Bargain Health 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. This key question has been rated Requires Improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

This service scored 59 (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.

Systems were in place to learn from lessons following accidents and incidents.

An incident and accident policy was in place that detailed the process to managing incidents. The registered manager told us that there had been no incidents but should incidents occur this would be analysed with action taken and lessons learnt to minimise the risk of reoccurrence.

The provider did not always manage or monitor people’s safety.

Systems were in place to capture information as part of the pre-assessment process to determine if the service can support people safely. This included speaking with the referring agency, the person and their relatives where possible.

Records showed a pre-assessment had been completed prior to supporting people to determine if the service can provide safe care and support and risks had been identified as part of the pre-assessment process. However, the information on risks such as with people’s health conditions were not detailed and therefore had not been effectively used to create risk assessments to ensure people received safe care at all times. This meant robust systems were not in place to capture information at pre-assessment stage to provide safe care to people.

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.

A safeguarding policy was in place that detailed the types of abuse and how to escalate concerns if staff suspected or saw abuse to ensure people were protected. A relative told us, “Yes, [person] is safe. They talk to [person] kindly; they listen to [person]. They just are very good.”

Staff knew about safeguarding processes and had received training in this area. A staff member told us, "I have had safeguarding training, it is the procedure to protect the service users from abuse and it is our responsibility to protect the service users. If anything happens, i will let my line manager know. "

The provider did not always work well with people to understand and manage risks.

Some risks to people were identified and included on care plans such as on falls and Urinary Tract Infections (UTI). However, measures in place following identification of risks were not being followed to ensure people were safe at all times. We found fluid intake charts were required to ensure the risks of UTI was minimised, however this had not been completed to minimise the risk of UTI.

Records also showed that people had health conditions and appropriate risk assessment had not been completed to ensure people were safe at all times.

We fed this back to registered manager who informed risk assessments would be completed and followed up on.

Failure to have robust risk assessments in place meant there was a risk people may be exposed to avoidable harm.

The provider detected and controlled potential risks in the care environment.

Environmental risk assessments were completed to ensure the people’s home was safe for both staff and people when delivering care such as identifying hazards to minimise risk of falls. Staff had been trained on fire safety.

The provider did not always make sure there were enough qualified, skilled and experienced staff. They did not always make sure staff received effective support,supervision and development. They did not always work together well to provide safe care that met people’s individual needs.

Staff had completed key training such as on basic life support, food hygiene, health and safety. Specialist training was also completed, including key topic areas such as on dementia. However, training had not been completed on learning disabilities, which is a requirement for all adult social care service delivering care and support to adults. The registered manager knew about the requirement and told us this training would be completed immediately.

Regular supervisions including appraisals had not been carried out to ensure staff were supported. The registered manager told us that supervisions should be completed regularly and appraisal completed yearly. The providers supervision policy also stated regular continual supervisions must be completed with staff with a minimum of 4 supervisions annually. However, we found that staff had not completed supervisions since 2023 and appraisal since the beginning of 2024.

Failure to ensure regular supervision were taking place and staff training needs were met meant that staff were not being supported in their roles at all times, which may impact on the support people received.

The service used a digital system to monitor staff timekeeping. The system alerted management if staff were late for calls, which then the office could monitor. The system gave the service oversight of staff timekeeping. Records showed that staff attended calls on time and there had been no missed visits. A staff member told us, “We are able to go care visits on time, I manage my time and we are given time to travel.” A relative commented, “Yeah, they do come on time. There has been no missed visits.”

Records showed relevant pre-employment checks, such as criminal records checks, right to work in the UK, references, health declaration and proof of the person’s identity had been carried out to ensure staff were of good character.

The provider had an effective approach to assessing and managing the risk of infection, which is in line with current relevant national guidance.

Systems were in place to prevent infection. Staff were able to tell us the process of ensuring people were protected from infection such as good hygiene protocols and wearing personal protective equipment and that they had been trained in infection control. Records showed that staff had been trained on infection control. Infection control audits were being completed. A staff member told us, “My company provides me with gloves, masks, aprons, shoe covers so everything I need. I have been trained on infection control as well.”

The provider did not always make sure that medicines and treatments were safe.

Medicines Administration Records (MARs) showed that some medicine had not been administered. The registered manager told us that this was due to relatives administering medicines prior to staff attending. This had not been included on the persons care plans or the MAR chart as the information on the care plan included that staff should administer medicines on certain shifts. The registered manager told us they would update the care plan to reflect the change in circumstances.

Medicine support plans were in place that detailed the type of medicines people were on and the support they needed. Risk assessment had also been completed for medicines that may potentially harm a person.

Staff told us they were confident in managing medicines and had received training on medicines.