Black Horse Care 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. 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 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.

The registered manager told us there had not been any safeguarding allegations or accidents and incidents whilst they provided care. There had been two complaints, and we saw these were dealt with in line with the complaints policy and lessons were learned and shared with staff. The provider had various policies including safeguarding, whistle blowing, accidents and incidents and complaints to help guide practice in this area.

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.

The registered manager told us all of the people using the service at the time of our inspection where self-funded, and as such were not under the care of local authorise or hospitals prior to them using the service. However, pre-care assessments of people’s needs were carried out by the registered manager to help ensure that care could be provided in a way that met people’s needs. The registered manager told us, “I do an assessment to identify the areas they [people] need support with and what their preferences are.” A person told us, “They [registered manager] came and sat down and asked me about all my health conditions and who my next of kin was. They checked the house out, they asked how I manage the stairs.”

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.

The registered manager told us there had not been any safeguarding allegations and we found no evidence to contradict this. The provider had safeguarding policies in place covering both adults and children and staff had undertaken safeguarding training. However, the manager was not fully aware of all their responsibilities for responding to a safeguarding allegation and was not aware of their responsibility to notify the CQC about allegations of abuse when we spoke with them. They gave a commitment to familiarise themselves with their safeguarding policies.

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.

Risk assessments were in place for people. These were drawn up with the involvement of people to help make them person-centred. They covered risks including moving and handling, skin integrity and medicines. They set out the risks people faced and included information about how to mitigate those risks. People told us they felt safe using the service. A person said, “They [staff] make me feel comfortable and safe.”

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

supported the delivery of safe care.

As this was a domiciliary care agency where the service supported people who lived in their own homes, the provider did not have responsibility for the safe maintenance of the property or the equipment used. However, the provider had carried out environmental and fire risk assessments of people’s homes to help ensure support was provided in a safe way.

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.

There were enough staff to meet people’s needs. The registered manager told us punctuality was good and they were able to monitor it electronically. People confirmed staff were punctual, 1 person told us, “[Staff member] is always on time.”

The provider carried out pre-employment checks on prospective staff to help ensure they were suitable to work in a care setting. These included employment references, proof of identity and the right to work in the UK and criminal records checks.

Staff received regular training to support them in their roles. This included training on working with people with learning disabilities and autism, dementia care and first aid. New staff completed the Care Certificate. This is a training programme designed specifically for staff working in adult social care.

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 had an infection prevention and control policy and procedure to help guide practice in this area. Staff had undertaken training on the subject. Staff were expected to wear personal protective equipment when providing support with personal care and there was a good supply of this in the location’s office.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.
The service supported 1 person to take their medicines at the time of inspection. Electronic medicine administration records were in place which staff signed every time they gave the person medicine. We checked a sample of these and found them to be accurately completed and up to date. The registered manager told us they audited medicine records every week but did not keep any record that they had been audited unless they identified an error. We recommend the provider keeps a written record of medicines audits to demonstrative that they are in place to help identify shortfalls and drive improvements.
Staff undertook training in medicines administration, and the provider had a policy in place to help guide practice. People told us they were happy with the support they got with their medicines. A person said, “They make sure all my medicines are taken, which helps me with my anxiety.”