Continuity Healthcare Services Private 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 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.

At the last inspection we found incidents and accidents were not consistently reviewed by the management team to ensure changes were made for everyone using the service where relevant. At this inspection we found this had improved. Incidents, accidents and near misses were recorded and reviewed by the management team to ensure actions were implemented. Learning from incidents was shared with all staff to ensure they understood changes in the way they needed to work. Staff told us this process worked well and they received clear, prompt information about any changes to the support people needed. Staff told us they took part in reflective practice following incidents, to look at what happened and whether there were ways a situation could have been handled better.

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 told us systems worked well when they started to use the service, with good communication between services. Comments included, “It was a seamless transition of care”; “Everything was set up from hospital, and they passed their assessment to Continuity”; and “The service fits well with the network of services we depend on.”

The registered manager told us senior members of staff completed assessments with people prior to their care starting. Staff told us they received good information about people’s needs and how they wanted their care to be provided.

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 with staff from Continuity Healthcare in their home. Comments included, “I get mostly the same carer, and I am very pleased with the standard of care and how I am treated.” People were aware how they could raise any concerns and were confident they would be listened to and action taken in response.

The provider had safeguarding policies, which were discussed regularly in staff meetings. Staff demonstrated a good understanding of their safeguarding responsibilities and said they completed regular safeguarding training. Staff were confident managers would take appropriate action if they reported safeguarding concerns. Staff were also aware how to raise these concerns outside of the organisation if they needed to.

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.

At the last inspection we identified shortfalls in the way risks were assessed and managed. At this inspection we found this had improved. People had now been supported to develop clear risk assessments and management plans, setting out support they needed to managed risks they faced. The plans had been developed with relevant professionals and had been regularly reviewed and updated as people’s needs changed. Examples included input from community nurses and an epilepsy specialist nurse.

People and relatives told us risks were well managed. Comments included, “[My relative] fell 4 months ago, which has had repercussions for their mobility. All the staff seemed well aware of the changes to the care plan. There is a risk assessment about trip hazards, key safe arrangements and so on, which has been reviewed every so often, so I believe safety has a high priority and I haven't had any worries” and “I’m very happy how they have assessed risks in the home and in the care.”

Staff demonstrated a good understanding of the risks people faced and how to support them safely. Staff told us risk management plans were regularly reviewed and updated as people’s needs changed. Staff had access to updated plans through an electronic care planning system and were notified of any changes.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Staff completed assessments of people’s environment and took action to ensure people remained safe. The provider made referrals to other agencies where relevant, for example occupational therapists and medical equipment suppliers.

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.

At the last inspection we found there were not always enough staff to ensure people received their care at the planned time. Staff did not always have the training and skills needed to meet people’s needs. At this inspection this had improved.

The provider had focused on the planning of schedules to improve the timing of people’s care visits. This had resulted in improved feedback from people about the reliability of their care. Comments from people included, “Timekeeping is very good”; “Two carers come together and they are absolutely on time”; and “They have very good timekeeping, and they inform me if they are running late, but that is very rare.” The registered manager kept an incident log of all calls that were more than 30 minutes late. Records demonstrated the registered manager had investigated the reasons for lateness and taken action to make improvements, for example changes to schedules to improve timekeeping. Records also demonstrated people had been contacted to inform them their carer was delayed and to apologise.

People told us staff had the knowledge and skills to meet their needs, with comments including “The carers are very respectful, they know what to do and they do it very well” and “So far I’ve been happy with the service. The carers are all fully competent and we’ve formed good working relationships.” Staff told us they received a good induction when they started work and completed regular training which helped them provide the care people needed. The registered manager had a record of all training staff had completed and when refresher training was needed, which helped them to plan the training schedule.

Staff had been recruited safely and all required pre-employment information had been obtained before they started work. These included a criminal record check and confirmation the staff had the right to work in the UK.

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.

People told us staff followed good infection control procedures, with 1 person telling us, “They wear [protective equipment] as necessary, I’ve never thought any aspect of hygiene has been overlooked.” Staff told us they had completed infection prevention and control training, and the management team checked this during observation of staff practice. Staff said they had access to all the equipment they needed, such as personal protective equipment. The registered manager said they completed spot checks on staff every 3 months to ensure they were following infection control procedures.

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.

People told us staff provided good support for them to take their medicines, with 1 person telling us, “They get my tablets out for me and record that I’ve taken them.” Medicines administration records had been fully completed, with details of the medicines people had been supported to take. Where people were prescribed ‘as required’ medicines, there were clear protocols in place, which stated the circumstances in which the person should be supported to take the medicine. This helped to ensure people were only supported to take these medicines when they were necessary. Staff had completed training in the administration of medicines and their competency to administer medicines was regularly assessed to ensure they were supporting people safely.