Angelcare UK 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 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.

This service scored 78 (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 service demonstrated a clear focus on learning from incidents and improving safety. Effective systems were in place for recording and reviewing incidents and accidents. Staff understood the reporting process. Incident forms were reviewed daily by the registered manager and appropriate actions taken. A monthly analysis was completed, which considered themes and trends and identified lessons learned. Care records were reviewed and updated following incidents to reflect any changes in people’s needs.

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.

Effective systems were in place to ensure people’s needs were assessed, and could be met by staff, before care packages commenced. Information from assessments fed directly into care planning, ensuring staff had all the information they needed. Staff said, “We always get information about the person and the support they need before the first call.” and “We’ve got a new client starting tomorrow and we can see everything that needs doing on our system.”

Records showed timely referrals made to other professionals and good partnership working with external agencies, which helped ensure continuity of care and reduced the risk of gaps in important information.

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.

A safeguarding policy was in place. Staff had a good understanding of safeguarding procedures, knew how to report any concerns and were confident these would be dealt with appropriately. Records showed safeguarding incidents had been reported to the local authority and some had been notified to CQC. During the assessment, we found a small number of notifications had been overlooked. However, the registered manager took immediate action and submitted them retrospectively.

We were assured all appropriate actions had been taken to protect people from abuse. The monthly log recorded all safeguarding incidents, including details of the incident, action taken and how lessons learned were acted on.

People told us they felt safe. Relatives also felt their family members were safe. Comments included, “[Staff] treat me very well and I feel very safe around them” and “I’m very safe as this is a good group, and I have a number to ring if there’s any concerns but I don’t have any.”

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.

Risks to people’s health and safety were effectively assessed, monitored and mitigated. Detailed risk assessments were in place ensuring staff had all the necessary information to provide safe care and support. Where needs had changed or incidents had occurred risk assessments had been updated. Staff we spoke with knew people well and were aware of people’s individual risks and how these should be managed.

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

Detailed environmental risk assessments were in place which included fire safety, smoking and personal emergency evacuation plans (PEEPs). Separate assessments were recorded for equipment used in people’s homes such as profiling beds, bed rails, hoists/slings and wheelchairs. Step-by-step instructions were provided on how to use equipment safely and staff confirmed they had received training. Staff said the managers were pro-active in ensuring people had the right equipment to meet their needs and to ensure the safety of people and staff. For example, 1 person had a very low bed which could not be raised. The registered managers arranged for this to be replaced with a bed that could be raised and lowered. A hoist was arranged for another person whose mobility had deteriorated significantly.

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

People and relatives told us staff arrived on time and stayed for the full duration of their visit.They said staff always let them know if they were running late. One person said, “If they finish early, they sit down and talk to me or take my rubbish out. They are all very pleasant.” Systems were in place for calls to be covered in the event of unexpected absences and recent audits showed no missed calls

Recruitment and induction processes were safe and well managed. Staff followed a robust induction and shadowed more experienced staff until they were confident and had been assessed as competent in their role. A timeline sheet was provided to new staff which provided information about their first year of employment including check in phone calls and settling in meetings as well as observations, supervisions and an appraisal. A new staff member spoke highly of the induction and support given and said, “It’s a much better place than where I was working before, feels like family, everyone has been so welcoming.”

Staff followed a training programme which included recommended training in supporting people with a learning disability and autism. Additional specialist training was sourced in line with the needs of the person staff were supporting. The service has completed training in the Gold Standard Framework (GSF) and has applied for accreditation. The GSF is a structured approach aimed at improving the quality of care for individuals nearing the end of their lives, ensuring they receive personalised and coordinated support. The GSF guidance has been implemented into people’s care. All staff have completed GSF training and spoke confidently about how they used this to ensure people received high quality end of life care.

A relative told us of the exceptional end of life care provided to their family member, “[Staff] looked after [family member] for 13 years and allowed them to die in their own home, which is what they wanted. [Staff] helped us so much. The registered manager stayed with us until the funeral directors came and couldn't have been kinder. They arranged for all the equipment to go back and helped us sort everything out. They couldn't have done more. They went over and above. Even now they keep in touch and are very supportive.”

People and relatives said the staff were well trained and reliable. Comments included, “Very competent, we have no problems as they are great with [family member]”; “They are well trained as they know what to do. They treat me very well and I feel very safe around them” and “Some are exceptionally well trained, but they are all good.”

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.

The service had effective measures in place to protect people from infection risks. A register of people and staff identified those at higher risk of serious illness from community‑spread infections. This enabled timely monitoring and informed action during any outbreak, helping to minimise the risk of transmission to both staff and people using the service.

Staff received training in infection, prevention and control and understood what action they needed to take to keep people safe. Staff were supplied with appropriate PPE including gloves, aprons, masks, goggles and hand gel. Plentiful supplies were available from the office. Monthly infection control audits were carried out.

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.

Improvements had been made since the last inspection. Electronic medicine records were completed, clearly showing when medicines had been administered and correct codes were used to explain when medicines had not been given. Staff worked with people or, where appropriate, their families to decide where medicines would be stored within their homes. People’s medicines were audited weekly by the registered manager to make sure they were stored correctly and that staff were administering them correctly. Staff had received training in how to administer medication safely and had their competency assessed.

People who required support from staff with their medicines said they were given them ‘on time’ and their medicines were ‘never missed’.