E2K 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 – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has remained 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 59 (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 proactive and positive culture of safety based on openness and honesty. Staff identified concerns about safety and investigated and reported safety events. We saw lessons learned were discussed with the staff team, and staff could describe recent safety events and the action taken. However, there was a lack of formal analysis to show professional involvement and how lessons were learnt, to continually identify and embed good practice over time. The provider was open to our feedback and told us they would strengthen their system on documenting learning going forwards, to show the work being carried out in practice.

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. We received positive feedback about support, for people returning home from hospital and saw the management team raised any concerns they identified about unsafe discharges. A professional who works with the service told us, “I have had numerous dealings with E2K Care when facilitating discharges for their service users and have always found the management along with their staff to be easily contactable, very professional and accommodating especially in assisting with the flow of discharges from the hospital. [E2K Care] have regularly gone the extra mile to support the hospital in the safe discharge of their service users. For example, they have supplied and fitted key safes, provided shopping for their service user for discharge and taken delivery of discharge dependent equipment when the needs of the service user have changed during admission.”

The provider worked well with people and healthcare partners to understand what being safe meant to them and how to achieve that. They concentrated on improving people’s lives or protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. However, the provider did not always share concerns quickly and appropriately, as we identified 1 incident which required local authority safeguarding review. We asked the registered manager to make a retrospective referral, and this was completed straight away. The outcome quickly identified all appropriate action had been taken by staff to keep the person safe. Staff felt confident any concerns raised would be followed up appropriately by the registered manager and knew how to report concerns externally if required. Everyone we spoke with told us they felt safe when being supported by the care team. A relative said, “I do feel that [person] feels safe with the carers.” Another person said, “I feel very safe with them (staff).”

The provider did not always work well with people to understand and manage risks. Whilst they provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them, this was not always fully documented in records. For example, some risk assessments were lacking in detail in relation to people’s modified diet, or in areas such as catheter care or other specific healthcare conditions to show potential risk factors.There was no evidence of impact on people using the service, as staff were knowledgeable about people’s specific care needs. The registered manager told us, “We are such a small company, we know these people inside out.” Leaders confirmed they were investing in a new electronic care planning system and would review all risk assessments and care plans as part of this transition, to ensure they were robust.

The provider detected and controlled potential risks in the care environment. They make sure equipment, facilities and technology supported the delivery of safe care. The provider had overarching processes in place such as a business continuity plan to support the continued delivery of care in adverse events such as heavy snow. We saw evidence the provider worked with other stakeholder such as the fire service, and occupational therapy (OT) to support people to live safely in their own homes. However, we found 2 people’s Personal Emergency Evacuation Plans (PEEPs) lacked some clarity on the support they would require in relation to their mobility in an emergency. We raised this with the registered manager who updated these documents straight away.

The provider made sure there were enough qualified, skilled and experienced staff. They made sure staff received effective support, supervision and development. Staff worked together well to provide safe care that met people’s individual needs. Staff received relevant specialised training in areas such as mental health, catheter care, diabetes, dementia care, Parkinson’s Disease and PEG. PEG stands for percutaneous endoscopic gastronomy, and it is a way for people to take on nutrition if unable to eat or drink safely by mouth. All of the care visits took place within a small geographical area, and there were no recorded late or missed visits. A person’s relative told us, “They (care workers) come in on time and stay for the time they are supposed to.” Another relative said, “If they (care workers) are running late, they will give us a call to let us know. If they are going to come in earlier, they always ring a day earlier to let us know. We are equally flexible with them. Before they leave, they always ask if there is anything else they can do.” Staff recruitment needed some minor improvements to ensure a full employment history was always clearly recorded. The provider told us they would act on our feedback.

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. We received feedback from people, they were satisfied with infection control measures employed by the service. Daily care records showed regular cleaning being undertaken by staff in line with people’s care plans. Staff had access to personal protective equipment (PPE). Staff received training in infection, prevention and control and food hygiene to support good practice in this area.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always fully involve people in planning medicines support. Staff received training, competency assessments were regularly carried out and medication practice was regularly audited. A person told us, “[Care workers] make sure I have taken my medicine by checking the container on the bedside table in the morning.” However, some improvements were required to ensure there were always detailed protocols for ‘as required’ medicines such as inhalers. We also found 1 person’s care plan referred to crushing their medicines to help the person to swallow them. Although we were informed a healthcare professional had agreed this verbally, the paperwork was not yet in place. The registered manager acted straight away during the inspection to follow this up with the person’s GP, and confirmed with the pharmacist this would be added to the prescription label going forwards.