Hales Group Limited - Ipswich

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 changed to good. This meant people were safe and protected from avoidable harm.

At our last inspection the service was in breach of legal regulation in relation to safe care and treatment. At this assessment improvements had been made, and the provider was no longer in breach of regulation.

This service scored 66 (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.

Lessons learned were documented and disseminated to staff, for example, as a message on their hand-held device, which was seen when logging into the system and a flag to the management team to show it had been read.

There was a duty of candour policy and procedure in place and the management team explained when this was used including providing people using the service and their representatives, where appropriate, an explanation of what went wrong and an apology where required.

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.

The management team told us they had good working relationships with other professionals involved in people’s care. The registered manager told us how assessments were undertaken prior to the start of a person using the service and received information from previous care services and commissioners, where appropriate. This information was used to ensure the move between services was managed to reduce the risks of people receiving inappropriate care.

A person’s representative told us how the service had worked with them and the person to ensure when the person started using the service it went well, and the person knew what to expect. Another person’s relative told us, “There was an assessment done from the hospital. The manager came and we went through things."

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 registered manager told us they had accepted safeguarding workshops from the local authority. We saw records which showed staff had reported concerns to the local authority safeguarding team, who were responsible for investigation concerns of abuse. However, we were not always receiving formal notifications for safeguarding. We were assured this was a misunderstanding relating to if the issues reached the local authority safeguarding threshold. The registered manager told us this would be addressed.

Care workers told us they received training in safeguarding and also in whistleblowing and understood their responsibilities in reporting concerns. As well as the training and the available policies and procedures relating to safeguarding and whistleblowing, care worker’s understanding was checked during the registered manager’s ongoing monitoring systems. Care workers were reminded of their responsibilities in reporting any safeguarding concerns in a team meeting in April 2025. A care worker told us, “Safeguarding is protecting people I care for from abuse, neglect and harm, I identify abuse by observing for isolation, breaking in homes, physical abuse example bruises, low self-esteem and I should report to the office and do understand our policy and procedures on safeguarding.”

Lessons were learned when safeguarding concerns were identified, which reduced future risks.

The provider worked with people to understand and manage risks by thinking holistically. However, improvements were ongoing in how risks and how to mitigate them were documented.

People told us they felt safe with their care workers. One person said, “I think their training is good, I have always felt safe with them.” A relative told us, “The carers are lovely, all nice and polite. My [family member] is very safe with them.” Another relative said, “One or two of the carers are not particularly good, but [family member] is always safe.” People and their representatives, where appropriate were involved in the planning of their care and how risks were mitigated, for example in assessments and reviews.

Care workers had received training in moving and handling, including equipment used, and their competency had been checked.

People’s care plans included risk assessments and guidance for care workers in how risks were being mitigated. However, the documents varied in quality, and some were not always person centred, such as reductions in risk were listed but were not always appropriate for the person, for example the use of bed rails when they were not being used. A person’s care records had been updated in part, but not throughout, when there had been changes in their need to reduce the risk of choking. However, the prompts for tasks the care workers were to deliver on their hand-held devices were up to date, which reduced risks. Care worker’s handheld devices also included a ‘bio’ of each person they supported which included important information such as allergies and specific risks they needed to be aware of. The registered manager had sent communication to care workers to explain the process for body maps and when these should be used, as well as care notes to ensure any injuries were reported.

The registered manager had identified improvements were required in care plans and risk assessments and this was in the process of being addressed. Progress was included in the service’s ongoing improvement plan. These improvements had not yet been fully implemented at the time of our assessment.

The provider detected and controlled potential risks in the care environment.

Risk assessments were undertaken by the management team on people’s homes. Guidance was provided to care workers on how risks were mitigated to ensure care workers and people who used the service were safe during care visits.

Systems were in place to reduce risks in the office environment, including the landlord’s fire safety checks and during our assessment we saw portable electrical appliances were being checked to ensure they were safe for use.

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.

The registered manager told us the service had enough care workers to undertake the planned visits to people and recruitment was ongoing. A care worker said, “The staffing levels are generally well managed, and rotas are planned to ensure all visits are covered and service users’ needs are met safely.”

A care worker told us, “Most of the time there are enough care workers to complete planned visits and meet people’s needs safely. Occasionally we have a few staff who may call in sick, whilst a few are on their holiday at the same time which may require the office to adjust our weekly/monthly schedule. But despite the unforeseen circumstances, we have always achieved success in meeting up with each schedule for our various service users as we have enough staff doing their rounds.” A member of the office team told us the office staff had received training in care, which enabled them to undertake care visits where required, such as unexpected absence of care workers.

Care visits were kept under review to reduce the risks of missed visits, a member of the staff team told us about the processes in place to prevent missed visits to people. The provider’s contingency plan included details of actions to be taken should there be a shortage of staff, including the use of agency.

Care workers told us recruitment checks were undertaken before they started working in the service and they received an induction which prepared them for their role. Records confirmed safe recruitment processes and included evidence to show the induction incorporated the Care Certificate standards.

Ongoing training kept care workers up to date with the requirements of their role and care workers could undertake relevant qualifications. Care workers told us they received the training they required to meet people’s needs. A care worker said, “Yes, I feel well-supported and adequately trained to provide safe and effective care. The company offers regular training updates, refresher courses, and access to guidance whenever needed.” People and relatives told us they felt the care workers were skilled. One relative said, “They are skilled and understand my [family member]."

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.

Care workers told us they had access to enough personal protective equipment (PPE), such as gloves and aprons and had received training in infection control. Training records confirmed care workers had been provided with training in infection prevention and control training. Care workers were monitored to ensure they were following good infection control procedures such as in spot checks.

Records showed care workers were advised on how to reduce cross contamination, including using PPE.

Ongoing improvements were being made to ensure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

The registered manager told us how ongoing monitoring of medicines administration were being undertaken, this was confirmed in records.

During our assessment we reviewed people’s care plans, daily notes and medicine administration records. Care plans did not always include the specific support people required with their medicines, such as how they took their medicines. The registered manager assured us this would be addressed. Where people did not require support with their medicines, the care plans did not always include information about their prescribed medicines which may support the care workers in identifying any issues such as risks of falls. The registered manager told us they would look into this and would also document if a person did not wish to disclose their medicines. A member of the office team told us they had not included all information about medicines when care workers were not supporting people with this to reduce confusion when supporting people, and care workers were aware of where people’s medicines were kept, for example, if other professionals needed to know what the person took.

People told us they were satisfied with the support they received with their medicines, when this was required. A person told us the care workers brought their medicines to them during visits, so the person could access them. Another person said, “I do my own medication, but they help with creams.”

A person’s representative told us how they had requested care workers support the person with their medicine, “Instead of the carers just saying yes, they went back to the office, and they contacted us, I had to copy the prescription, and they checked, added to care plan… got it all in place really quickly. Filled me with confidence.” A relative said, “Staff check [family member’s] medication every single day without fail and prompt medication if [family member] has not taken it.In this respect they are very thorough and have reported to me straight away when [care workers had identified issues].” Another relative told us how they had recently received a message from a care worker to let them know their family member’s medicines were due to run out. Although they were aware and were taking action, it was positive the care worker had recognised this and acted.

Care workers had received training in the safe administration of medicines and their competency checked. A care worker said, “Medication training is provided, and competency checks are carried out regularly to ensure safe administration and record-keeping in line with company policies.”Another care worker told us, “I support people with their medications, I have received intensive training, and this is done safely and well documented."