Compassion First Home Care

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 72 (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 they had made recent changes to the management team to further improve the service. They had recruited an operations director who had begun to review the oversight of the service. One area already completed was to review accidents/incidents for any themes or patterns. The operations director had reviewed all incident reports (although some were staff actions to take rather than incidents) and was still completing overall analysis. The operations director was confident there was no concerns at the service but felt through improved systems, they would have confidence and could act swiftly if themes emerged.

The registered manager and the whole staff team were involved and participated well in this inspection. They wanted to learn from the inspection and had researched the changes to (CQC) inspection methodologies to best prepare themselves. The registered manager welcomed any suggestions we discussed, particularly around medicines and quality assurance. They viewed the inspection as another learning opportunity to embed good practice.

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 provider’s systems held information about individual risks to people’s health, their medication and wishes. This information in an emergency, could be shared with other health professionals, such as when a person could be admitted to hospital. This information would help to ensure people’s pathway to other care services was seamless. Senior staff and the registered manager described to us their processes for assessing new people to the service. This included additional reviews of people’s care calls to make sure, people were happy with the care, continuity and timings. Staff liaised with occupational therapy when people needed specific equipment and other health professionals’ involvement was managed well, meaning people received care, especially when their needs changed in a timely way.

The provider did concentrate on improving people’s lives to protect their rights for making decisions in people’s best interests. People did live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider did work well with people and healthcare partners to understand what being safe meant to them and how to achieve that.

Without exception, people and their relatives felt completely safe with those staff who supported them. Staff knew their responsibilities to help people remain safe and protected from poor practice. Staff were clear that any incidents of abuse would be reported to management or to other external agencies where needed. Staff told us they received safeguarding training and had access to contact details for those agencies who could offer support. The registered manager had not had to make any referrals to safeguarding but they understood when and how to do this.

The provider worked well with people to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

An important part of assessing people’s care and treatment, was how to manage any present risks related to people’s health and welfare. Care records informed staff about individual risks. For example, 1 person’s care records included guidance to mitigate the risk of managing and maintaining their skin integrity. A risk strategy included making sure prescribed creams were applied to keep skin on sensitive areas, moisturised. Records showed staff had followed this instruction.

Staff told us they referred to people’s risk management strategies to help keep people safe. One person needed help from staff when using a piece of walking equipment. This person said, “I use a walking frame. Staff help me around with it and they help me to get washed. They stay by my side so there's no risk of falling.”

We found some care records needed to include further guidance for staff. In particular, how to manage a person’s anxieties or how to encourage a person with personal care. However, speaking with the registered manager and staff who all delivered care, they knew what to do. The registered manager assured us they would update the care records to include this information.

The provider did detect and control potential risks in the care environment.

The provider ensured that equipment, facilities, and technology supported the delivery of safe care. People lived in their own homes, so the care provider was not responsible for individuals’ personal equipment or the condition of their home environment. However, the registered manager undertook risk assessments in people’s home to ensure the environment was supportive to deliver safe care and treatment. Regular equipment checks were completed by external professionals to make sure people’s safety was protected. Staff told us if they saw any concerns of safety risks within the person’s home they would tell the person, their family members and office staff.

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.

People and relatives were positive about the staff. People said their care calls were on time and for the time duration they needed.The registered manager used an electronic system to manage care calls. Daily oversight of the ‘live system’ showed what care calls had been completed and which calls were next. If staff were running late, the system flagged this and a staff member would let people know. The system was co-designed by the registered manager so if they needed to make any design changes in line with improvement suggestions, this could be achieved.

Speaking with staff, they confirmed they received training relevant to their role and they had their practice observed through on the spot checks. Staff said they usually saw the same people so knew them well and they had enough time to provide the support people needed. Staff said travel time was factored into their day so they were not always rushed.

The provider used safe recruitment checks that were completed prior to staff starting with the service. Recruitment checks included staff identity checks, references and Disclosure and Barring Service (DBS) checks. DBS checks provide information about convictions and cautions held on the Police National Computer. This helps providers make safe recruitment decisions. Senior staff completed ‘observed staff practice’ checks on staff to ensure they continued to be safe to support people and staff received supervisions to discuss any learning opportunities.

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.

Staff knew when to use personal protective equipment (PPE) and they understood when to use PPE to minimise cross infection risks. One staff member said, “We wear gloves, aprons and we wear masks if people have a cold.” One staff member said in addition to gloves and aprons, they wore shoe protectors at some people’s request to protect people’s flooring, as well as minimising risks of cross infection.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

People told us they received their medicines when needed. In some cases, people who were able to, were reminded to take their medicines during their care call. Nobody raised any concerns to us when staff administered their medicines.

Staff completed an electronic medication administration record when they administered people’s prescribed medicines. However, we found some improvements were required in the way some people’s topical creams were recorded. The provider’s electronic medicines administrations records were not enabled to record where on the person; staff applied a prescribed topical cream. This was not in line with national guidance. Staff documented they had applied a topical cream, but they confirmed there was no chart to record the site on the body where it was applied. The registered manager told us following our visit, they had spoken with their system provider to include a topical cream chart for staff to complete. This would help ensure staff had the information they needed to ensure people’s topical creams were applied to the correct area of skin as prescribed. Medicine audits were completed, but they had not specifically checked if topical cream charts were being used by staff. Following our visit the registered manager told us they had included additional checks and would remind staff how to document topical creams.