Mach Care Solutions (Birmingham)

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 Inadequate. At this assessment the rating has changed to Good.

This meant people were safe and protected from avoidable harm.

At the last inspection the provider was in breach of legal regulations in relation to person centred care, ensuring peoples consent was gained, ensuring people received safe care and treatment as well as not ensuring staff were suitably deployed. At this inspection we found improvements had been made and the provider was no longer in breach of any legal regulations relating to safety.

This service scored 75 (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 listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The registered manager told us they promoted ongoing development and a learning culture. This was evidenced when improvements had been made following our last inspection.

The registered manager said they always talked to the person about any accident sustained, including any steps needed to minimise a reoccurrence. These steps were then discussed with the staff team. Staff confirmed this and said they were informed of any changes to a person’s support in a timely manner.

Staff told us they had regular meetings including lessons learnt and best practice following any concerns, accidents or complaints. They said ways in which the service could be improved were always agreed within the team. This ensured ongoing development within the service.

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.

A copy of the person’s care plan was sent with them if they were admitted to another service. A care summary sheet, which contained basic details of the person’s medical history, their medicines and communication needs was also sent. This provided the new service with information about the person and their needs.

Staff told us they would accompany the person to appointments, if they were anxious or had communication difficulties. This ensured the person had an advocate to help them express their needs effectively and understand what was being said to them.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff 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 provider shared concerns quickly and appropriately.

People told us they felt safe with staff and their relatives had no concerns about safety. One person said, “I know my loved one is safe with the carers so I can get out for a few hours. They [staff] are absolutely amazing. They always go above and beyond; they are like our family.”

People and their relatives knew how to raise a concern. One person told us “When I had a problem I spoke with the manager. They came out to see me straight away and I felt happy with the actions they took.” Others told us they were confident they would be listened to, and any issues would be satisfactorily resolved.

Staff had received training in safeguarding and were aware of their responsibilities to keep people safe. They said they would report any concerns immediately. Management told us they were always open and transparent and promoted this ethos within the staff team. They said they gained advice and discussed concerns with the local safeguarding team. There was a safeguarding policy for staff reference as needed.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Care planning identified risks people faced and detailed how staff can support to minimise these risks. There was evidence of how assessment of the risk was completed and what actions were needed to enhance safety. This included areas such as pressure area and catheter care, choking and the risk of falling. The risks associated with specific health conditions such as diabetes, epilepsy and other complex conditions had been assessed and gave staff detailed instruction which also considered the emotional needs which may be experienced by people when receiving support. Staff knew people’s needs very well and people had a consistency of care which reduced risks to people’s safety.

People and their relatives told us staff were flexible and helped manage any risks. People’s comments included, “Staff are always nearby which is reassuring as I can be unsteady” and “My [loved one] always tries to rush, the staff are very patient and encourage them to take their time. They know when they are not well. I would be lost without them.”

The service used an electronic monitoring system, which identified if staff were running late or had not arrived at a person’s property. Staff rotas allowed for adequate travel time, visits were generally punctual, with minor delays explained and monitored through a live system.

One person told us, “They [staff] are always on time and when I have appointments come early to help me get ready. I wouldn’t go anywhere else.” The electronic monitoring system highlighted to management if people had not received their medicines. This enabled action to be taken to minimise the risk of error.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Staff told us they were vigilant and checked the safety of the person’s environment whilst supporting them. This included identifying broken equipment, trailing leads or out of date food. They said they would discuss any concerns with the person or their family to enable action to be taken.

One member of staff told us they were concerned about the safety of a person’s equipment and raised it with the family who didn’t know what to do. They spoke with the office who arranged for a full reassessment and new equipment to be delivered.

Records showed risks associated with a person’s environment were assessed during their initial assessment. This included adequate lighting and ensuring windows and doors were secure. Records showed smoke alarms were in situ and fire escape routes were kept clear. The registered manager told us they would add details about any evacuation procedures.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Recruitment records were safe and consistent. All staff completed a structured five-day induction, shadowing, and competency assessments prior to lone working. Staff told us that training was good and that they only worked alone once they felt confident and comfortable.

People were very complimentary about the staff. They said they were supported by a small staff team who knew them well.

The registered manager told us many of the staff team had worked at the service for many years. They said staff were experienced and supported people well. Spot checks and home visits confirmed strong relationships and familiarity between carers and service users. Matching considered language, culture, religion, age, and complexity of need. The service had regular bank staff, which ensured continuity even during absences.

Staff received regular support, supervision, and ongoing training to keep their knowledge and skills up to date.

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.

People told us staff demonstrated good infection prevention practice. They said staff regularly washed their hands and changed their personal protective clothing when required. One person told us staff were “brilliant” when helping them with personal care. They told us “They always make sure everywhere is clean and tidy after helping me.”

There were effective systems to prevent and minimise infection. This included staff training and regular audits of staff practice. Staff confirmed this and said their training included hand washing and how to safely put on and remove personal protective equipment. Staff said there was always personal protective equipment in nearby locations and would always wear a mask if they had been unwell, or if a person wanted them to.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

The medicine administration records showed clear instructions, and staff had signed to demonstrate they had given the person their medicines.

There was written guidance regarding medicines to be taken ‘as required’. Staff told us most people were able to ask for these medicines, but for some people the guidance helped them to understand if a person may need things like painkillers to ensure that people were comfortable.

People told us they were happy with the support they received with their medicines. They said staff prompted them to take their medicines and watched to ensure they had taken them.

There were systems to ensure the safe administration of people’s medicines. This included staff training and assessments of staff’s competence.

The electronic care planning system highlighted if medicines had not been given, and there were regular audits throughout the day. This identified any errors so prompt action could be taken to minimise any harm.