Parry Healthcare Wiltshire

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. Requires Improvement: This meant people were not always safe and protected from avoidable harm.

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 detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. For example, equipment required by a person had stopped working and the provider ensured that they contacted the correct people to have the equipment repaired quickly. Staff told us about environmental risk assessments which detailed areas of risk and ways to mitigate these risks. Staff told us that they checked equipment for maintenance dates before use.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. Care records contained assessments which had been completed with people. These assessments identified risks to people and how they would be mitigated. Staff told us that information about people new to the service was shared with them. One person told us their transition was 'excellent.'

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 safety and supporting them to be free from bullying, harassment, abuse, discrimination, avoidable harm, and neglect. The provider shared concerns quickly and appropriately. Where people were at risk of harm, the provider took appropriate action and notified healthcare partners. People told us they felt safe. Staff told us they had access to risk assessments and training to keep themselves and the people they supported safe. However not all staff had read these risk assessments. Staff completed safeguard training. Some staff told us they had a safeguarding lead and knew how to report concerns or signs of abuse. However not all staff we spoke to were confident or had a clear knowledge and understanding of safeguarding. .

The provider did not always work well with people to understand and manage risks. Staff told us that administrative or senior staff completed risk assessments which they had access to on an electronic system. However, not all risk assessments had been read by all staff. For example, a risk assessment was in place for a person with moving and handling needs. We saw that not all staff had read this risk assessment prior to supporting the person. The Registered Manager told us the electronic system did not record who had read documents and there was no other system to enable them to monitor that staff had read risk assessments. This meant that the provider could not ensure that staff were aware of risks or the actions to take to mitigate these risks and keep people safe.

Risk assessments for medicines did not always identify individual risks regarding specific medicines. We saw that a medicines risk assessment for a person identified medicines that may pose a risk but did not identify if these medicines were prescribed to the person.

People’s emergency evacuation plans (PEEP) which were completed to give guidance in the event of a fire, did not have adequate details to ensure staff knew how to support people safely. For example, one PEEP we viewed, for a person who required a wheelchair and hoist, did not state who controlled the wheelchair and had not identified the additional time it may take to use the hoist. This meant the provider could not always ensure that people were supported safely.

People we spoke to were not always aware of their risk assessments. One person we spoke to said they did not know about their risk assessments. This meant that the people were not fully involved in their risk assessments and may not have been fully aware of what would happen in the event of an emergency.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. For example, equipment required by a person had stopped working and the provider ensured that they contacted the correct people to have the equipment repaired quickly. Staff told us about environmental risk assessments which detailed areas of risk and ways to mitigate these risks. Staff told us that they checked equipment for maintenance dates before use.

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. The provider’s training records showed that staff had completed training required to ensure they could meet people’s needs. Staff told us they had a 4-6 week induction which included online training and shadowing competent staff. The provider had recruitment records which showed that pre-employment checks had been completed. However not all of these records were complete we saw that one staff members application form dates of employment di not match the reference provided. One staff members records contained one reference but the provider had not completed a risk assessment to mitigate any risk associated with this. This meant the provider could not ensure that all staff were recruited safely.

People we spoke to said they felt staff were trained. The provider told us that 6 staff predominantly worked within the Wiltshire branch, and that people were supported by set staff members. However, people told us that staff they did not know often arrived and that staff were late. For example, we saw records which demonstrated, for one person they supported, that staff were more than 10 minutes late on 23 occasions over a 3 month period. Another person received visits over ten minutes late on 102 occasions during a 4 month period This meant staff provision was not effective, and people may have been left at risk of harm.

The provider assessed but did not always manage the risk of infection. They did not always control the risk of infection spreading. The provider had an infection prevention policy that gave guidance to staff.

Staff had completed infection prevention control training. Staff were able to tell us when they would wear personal protective equipment such as gloves and aprons and that there was enough of this equipment available to them. However, one person we spoke to told us that staff did not always wear gloves and aprons, or clean items thoroughly. We were told by one person that urine was regularly spilled on the floor and that their water bottles are not adequately cleaned. This meant that people were at risk of infection.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. The provider completed medicines audits to ensure staff were competent and supporting people safely. However, medicine administration recording sheets (MARS) did not contain full information in line with national guidance. For example, the completed audits failed to identify the number of tablets to administer in line with the prescription. We requested the medicines policy on more than one occasion and the provider did not provide this. This meant that if the policy was not available within the service there was a risk staff would not have full guidance when supporting people with their medicines and may not administer them safely.

However, staff had completed training to enable them to support people with their medicines. Staff told us they received training and the manager checked their competency. Staff knew how to report any errors in medicines.

People told us they were helped with their medicines. However, one person said that their medicines were not ordered in a timely manner. This meant that they were at risk of running out of medicines.