Amaiva Homecare Services

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 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 providerhad 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.

Systems were in place to effectively monitor and manage accident and incidents. Information was evaluated and the registered manager acted upon any identified risks to improve safety for people and minimise future. For example, one person was trying to walk upstairs unaided and fell; after discussion with the person and their family a stair gate was introduced to minimise the risk of recurrence.The registered manager encouraged staff to be open and report all accidents or incidents. Staff followed correct reporting procedures and would fill in a form on the digital system as well as contacting a member of the management team to verbally communicate the event. Staff told us, “I do an accident form on an app on my phone and also report it to the manager” and “I know how to report, we fill in a form, do notes and inform the on-call manager.”Staff confirmed they were regularly updated and informed of any changes the registered manager made, either personally by managers or via the online system.

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.

After confirmed acceptance by the service, the core members of staff who would be supporting that individual were contacted by the registered manager for a verbal update on care needs and actions required; staff would then be accompanied and introduced to people on their first visit making sure the transition into Amaiva Homecare was a smooth and friendly experience for everyone involved. Staff spoken with confirmed this process happened. Staffing levels and the number of visits needed were discussed with people, and any specific equipment required to support safe delivery of care within the home, such as hospital beds or mobility aids, were requested by the registered manager to be put in place prior to the start date. A hospital passport was available which detailed the support needed and could accompany people in an emergency if moving to a hospital or different healthcare environment.

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.

All staff received training in safeguarding and the Mental Capacity Act, (MCA) and those spoken with confirmed they understood the importance of safeguarding and what signs of abuse looked like. Staff told us, “I would look for any changes in behaviour, or being more stressed than usual, look for all different signs” and “Physical signs, I would look for any extra bruising on a client’s body, things like that.” Staff knew how to report any concerns and confirmed they had spoken to managers about a previous client when they had concerns about a person’s family and a staff member told us, “The door is always open for us to talk with the managers.”People were supported in line with MCA principles which ensured people with capacity were able to make their own decisions, and any relatives that were legally authorised to make decisions on behalf of someone were involved in best interest’s meetings and decision making.The registered manager notified relevant parties, for example CQC and the Local Authority, of safeguarding concerns in a timely manner as required

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.

People’s care plans included risk assessments that identified specific risks and needs and how to manage them safely. Staff knew people well and supported them to manage any risks associated with their care or equipment. For example, a free-standing aid was used to enable someone to leave their home when wishing to go out into the community so they could navigate the entrance/exit and safely reach their wheelchair which staff had waiting for them outside. Staff recognised the importance of encouraging people to continue to do things they enjoyed and remain as independent as possible, and they mitigated associated risks accordingly. A staff member confirmed to us they accompanied people into the community and said, “It’s important that they get out, either a walk to the beach or what they like doing, for example we go to charity shops.”

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

Prior to commencing a package of care, risk assessments were completed on individual home environments and identified specific risks, for example ‘steep steps’, and highlighted things like ‘well-lit area’ and ‘well populated area’ so staff were informed and aware of the surroundings. Staff were provided with any required equipment, such as torches for out of hours calls, and personal alarms, ensuring staff safety was considered when accessing different properties. There was always an on-call person staff could contact for additional guidance if required. Internal risks were evaluated, for instance cluttered environments, where safe working space could be a challenge, and the presence of any pets. Smoke alarms were in place in people’s homes, and these were checked regularly with staff being made aware of the exits and general fire procedures to follow should an emergency occur. The registered manager ensured the correct equipment was in place to enable safe support for people.

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.

Staff recruitment processes were managed safely, with the required checks being made, for example, the Disclosure and Barring Service, who help employers make safer recruitment decisions and prevent unsuitable people from working in roles where they could cause harm. When joining the service staff were provided with a 2-stage induction, firstly shadowing experienced staff on visits to meet people and observe the support required, and then a formal induction, completing training and visual competencies. A staff member told us, “I had a good induction from the registered manager.” Staff confirmed they had access to all the necessary training needed to carry out their role, and accessed this on a digital system, with face-to-face refreshers, which were delivered by the registered manager who had completed a ‘train the trainer’ qualification.People were allocated a core team of between 3 to 5 staff ensuring continuity of care, and the registered manager considered staff skills and personality when matching staff to people, contributing to a positive working environment where trusted relationships could be established between client and staff. The staff rota evidenced this working pattern.At times staff worked together to support people who required more than one carer and staff confirmed they worked well as a team. Staff told us they had a good routine, communicating well with each other to deliver safe care and support, for example when using equipment to transfer people, and repositioning to maintain skin integrity. Staff were given regular supervision with managers to allow opportunity to discuss any concern or issue they may have and evaluate their current work performance.

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.

All staff completed infection control training. Staff told us they had good access to personal protective equipment (PPE) and confirmed they understood the importance of always using correct PPE when supporting people. We sawa stock of supplies in the main office and staff told us they would ring in to management if stock was low in people’s homes and it would quickly be replenished. A member of staff said, “I make sure I always have gloves in my car and when I wanted some aprons I was told they were already there in the home to use.”Daily care records confirmed staff used PPE appropriately when assisting people with personal care and documented that good hand hygiene was followed. Protocols were in place for the management of any outbreak of infection and the registered manager had policies available for staff to access and reference.

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.

Medicines were managed safely and people were receiving their medicines in line with the prescriber’s instructions. The registered manager completed ordering for people who requested support with this and liaised with GP surgeries and pharmacists, making sure everyone had enough medication in stock. All staff involved in supporting with administering medicines received training to ensure that they followed the correct procedures and protocols. Visual competency assessments were completed by managers before staff were left unsupervised to administer medicines on their own. The registered manager carried out regular staff spot cheques to make sure standards were maintained. The service used paper Medicines Administration Record Sheets, MARS, to record when and how medicines were given and had just changed over to a digital Emarssystem, but not everyone was fully enrolled in it, so both ways of recording were still in use. The digital systems had alerts which came through to managers and identified any changes with routines and meant staff had to adhere to correct practice and time frames or it would flag up on the system.Regular audits were carried out by managers, for example where someone had live-in care staff who worked 2 weeks on 2 weeks off rota, medication audits were completed every 2 weeksto ensure that if there were any errors they could be addressed with the correct member of staff.People’s preferences on taking medicines were detailed in care plans, for example, “Likes to take medicines with yoghurt or similar.” During our visit we did find some areas that required clarification and more detail, which we discussed with the registered manager; they immediately addressed the points raised and were responsive and proactive in their approach.