Heart Of Hope Care Ltd - Cumberland

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 good. This meant people were safe and protected from avoidable harm.

This service scored 72 (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 had a positive culture of safety, based on openness and honesty. Staff raised concerns and reported matters without fear of blame. Managers listened to and reviewed concerns about safety and investigated untoward events.

Incidents were recorded and investigations showed a thorough and reflective learning approach with clear actions to support learning across the service. We identified the incident log in place at the time of the inspection did not fully capture all reportable events however, we were assured incidents were appropriately investigated.

Managers shared learning from feedback and incidents with staff at team meetings and supervisions. Managers also conducted ‘spot-checks’ to ensure lessons learned were applied and embedded into practice.

The provider worked with people, their families and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. There was evidence of guidance and recommendations from professionals within care plans, and these were followed.

Staff shared relevant information to support continuity of care, including when people moved between different services.

People found there was a smooth transition into the service. One person said, “As soon as the service was engaged, we went through the care plan.” Another commented how staff “worked alongside the occupational therapist and multiple sclerosis specialist nurses” to ensure safety and continuity.

The provider worked with people and health and social care partners to understand individual care needs, associated risks and safety concerns. Staff supported people to live safely whilst protecting their individual rights to make independent decisions and engage in positive risk-taking activity.

Staff had an awareness of what constituted unacceptable care, abuse and neglect and reported safeguarding concerns appropriately.

One person told us they felt “100% safe,” family members stated they had “no concerns about the level of care” and a number of other people commented how staff treated them well.

There were no Court of Protection deprivation of liberty applications in progress or authorised at the time of the assessment. The registered manager told us such applications would not be appropriate within this type of service, and if restrictions of this level were required, they would need to review the person’s placement and consider whether another setting would be more suitable.

The provider worked with people to understand what was important to them and manage associated risks together. Staff provided care to meet people’s needs that was safe, supportive and enabled people to maintain independence.

Care plans showed clear evidence of individual and relevant risk assessments. Records demonstrated that discussions with people about their care and support needs had taken place.

Where people wanted to engage in positive risk-taking activity, staff supported them to do so. One person really enjoyed local travel, using public-transport and getting outdoors. Staff ensured they worked around the person’s schedule to provide necessary care and support whilst promoting autonomy.

Staff were respectful of the person’s personal environment and how they wanted their home to be. Staff identified and recorded potential environmental risks in the care environment and discussed these with people.

Staff ensured where animals, equipment and technology were factors in the person’s care and support, this was managed in a way to enhance and support the delivery of safe care. One family member told us, “They use a hoist and are so careful as [the person] is fragile and frail.”

One person told us how their loved one was at risk of falling and staff had assisted them to relocate to the ground floor and helped her settle in. Another said, “Nothing is left around, they leave the home tidy.”

The provider made sure there were enough qualified, skilled and experienced staff to safely meet people’s needs. Recruitment checks were completed to ensure staff were fit and proper to work before completing a thorough induction, core training and supervised shifts. Staff also had regular meaningful supervision sessions to support them to deliver safe care.

Staff rostering was well managed to ensure people received their care and support at an agreed time and to provide staff with adequate travel time between visits. The rostering system provided alerts in the event of issues or delays. There had been no complaints received by the provider about timeliness, lateness or missed calls.

People told us staff were reliable, arrived on time and often sent a text message before visiting. In the previous 3 months, there had been no missed calls and in the previous six months, 97% of calls had been attended within the rostered time.

Staff were trained in infection prevention and control (IPC) and assessed people’s individual infection risks which were recorded within their care plan. Staff sought assistance when they had concerns about a deterioration in a person’s condition which may be due to an infection.

Staff managed the risk of infection with hand cleansing between care tasks and calls, and using the appropriate personal protective equipment (PPE). Staff safely disposed of waste and supported people to maintain the cleanliness of their home environment in accordance with their preferences and wishes.

The provider carried out spot checks to monitor IPC standards which helped to detect and control the spread of infection. IPC audit processes were in place but needed further embedding to ensure they were fully effective.

There was a system in place to manage medicines, however records relating to medicines required strengthening in several areas.

People had individual medicines profiles in place to support safe administration in line with their needs.

We identified anomalies in recorded administration times, which the provider was addressing with the software supplier as they used an electronic system to record this information. While ‘as required’ protocols were in place and contained relevant information, there were no protocols in place for people prescribed variable dose medicines. In addition, the electronic system also did not support accurate recording of variable dose administration, and this was being followed up by the provider.

Despite these issues, staff had completed medicines training and a competency assessment, which had been signed off by the registered manager. The electronic medicines administration system meant managers could monitor administration in real time from the head office.

Staff supported people to store and manage medicines safely within their homes with appropriate risk assessment in place. There had been no recorded medicines related incidents in the previous 3 months.