Pentowan Home Care

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

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 good.

At this assessment the rating has remained good.

This meant people were safe and protected from avoidable harm.

This service scored 69 (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. Staff listened to concerns about safety and reported them. However, these were not consistently investigated. Lessons were not always learnt to continually identify and embed good practice.

Records showed that accidents and incidents were documented, and staff understood the importance of reporting concerns. However, investigations did not always include sufficient analysis or follow-up to understand underlying causes. As a result, opportunities to embed learning and strengthen safe practice could be missed.

Despite these shortfalls, staff told us they felt comfortable raising concerns and were confident these would be addressed by management.

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.

External professionals told us the service worked effectively with them and was responsive when concerns or changes in people’s needs were identified. Comments included, “Never had any concerns or issues” and “Worked really well with complicated cases …keen to learn and worked well alongside other health professionals.”

Summary information about people’s specific needs, risks and preferences was available to be shared with health professionals to support safe transitions of care, if hospital admission became necessary.

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 consistently reported and demonstrated through their actions that they felt safe with their support staff. We observed people were comfortable requesting support and reassurance from staff. People told us, “Never have I felt unsafe” and “Very conscientious, always make sure the house is correct, do you feel safe, do you feel comfortable, anything else needed before they go”.

Involved health care professionals were confident the service provided safe care. They told us, “There are effective governance and oversight arrangements in place, and staff demonstrate a commitment to maintaining hight standards of care and safety, which is driven by a high level of communication.”

Staff had a good understanding of local safeguarding procedures and were confident any safety issues they raised would be investigated and resolved. Staff said, “Just done safeguarding training, given 3 weeks’ notice and to be completed within 3 weeks, if not completed then will be asked to come to the office and to complete and if you are finding it difficult then [manager] will sit with you and help” and “Any concerns raised would be dealt with.”

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. We checked whether the service was working within the principles of the Mental Capacity Act. We found staff supported people in the least restrictive way to ensure people and their families felt in control of their care.

There were processes to ensure people were protected from financial abuse. Where the service provided support with shopping tasks, records and receipts were maintained for all purchases made.

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.

Staff were confident people were safe; risks had been assessed and were mitigated effectively. Care plans included guidance on how to support people if they became upset or anxious. Care staff said the office made sure they were aware of any updates to risk. A relative told us, “[My relative] has vascular dementia and can have mood swings, but the carers manage this well with skill and patience.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Care plans included environmental checklists, highlighting potential hazards such as flooring, electric, gas, and adequate washing facilities for care staff to wash their hands. This supported staff to respond appropriately and safely when working in people’s homes.

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.

The provider had enough suitably qualified skilled and experienced staff to meet people’s needs safely. Staffing levels were planned to ensure people received continuity of care and visits were delivered as scheduled. People told us staff arrived on time and stayed for the full duration of visits. Comments included, “They are on time, within the parameters agreed and usually call about 9.45 am” and “I have had no missed calls, they always arrive.”

The provider had good induction training, this helped ensure new staff had appropriate skills and knowledge to support people in line with their needs and preferences. Professionals constantly told us how well the staff team were trained, “Have found them to be knowledgeable and compassionate.” Care staff told us, “Induction was very good, went through loads of paperwork, practical manual handling course, lots of on-line training and also did training that I had never undertaken before, Huntington’s disease.”

We saw records of training provided during induction which included on-line training and face to face sessions with external trainers.

Staff were recruited safely and necessary pre-employment checks had been completed. Staff files contained photographic identification and full employment histories.

Supervisions and appraisals were carried out regularly although some concerns that staff had raised did not have any written acknowledgment or actions against them. However, staff told us they felt supported and able to raise concerns or seek advice when needed.

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 good stocks of Personal Protective Equipment (PPE), including gloves, aprons, and hand sanitiser. Staff told us PPE was readily available and could be replenished when needed. We noted during home visits that PPE was used and people and their relatives told us, “They wear their gloves and aprons and always wash their hands before giving [my relative] food and drinks” another said, “PPE is always worn and disposed of appropriately.”

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.

Staff understood how to manage people’s medicines safely and had access to guidance. At the time of the assessment the provider was changing their digital care planning App, and not all staff could access the digital version. There were paper Medication Administration Records (MARs), and these were available in people’s home for care staff to complete.

Missed medicines were reported by care staff to the office. Senior care staff brought the MARs back to the office each month to audit. Where medicines had been missed an incident form was raised with lessons learnt captured.

People told us, “There have been no errors with medication administration, and this is done safely.” Staff told us, “If a client is prescribed antibiotics the family will let the office know and the office will let us know straight away, all the people going in to that client will get a message with all the details.”

At the time of the assessment the paper MARs did not have facilities to record why 'as required' medicines were used. There were no protocols to guide staff on when to offer these medicines. This meant there was a risk staff might not be consistent in their approach. We raised this during the assessment and the provider produced a protocol on 'as required' medicines immediately following feedback.