Mend 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 service. This key question has been rated good.This meant people were safe and protected from avoidable harm.

This service scored 75 (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.

There was a strong culture of learning from events embedded within this service.Systems and processes were in place to learn from incidents, to prevent re-occurrence and promote safety. Learning from events involved a whole staff team approach. The registered manager told us that from the point of identifying an incident or concern, this was shared with the staff team, and where appropriate at each point of the process.Following this, the team would then discuss and debrief during a team meeting‘what can be done better’,decisions taken as a team moving forward, and shared further in newsletters.Staff confirmed this in their feedback, and we also saw evidence and audit trails of completed learning from events processes.This supported continuous improvement and helped reduce the likelihood of similar incidents occurring.

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.

The provider enabled people to have a safe transition between services. People’s care needs were identified before the person’s care started. At the start of a care package, the person’s health and care needs were assessed to ensure they could be met by staff and if any additional training or equipment was required. The information from the person, health professionals and the local authority was used to create an interim care plan and risk assessment. The interim care plan was reviewed after two weeks, and again after eight weeks to ensure it reflected the person’s care needs. Care plans identified any health and social care professional involved in the person’s care. External professionals provided positive feedback about the service’s approach to multidisciplinary working and advocacy for people.

People were involved in decisions about their care, and care plans were reviewed and updated to reflect any changes in need.

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.

People and relatives told us they felt safe receiving care and support from Mend Care.People were protected from the risk of abuse, and their rights were upheld. The provider had a safeguarding procedure so concerns could be reported to the appropriate safeguarding authorities immediately.

Records showed staff had received safeguarding training; staff understood what to recognise and how to report concerns of a safeguarding nature. Staff were aware of the provider’s safeguarding and whistle blowing policies and knew which agencies to contact if they felt the provider was not acting on their concerns.

Safeguarding concerns were shared with the Local Authority (LA) and CQC, as required.

Records showed concerns were logged, reported, and monitored to show what actions were taken and the outcomes from each case following safeguarding investigations.

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 were identified, assessed and kept under review. Care plans and risk assessments reflected people’s individual needs and preferences and supported positive risk taking. Staff worked with people to agree how risks could be managed in a way that respected their routines and abilities.

Staff understood their responsibilities under the Mental Capacity Act 2005. Where people had capacity, staff respected their right to make unwise decisions, ensured risks were explained, and escalated concerns appropriately when a person’s well-being was at risk.

People and relatives mostly told us they felt safe, and risks were managed well. A relative said, “The carers know [family member] so well, and [family member] knows them. The [service] fiddled around with the care, until they got it right, but it’s lovely care now… They fill me with confidence that [family member] is safe with them.”

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 provider undertook risk assessments, with measures to reduce risks, of people’s home, equipment used and fire safety. Guidance was provided for staff on how to support the person in case of an emergency. Following an audit of care notes, the managers incorporated a section for staff to complete to address the safety of the environment and a hazards check. This ensured staff were always assessing the environment both for the people living there and the safety of themselves and colleagues.

People and relatives told us that they felt staff worked safely in their home, and ensured the environment was safe when staff were both in the home and after they had left. We were told by relatives, “The [service] has very professional staff, and are on top of anything,” and, “[Family member] trusts all the carers.”

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 told us staff usually arrived on time for their care visits, let them know if they were going to be late and stayed for the full time of the visit. In response to this question one person answered, “Yes always”, however one relative said, “We’ve had a couple of instances where nobody has turned up, but they have apologised, it was OK”. The manager carried out audits of visit times to identify any gaps or patterns of lateness. The provider apologised, in line with the duty of candour responsibility to be open and transparent when things go wrong. Visit times were now monitored using an electronic system to ensure they occurred as planned.

There was a process in place for safe recruitment to ensure new staff had the appropriate skills, knowledge and were suitable to work with people using the service. Systems had been implemented and tightened following an incident which highlighted a gap in their due diligence of confirming staff were safe to work with vulnerable people. Managers were able to reflect and be open and honest about what hadn't been done well, and what has since improved.

New staff completed an induction and shadowed experienced staff. Staff had their competency and skills assessed. Staff were supported through supervision and team meetings.

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 provider has processes for the management of infection. Personal protective equipment (PPE) was readily available and used appropriately by staff. Staff received infection prevention and control (IPC) training, and competency checks to support safe practice. People confirmed staff followed good IPC practices in their homes.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. People’s medicines were administered as prescribed and in a safe manner. People were involved in decisions about how their medicines were managed.

Where the service administered medicines, effective systems were in place to ensure medicines were given as prescribed. People told us staff supported them appropriately and responded when they were unwell. One person said, “They help me with my meds .. they say to me ‘shall we take this now?’, they’re ever so nice.” Relatives also told us medicines were managed well and they were involved in the processes as agreed. A relative told us, “I get the medicines from the chemist, and the carers administer to [family member]. It works well.”

Staff completed training on the administration of medicines and had their competency regularly assessed. Staff confirmed they felt confident when administering medicines due to the training and guidance provided. A staff member told us, “A medication administration training certificate was required at the beginning of employment, and often, we are given material to reflect on and refresh our memory, on top of the company policy we can refer to.”

Records were monitored so any concerns could be identified and addressed promptly. Where errors occurred, these were reviewed and actions taken to support learning and reduce the risk of recurrence.