Tamworth Home Care Limited

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 inspection we rated this key question inadequate. At this inspection the rating has changed to good. This meant people were safe and protected from avoidable harm.

The provider was previously in breach of legal regulation in relation to safe care and treatment and staffing. Improvements were found at this inspection and the provider was no longer in breach of these regulations.

This service scored 69 (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 provider explained the changes they had made since the last inspection where we found significant improvements were required. Comments from management and staff were, “It was chaotic, and we worked separately” and “We have worked so hard to improve.”

It was clear from management and senior staff conversations; they understood their roles and responsibilities. Staff said supervisions and observations of their practice helped them maintain expected standards.

Senior care staff explained they were responsible for reviewing people’s risk assessments and care plans, especially following adverse incidents to ensure any emerging risks were identified and plans implemented to keep people safe. We found care plans and risk assessments had improved since our last inspection. One senior staff member explained to us how they completed care quality audits and understood the benefits in how improvements led to positive outcomes for people.

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.

During our visit a senior staff member told us how following a medicines error they had informed external health professionals and sought emergency services support as a precautionary measure. They told us although there were no obvious issues they wanted to make sure the person was okay.

Throughout our conversations with staff we were told important information was communicated across staff teams and to others promptly.

During our visit we identified additional security measures needed to be considered to protect sensitive information about people held on the provider’s electronic care application on staff’s mobile phones. The manager took immediate action to resolve this with their IT provider.

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.

Improvements were found at this inspection regarding the effectiveness of the provider’s systems and processes to keep people safe from abuse. People and relatives told us they felt safe with staff.

Staff knew what to do to protect people from abuse. Accessible information and guidance was available to staff to remind them of their safeguarding responsibilities and how to report any concerns. Staff described to us what signs they would look out for, for example if people were withdrawn or if they noticed any unexplained bruising or injuries. Staff said they would have no hesitation in reporting any concerns to the managers, provider, Care Quality Commission (CQC) or to safeguarding teams in the local authority.

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.

Since our last inspection marked improvements had been made to the management of risks associated with people’s care and support needs. Care records provided staff with guidance they needed to provide safe care, including the equipment to be used and the number of staff needed to assist people who required support to move around their home. Care records for people who had catheters or risks associated with skin integrity, informed staff how to manage potential risks and the signs to look for.

Care records evidenced people’s involvement in risk management by clearly recording what people and or their families were able to manage independently and when staff should offer support.

Improvements had been made since the last inspection to identify, mitigate and manage potential risks in the care environment to support the delivery of safe care.

Environmental risk assessments of people’s own homes had been completed to ensure a safe working environment for staff to deliver care. Risks included the home layout, utilities, any potential hazards and equipment. For example, one person had a ceiling track hoist, and this was included within the environmental checks.

The provider ensured staff were trained to use any required equipment and to check they were in good working order, though not owned by the service.

The provider had improved their systems and processes to ensure the service could continue to be provided to people in the event of their IT system failing.

We received mixed feedback from people and relatives regarding the skills and experience of staff who supported them. Some people told us they were not always supported by a regular group of staff which impacted on the service they received, as they felt not all staff knew them well or fully understood their needs and wishes. Relatives shared some staff lacked training and understanding of some health conditions, for example dementia and how best to support their loved one. Despite this shortfall, people received safe care.

People and relatives confirmed they had not had any missed calls and staff stayed for the full duration of their call.

Staff had been recruited safely in line with the provider’s safe recruitment processes to ensure their suitability before they started working at the service.

New staff received an induction which included training appropriate to their role. One staff member told us, “I did my training when I started, everyone was so supportive, I found it really useful."

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.

At our last inspection concerns were highlighted in relation to staff’s compliance with the provider’s Infection Prevention and Control (IPC) policy. At this inspection people confirmed improvements had been made. One person told us, “They come in with PPE on, dispose of it into bags and take it to the bin. They always wash their hands.”

Staff had completed IPC training and demonstrated an understanding of how to reduce the risks of infection. One staff member said, “We have gloves, aprons and masks. We don’t always use the mask, but we have them. You can get a new stock from the office; there is always plenty."

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.

People’s care plans included a list of their medicines. We saw the list of medicines for 1 person did not mirror those recorded on the person’s medicines administration record (MAR). A senior staff member told us the person’s care plan did not always reflect the person’s MAR. This meant there was a risk staff did not have the correct information to support the person to take their medicine as prescribed. We reviewed examples of MAR’s and found medicines were administered appropriately. Staff completed daily observation records to evidence the times medicines were given.

Where people were prescribed creams and lotions to be applied directly to their skin, staff had completed body maps to show where these were to be applied.

Protocols for medicines prescribed as and when required (PRN) included clinical guidance in terms of medicine to be administered, reason for administration, and the maximum dose to be taken in 24 hours.

During our visit we found a medicine error had occurred. Staff noticed this at the following care call and promptly contacted health professionals to ensure the person was not put at risk.