Grace Care 24/7 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 newly registered 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.

The service was in breach of legal regulation in relation to staff training and recruitment.

This service scored 62 (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.

The management team encouraged staff to report any accidents incidents or concerns that occurred. We were told there had not been any accidents or incidents that needed to be recorded to date, and staff spoken with confirmed this. However, the new electronic care system being used had a reporting facility and the registered manager confirmed this was to be used by staff in the future. This allowed for immediate reporting and review by the management team, that would also record any actions taken and lessons learnt. Staff and people told us they were confident the management team would take the necessary action if they reported any incidents or accident.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored.

An assessment of need was completed before a package of care was agreed. This included visiting people in hospital to assess people’s needs and promote a smooth transition following discharge. Although care records were not complete the registered manager had established links with the local district nursing team to respond to any nursing need effectively.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. The provider shared concerns quickly and appropriately.

Staff completed safeguarding training and understood the importance of raising any safeguarding concern to the management team as soon as possible. They, and the management team knew how to recognise and report abuse. The registered manager told us they would work with the relevant external health and social agencies when a concern was raised and take appropriate action as and when required to protect people from further risk of harm.

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.

People’s risks were assessed with people and their relatives and recorded on the electronic care planning system. This included risks, associated with people’s mobility and skin care. Staff had access to this information via their smart phones and an application used for the electronic care planning system. Staff followed risk guidelines to keep people safe. For example, moving people with slide sheets while in bed.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

Although a visit to the home was completed as part of the assessment process, an environmental risk assessment was not completed. The provider could not be assured any potential risks to people and staff had been identified or addressed in any way to support the safe delivery of care. This included health and safety and fire risks. We followed this up with the provider who responded appropriately and provided a suitable risk assessment tool that was to be used in the future.

The provider did not 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 work together well to provide safe care that met people’s individual needs.

Training records confirmed staff did not complete an induction programme to ensure staff had an understanding and the relevant skills to work in home care. Staff had not worked in this area before. Records also confirmed staff had not completed all relevant training to meet the needs of people they were supporting. For example, staff supporting people needing end of life care and living with diabetes had not received specific training in these areas. Supervision or spot check visits to assess staff competence in practice were not undertaken. The provider could therefore not be assured that staff were competent or followed best practice guidelines.

The provider had ensured there were enough staff deployed to cover the hours required but had not ensured they were qualified, skilled and experienced.Recruitment records did not support a robust recruitment process. It did not follow the service’s own procedure and did not meet the legal requirements. For example, references were not always sourced from previous employers, a full employment history was not recorded. The provider could not be assured that staff had been recruited safely.

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 completed training on infection control, and the appropriate use of personal protective equipment (PPE). Staff told us they had a good supply of PPE from the office.Staff followed good infection control procedures, and these were recorded within care plans. For example, guidelines were in place to support staff to care for a urinary catheter. A relative told us, “Carers always wear gloves when providing personal care.”

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.

During the assessment we were told that people were not being supported to take their prescribed medicines. We were advised that before this was undertaken staff would receive appropriate training with competency assessments being completed.

However, we noted staff were supporting people with applying some prescribed creams and lotions. The provider could not be assured that these were being applied safely. Once this was identified, the registered manager took action to ensure appropriate records were in place to support staff to apply these safely and in accordance with its prescription. Staff training and competency still needed to be addressed, and the registered manager said this would be progressed.