Carinyo Care Ltd

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• 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 service. This key question has been rated 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 regulations in relation to safeguarding service users from abuse and improper treatment, good governance, staffing and fit and proper persons employed.

A safeguarding concern was not reported to the relevant authorities. Staff did not have the appropriate training and competency assessments to enable them to carry out the duties they were employed to perform. The provider did not assess all new employers to ensure they were of good character.

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 was aware of their responsibilities to investigate and report safety events. Any areas of concern were reported to the registered manager.

Staff told us they felt confident to report any accidents or incidents to the registered manager. One staff member said, “Yes, the manager is always ready to listen and attend to any concerns or answer any questions.” Despite this, there had been no accidents or incidents recorded. This made it difficult to determine whether the absence of records reflected genuinely low levels of incidents or whether staff were not consistently documenting events in line with the provider’s reporting procedures.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored.

People using the service were privately funded and had arranged their own care packages. We reviewed the experience of a person who had previously used the service and found they had been supported by several health professionals. Records showed there had been a consistent, joined‑up approach between the provider and external professionals, which helped ensure continuity of care and supported the person to remain safe.

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. The provider did not always share concerns quickly and appropriately.

We found a family had raised concerns about the conduct of a care worker, indicating that the behaviour may have placed an individual at risk of harm. Although the provider carried out an internal investigation, they did not escalate the concern to the local safeguarding authority for further assessment. In addition, the provider failed to submit a statutory notification of alleged abuse to the Commission, as required under the relevant regulations.

Staff received safeguarding training and told us; they were able to raise concerns with the registered manager. People and a relative confirmed they knew how to raise any concerns and they felt safe being supported by staff.

People did not receive an assessment of their mental capacity; however, this could be undertaken should staff raise concerns around people’s capacity

Risks to people were assessed and strategies were recorded to support staff to understand how to reduce any risk identified.

Staff were aware of how they should support people to mobilise safely. They told us they were able to read people’s care plans and risk assessments to understand the correct techniques and level of assistance required to keep people safe.

People confirmed they were supported in a safe way which mitigated any potential risks. One person told us, “These carers, they just encourage me to walk up and down the stairs with the aid of a walking stick, and I also have a Zimmer frame, something like that, which I can get out of my chair and hold the Zimmer frame and wheel it to the chair, the carer gives me the walking stick, comes up the stairs and watches what im doing.”

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 provider had assessed people’s homes to ensure the environment was safe. However, they had not fully considered the risks associated with staff working alone in people’s homes for extended periods. A lone‑worker risk assessment had recently been introduced, which stated, a check‑in system was in place to maintain regular contact with staff throughout the day. Staff told us these check‑ins did not always occur, and there was no evidence of daily check‑ins being recorded. This meant the provider could not demonstrate that lone‑working arrangements were being implemented effectively to keep staff safe.

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

Staff were not recruited in line with safe recruitment practices. Several staff files contained unexplained gaps in employment history, and there was no evidence these gaps had been explored or risk‑assessed. One staff member had no references on file at all. For others, the references obtained did not confirm the referee’s relationship to the applicant, and there was no record the provider had verified the authenticity of the references.

Staff had received some training, including modules on the administration of medicines and moving and handling. However, this training was delivered solely through e‑learning, and there was limited access to practical, hands‑on training to ensure staff could apply their learning safely in practice.

We found, competency assessments for safe moving and handling and the administration of medicines had been completed by the registered manager and another staff member. However, neither had received specific training or qualifications to assess staff competence in these areas. This meant the provider could not be assured, competency assessments were being carried out effectively or staff were fully competent to deliver care safely.

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 told us they were aware of infection prevention and control procedures. They explained, the person using the service was responsible for providing personal protective equipment (PPE). Staff confirmed they had access to PPE when required and were able to use it appropriately to reduce the risk of infection.

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 involve people in planning.

One person received support with the administration of their medicines. We found their medicines were often given outside of the recommended times. For example, the individual was prescribed a medicine to manage their diagnosis of diabetes, that required administration at a consistent time each day. Records showed this did not always occur, which meant the person was at risk of not receiving their treatment as intended. We also found another medicine was required to be administered before breakfast and there was no evidence, this was occurring. People felt staff supported them to take their medicines safely.