Mount Joyce Care Ltd Also known as Mount Joyce Care Ltd - Kettering

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.

This is the first assessment for this service. This key question has been rated Requires Improvement.

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 safe care and treatment.

This service scored 44 (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 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.

There was no system in place to report, record and monitor incidents and accidents. This meant management lacked the means to identify lessons learnt or to implement actions to help to prevent recurrence. We discussed this with the management team who assured us this would be put in place.

Staff told us they had regular staff meetings, supervisions and that the management team regular did spot checks whilst supporting at care calls. One member of staff told us, “We have monthly meetings, where we get updates and everyone can give their point of view, we don’t get paid for meetings, they are done in our break.” The management team confirmed staff are not currently paid for meetings.

People told us they would be confident to make a complaint. One person told us, “I have not had to discuss a concern, but I would contact the agency either verbally or in writing, it is easy to contact the managers. It works both ways, as they contact me if needed” However, the management team confirmed that no complaint log is currently in place, this means they are unable to identify recurring themes, trends or learning from complaints.

The provider did not always work well with people and healthcare partners to establish and maintain safe systems of care. They did not always manage or monitor people’s safety. They did not always make sure there was continuity of care, including when people moved between different services.

The management team told us they completed pre-assessments prior to supporting people however this information was not retained. This was discussed with the management team who assured us records would be kept going forward. During this inspection, the management team completed a pre-assessment and were able to provide evidence of this.

People’s care records required more information to accurately reflect their needs and provide adequate guidance to staff so they could support people safely and to provide accurate and up to date information if required to be shared with other parties. However, people were supported by a small team who knew them well, this supported good continuity of care and helped to reduce any impact on people.

Staff told us people’s care plans contained enough information for them to be able to support people safely.

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.

People told us they felt safe with the support they received. One person told us, ““I trust the carers, it’s their attention to detail and the way they remember things that makes me trust them”.

Another person told us, “I have no concerns about any of the carers, and I know that my relative would tell my if there were any”.

Staff had completed safeguarding training and had access to the providers safeguarding policy and procedure. Staff told us they were confident the management team would act on any concerns that may be raised. Most staff could explain how to raise concerns; however, some staff were unsure how to escalate beyond the management team.

The management team could not provide evidence of any safeguarding referrals made to external agencies, as no log was in place. This meant they were unable to learn from incidents or identify any themes or trends to prevent recurrence. This was discussed with the management team who assured us this would be put in place.

The provider did not work well with people to understand and manage risks. Staff did not have all the information for them to be able to provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Risks to people were not always identified and risk assessments were not always in place. For example, we identified some people who were supported with hoist transfers or using flammable topical creams did not always have risk assessments in place This was discussed with the management team who began addressing these during this assessment however these required further information such as sling size and hoop type.

Some people’s care plans required further information. For example, one person’s care plan did not include guidance for staff on catheter care or signs of infection.

Staff told us they were able to access people’s risk assessments through their electronic system.

Despite the above, people and their relatives told us they felt safe with staff, and they knew them well. One person told us, “I feel safe physically, mentally, and emotionally, the carers work so hard; they are so diligent. I can rely on them, if they say they are going to do something they do it”.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

The management team told us they completed an environmental assessment at pre assessment, but this was then shredded, therefore were unable to evidence this. We discussed this with the management team who assured us they would keep this going forward.

People had Personal Emergency Evacuation Plans (PEEP)in place.

The provider did not always make sure there were enough qualified, skilled and experienced staff. They did not always work together well to provide safe care that met people’s individual needs.

People told us, they felt staff had received appropriate training. One person told us, “The carers are well trained in using the hoist and helping my relative move. They will move (relative) from bed to chair to commode with the hoist, ask (relative)if (relative)is okay and if (relative) is in pain”.

During the assessment we reviewed 4 staff files. We identified gaps, for example: missing start and end dates of employment and unsigned paperwork. This meant the management team were unable to identify potential gaps in employment. We discussed this with the management team who assured us they would look in this.

Staff supporting people with catheter care had not received specific training. Management assured us all staff would complete the training. Additionally, staff had also not received end of life care training, despite previously supporting people in this area, The management team confirmed steps would be taken to ensure all staff receive the appropriate training.

The provider had failed to ensure the training matrix contained accurate dates, despite this being identified previously during a local authority monitoring visit.

Staff told us they felt they had received adequate training for their job role.

The provider did not always assess and managed the risk of infection.

People told us staff used personal protective equipment (PPE) appropriately when they received support with their care.

Staff told us they had adequate supply of PPE and had received infection prevention and control training.

The provider had an infection prevention and control policy in place. However, this was not always followed for example 5.3 of the policy states 'Service Users will be assessed prior to service commencement for infection risk and this will be re-assessed on service commencement and throughout their engagement' we saw no evidence of this being followed. Additionally, people with catheters lacked risk assessments we raised this with the management team who told us this would be addressed.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

People told us they felt they received their medicines safely. One person told us, ““The carers will give my (relative) her medications, including antibiotics, they are very good at making sure that she has taken them”. Another said, They have a system that identifies when medications have been given. The app lets the manager know. it is fail safe and picks up if the medications have not been recorded”.

The provider did not ensure people received their medicines as prescribed. For example, there was no evidence that medicines such as levothyroxine or lansoprazole were given at appropriate times in relation to food or caffeine. This was discussed with the management team, who assured us they would address this.

People had PRN protocols in place; however, these were not always reviewed within the required timescales.

The system they used included time restrictions to ensure people had adequate gaps between doses. However, when medicines were refused or not in stock, no actions were recorded. Additionally, this was not identified in provider audits. There was no system to ensure people had the correct quantity of medicines, this was discussed during this assessment, and the provider took steps to address this. People's care plans contained allergy information and staff had received medicines training and competency checks. A medicines policy was in place.

When staff had recorded no medicines or refused medicines there were no actions recoded. Additionally, these were not identified within the provider’s audits.

The provider had no system in place to ensure people had the correct number of medicines in place. This was discussed with the provider who, during this assessment, took steps to put this in place.

People's care plans contained information about allergies.

Staff had received medicine training and competency checks.

The provider had a medicines policy in place.