Lifeline Agency 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 good. At this assessment the rating has changed to 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.

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 service had a proactive and positive culture of safety. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. The provider had processes in place for staff to report incidents and near misses. However, these needed to be more robust in areas. This included reviewing and learning from incidents and adjusting people’s care accordingly to keep them safe. Staff confirmed they would report any concerns to the office straight away. We found shortfalls during the last inspection that we have identified at this inspection so we were not always assured that the service promoted a safe learning culture.

The service 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 supported people to transition into the service including from hospital and kept in contact with health professionals to support people safely back to their home. One person told us, “I was very involved in the beginning. We went through everything.”

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They 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 service shared concerns quickly and appropriately. Records showed the provider had reported safeguarding concerns to the relevant authorities and cooperated with investigations. One relative told us, “He is very safe, there are no issues there. I can leave our home and give keys to them [staff].”

The provider did not work well with people to understand and manage risks. Staff did not provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Assessments were undertaken to identify risks to people and to the care staff who supported them. Areas covered by these assessments included risks associated with the environment, falls and moving and handling. However, we found some people were at risk of harm and this had not been identified by the provider. For example, 1 person had a risk assessment for living with diabetes; However, it was not robust. There was no detail to guide staff what to do in an emergency situation, did not include details of how to monitor this person and did not include information on how to support this person with a diabetic friendly diet. There was no information this person had been involved in the development of the care plan.

The provider was not working in line with their policy on personal care which stated for a person who is diabetic, ‘nail care to be provided by a health professional.’ However, their care plans informed staff for nail care, ‘to be conducted by carers when required.’ Fire risk assessments were in place; However, not all risks had been considered which put people at risk of harm. These shortfalls were an area for improvement. Following feedback with the provider they informed us of actions they were going to take to make improvements. We have not been able to assess whether these actions have been effective and we will fully assess at our next inspection.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People and their relatives told us staff were aware of how to use equipment in their home, and they felt safe with staff. One person said, “There is lots of equipment, everything is fine.” A relative said, “Everything is well maintained.” Records showed equipment had been assessed and maintained to ensure safety in people’s homes.

The provider did not always make sure there were enough qualified, skilled and experienced staff. Staff received effective support and supervision. They did not always work together well to provide safe care that met people’s individual needs. Staff received training relevant to their role and systems were in place to promote their ongoing learning and development, including spot checks and shared learning through team meetings. However, not all staff had completed training on diabetes management. Following the inspection more staff had completed this training, and the rest of the staff were booked in throughout the year. Records showed that staff were not always on time and did not always stay the full allocated time in people’s homes. One relative told us, their relative informed them staff don’t stay long and they sometimes just pop in and out. They added, “The neighbours have also said they just pop in and out and stay in the car.” Other people and relatives informed us staff can be late, and timekeeping can vary.

Recruitment processes showed staff were recruited safely and were checked for suitability before being employed by the provider.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.