Pearl Home Care Ltd

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 service under its new registration. This key question has been rated good.

This meant people were safe and protected from avoidable harm.

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. Feedback showed the provider was open and honest and acted promptly to address issues when they occurred. Accidents and incidents were recorded and reviewed for themes and trends and any lessons learned shared with the staff team to mitigate future risk.

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. People’s needs were assessed before support commenced with involvement of both people and, where appropriate, their families. The service worked with other professionals to promote safe transitions between services. For example, we saw where people had been discharged from hospital, staff had worked with health professionals to ensure safe support was in place on their return home.

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. Records showed safeguarding concerns were reported promptly to the local authority and the Care Quality Commission (CQC). People and their relatives told us they felt safe with the support provided by Pearl Home Care Limited. One relative told us they had no concerns with the support provided, “Staff are warm and compassionate, and [relative] feels safe with carers.” Staff had completed safeguarding training and the provider’s policy guided staff about how to recognise and report abuse. Staff told us they felt confident to raise concerns if they felt people were at risk and that action would be taken. One staff member told us, “I follow the safeguarding policy immediately by reporting my concerns to [Name of registered manager] and recording the information accurately, and I will contact Barnsley safeguarding authority via telephone or use the local referral form. Ensuring the individual’s safety is always the priority.” The principles of the Mental Capacity Act 2005 (MCA) were understood by the registered manager and there were processes in place to review people’s capacity in line with the MCA.The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act (MCA). We found the service was working within the principles of the MCA.

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. However, some care records or risk assessment needed additional detail to allow staff to have sufficient guidance to support people appropriately and mitigate all risks. For example, the care plan for 1 person with a Percutaneous Endoscopic Gastrostomy (PEG) feeding tube who also had a modified diet needed clearer guidance for staff around their modified diet and any potential choking risk. This was a recording concern, and we found no evidence of harm to people as it mainly related to people where family or partners provided overall support. The registered manager agreed to review care records immediately and ensure they had the level of detail required to support people safely and effectively. Staff had completed a range of training to support them in managing risk. One staff member told us, “I learned how to move clients safely without causing harm to them or myself.” People and their relatives told us staff supported them safely.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The environment was assessed prior to support starting and reviewed at intervals to ensure safety of the individual and staff. Where equipment was used to support people, systems were in place to ensure checks of equipment were completed regularly. Staff had received training in health and safety and knew how to assess and report environmental risks. One staff member told us about training they had completed, “It covered how to support individuals safely while protecting staff and the person from injury. It also covered risk assessments and safe moving techniques, also use of equipment.”

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. People and their relatives expressed no concerns about staffing levels or calls. One relative told us that staffing levels were good and that they had never had a missed call. They told us that the correct number of staff always attend even at weekends and evenings and on the rare occasion that staff have been more than 15 minutes late staff have always remained in contact to explain the reason they were running late. One relative told us they would like more consistent staff for their relative to allow relationships to build but was positive about all staff that visited. Staff generally expressed no concerns about staffing levels, but some staff told us that improvements in rota planning and travel time as well as call spacing would improve consistency, reduce pressure on staff at busy times and improve work life balance with hours worked over a shorter period. Staff completed an induction on commencement of employment and ongoing training and refreshers to enable them to carry out their role effectively. Staff working with adults with a learning disability or autistic people had completed training in learning disability and autism. A few staff commented that morale was sometime variable and could be improved by an increased focus on staff wellbeing. However, staff overall told us they felt well supported in their roles and received regular support and supervision.

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 received training in infection prevention and control (IPC) and policies were in place to manage the risk of infection. No concerns were raised by staff, people or families about the availability of personal protective equipment (PPE) or the management of infection. One person told us that they never have any concerns regarding staff and PPE. They commented, “Staff always wear PPE, for example shoe coverings, as soon as they enter the house. Plastic gloves, aprons etc are worn when helping with personal care.”

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. However, guidance for staff on the administration of some medicines needed further detail including for those medicines taken as required (PRN). Guidance for staff on administering medication for people with a PEG (Percutaneous Endoscopic Gastrostomy) tube also required further clarification to ensure safe and consistent practice. These were recording issues, and we found no evidence of harm to people. Management oversight of medicines recorded on the electronic system was difficult with reports providing different views for staff and managers. The registered manager acted promptly to resolve this with the providers of the system to ensure clear oversight of medicines was available and to allow more effective medicines audits to be completed. Staff were trained in medicines administration, and their competency had been assessed. People were supported by staff who followed systems and processes to administer, record and store medicines safely. People and their families raised no concerns regarding administration of their medicines. The provider had a medicines policy, and this included the principles of STOMP (stopping over-medication of people with a learning disability, autism or both). People were supported with their medicines in line with the policy.