.

People were protected from the spread of infection. Staff had received training in infection control. The provider made personal protective equipment available to staff and staff confirmed they used it to prevent the spread of infection.
People and their relatives confirmed staff followed steps to reduce the risk of infection. One relative said, “There is good provision of PPE, and the carers use it when doing personal care.”

The provider did not make sure that records relating to the administration and management of people medicines were accurate and well maintained.

People told us staff supported them to take their medicines as required. One person mentioned, “The staff give medicine as part of the care package. I saw it in action, including how they recorded and reported refusals.”

Records showed staff had completed training in safe administration and management of medicines. Staff signed MARs when they administered people’s medicines. However, the provider did not ensure that medication administration record charts (MAR) contained clear and relevant information as recommended by the National Institute for Health and Care Excellence (NICE) guidelines. We reviewed 5 people’s MAR charts and found they did not contain information about formulation, strength, route of administration, frequency at which medicines should be taken, GP details and pharmacy. Where people received medicines that were at a higher risk of misuse, there was no indication of this on the person’s MAR or care plan, as stated in the provider’s controlled drug policy.

The daily care notes which carers complete at the end of their visits to show tasks completed showed they administered people’s medicines, but it does not contain all relevant information individual medicine administration records should have as required by relevant guidelines and required.

The provider had medicine administration and management policy and procedures which contained information that should be maintained when people are supported with their medicines. We found the provider’s medicine administration and management policy did not contain the definitions of the different levels of support people received with their medicine. The provider shared the training modules provided to staff which covered the different levels of medication support. However, Three of the 4 staff members we spoke with were not clear about their responsibilities with differing levels of medicines support.

After our inspection, the provider updated and amended their medication policy to clearly define the levels of medication support.