Archived: Dale Care - South Tyneside (Homecare, Extra 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.

This is the first assessment for this newly registered 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.

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 did not always have a proactive and positive culture of safety based on openness and honesty. The management team did not always listen to concerns about safety and did not always investigate and report safety events. Lessons were not always learnt to continually identify and embed good practice.

People who used the service and their relative’s felt improvements were needed. One person said, “I had one [care worker] who I couldn’t get on with, I asked them not to send this care worker back, but they kept sending them, so I had to get quite uppity with them, I think they got the message because the care worker has not been back since, but I shouldn’t have to get shirty should I.” Another person said, “You can ring them, but it goes through to the answerphone and just says, ‘can’t take your call ring back later,’ and that is the emergency line.”

The provider did not always work well with people and healthcare partners to establish and maintain safe systems of care. They did not always manage or monitor people’s safety. They did not always make sure there was continuity of care, including when people moved between different services.

The management team told us they identified when people needed additional support and made the requests to the person's representatives and local authority for additional time and requests for adaptations.

Assessments of people’s needs and associated risks were completed during the initial assessment of care to ensure safe, effective support.

Care plans detailed people's health conditions and provided the guidance staff needed to seek additional professional health support and when to make appropriate referrals to partners. However, staff we spoke with felt records were not always updated in a timely manner. Staff we spoke with said, “The care plans are updated to match people’s needs, but outdated tasks are rarely taken off, which adds to ticking of boxes which are not necessary and adds up to be time consuming.” And “Sometimes due to the amount of new packages in, the task of updating care plans gets lost and they are not always completed or sometimes delegated to a team that is not contracted to do the task.”

The management team worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They 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 management team shared concerns quickly and appropriately. Staff had training and a good understanding of what to do to make sure people were protected from harm or abuse. One staff member said, “Safeguarding means protecting the well-being, rights, and safety of individuals, especially those who are vulnerable, such as children, older adults, and people at risk of harm. It involves creating a secure environment, preventing abuse or neglect, and taking action when concerns arise.”

The provider did not always work well with people to understand and manage risks. The issue with late calls prevented staff being able to provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risk assessments were in place to support people’s health conditions. One person said, “The carers are very nice to me and I feel safe with them.” However, due to the lateness of some calls people were left at risk. One person said, “Well I have [a set appointment] three times a week and they are supposed to come and give me a shower before I go, they should be here by 8am but they can turn up at 6.50am or not turn up at all. Take last week, they didn’t turn up until 10.30am and I had already had to leave for [appointment].” One relative said, “Well they can turn up any time, we are waiting for the breakfast call now [9.35am].” We asked when they should call, “I don’t know, [relative] has 4 calls a day, double ups and they can turn up anytime, never when they originally said they would.” We asked about times, “Well, the earliest they [staff] have come is before 8am and the latest 11.30am, we were really cross yesterday as we waited for the lunchtime call until 3pm, it’s really dreadful, they have to be hoisted you see and it’s a long wait.”

We discussed the late calls with the operations manager who set up an action plan to rectify this.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care and worked with external professionals to review people’s aides.

Staff regularly checked that people were not at undue risk from their environment, for example trip hazards, clutter or electrical hazards. Staff we spoke with knew how to use equipment safely. One staff member said, “At the beginning of employment all staff undergo a three-day training course which we look at every piece of equipment we come across safely.” Another staff member said, “I know how to use equipment safely, we receive yearly training and training staff are on hand if we ever need help.”

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.

People and their families said they do not see the same staff; staff are rushed and staff turn up any time. Comments included, “We were really cross yesterday as we waited for the lunchtime call until 3pm, it’s really dreadful”, “They [staff] come four times a day, its all different ones, I don’t know who is coming” and “It is getting better, but some of the carers still want to be out before they come in.”

Staff we spoke with said, “No there is never enough staff” and “There is not enough staff to cover holidays and sickness.”

We passed these comments onto the provider who told us new staff had been recruited.

Recruitment processes were robust, and pre-employment checks were completed, further work was needed to ensure correct DBS checks were recorded.

Staff told us they did not feel supported by the provider and supervisions were not always supportive. Comments included, “If I look at supervision, I have attended myself I have found they are more of a ‘telling off’ and not very progressive”, “I have been contacted by phone to arrange a supervision three times in two years and haven’t had one yet” and “I have not had a supervision since Dale Care took over.”

We discussed these comments with the provider who assured us improvements had been and will continue to be made.

We saw evidence that staff had received the required training and staff we spoke with confirmed this. However, the provider could not evidence all staff supporting people with any additional needs or specific illnesses had received the required training. The operations manager said, “To rectify this, we are currently arranging refresher training with staff.”

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 appropriately followed the required infection control guidelines. People told us care workers wore Personal Protective Equipment (PPE) when supporting them and staff confirmed they had access to adequate supplies of PPE which were stored in the office.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. We could not evidence that people were receiving their time critical medicines as prescribed and protocols were not always in place for tablets to be administered when required.

Staff who administered medicines had the appropriate training and competency checks. One staff member said, “I feel I have had the correct training to feel confident enough to administer medications.”