Balby Care and Home Services 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.

At our last assessment we rated this key question Good. At this assessment the rating has remained Good.

This meant people were safe and protected from avoidable harm.

This service scored 66 (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. Systems and processes were in place to appropriately raise, report and resolve concerns about safety. The registered manager understood their responsibility to be open and transparent under duty of candour and attended meetings with other local care agency leaders to share lessons learned and implement this learning into 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 registered manager had processes in place to support people prior to using the service. This included an assessment of people’s needs, either in the person’s own home or in a health care setting. A ‘service user guide’ was also provided to people, which contained important information on people’s rights and what they could expect from the service. People’s care plans were also in paper format within their own home; this information could be taken into hospital if required.

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.Staff had received safeguarding training and had a good awareness of reporting safety concerns. One staff member told us, “If I suspected abuse of any form, I would immediately document this information and raise the concerns to my manager.” Another staff member told us, “My focus would be to ensure that the service user in question is kept as safe and supported as much as possible. I would refer to the safeguarding policy.” The registered manager understood their responsibility to report any safeguarding concerns to the local authority and to CQC.

The provider did not always work well with people to understand and manage risks. The provider did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. We found that people’s care plans and risk assessments did not always contain sufficient information to guide staff on managing risk.For one person, who was at risk of falls, the risk assessment did not contain relevant information on how staff should mitigate this risk during their care visits or how to respond to any concerns about the person’s mobility. For one person who had diabetes, we found no information around the responsibility of Insulin management, how this person presented when unwell and what actions staff should take if a decline in health was noted. The provider was in a transition period of implementing a new care system and were in the process of updating people’s care plans. The service provided assurance of their plans to ensure care plans were reflective of need and risk.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Care was provided in people’s own homes. Environmental risk assessments were completed to identify any hazards to the safety of people or the staff supporting them. Where people needed additional equipment to ensure a safe environment, referrals were made to other healthcare professionals or agencies.

The provider made sure there were enough qualified, skilled and experienced staff, whoreceived effective support, supervision and development. People told us they felt confidence in the staff who provided their care. However, we analysed the provider's electronic call monitoring data and found some concerns with logistics. We saw data indicating there was little travel time between some calls, which correlated with short calls and or staff being late. We received mixed feedback from people in relation to their care call times. One person told us, “This morning it was late, the [service] said dinner time would be 11.30 instead of 12, but it was one o’clock.” A relative also commented, “Unfortunately, it’s frequently not half an hour, and it can be a very long day for [family member]. I find it hard to believe that [staff] come, do all the duties they should be doing in 10-15 minutes.” However, people also told us, “Very rarely do [staff] not get there at a reasonable time, and they will ring us and tell us if not, but that’s on a very rare occasion.” A relative also commented, “Yes. [Staff] arrive on time. Yes, they phone me up if late.” The provider provided assurance that care call times would be reviewed for people who were receiving late or shortened care calls.

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 had access to enough Personal Protective Equipment (PPE) to allow them to carry out their role safely. People told us, “Yes, [staff] always wear gloves and aprons.” Staff told us, “Yes, there is always PPE available. You can go to the office, or the supervisor always has some for us.” Staff had also completed training in Infection Prevention and Control (IPC) and knew how to implement good practice within their role.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. People received their medicines as prescribed and told us, “Yes, [staff] see to my medication and there are no problems.” Relatives commented on staff administering medicines safely telling us, “I have no worries about [family member’s] medications, they are always given.” However, we did find care plans often lacked relevant information on how people ordered and received their medicines. The service was in a transitional period at the time of inspection and this information was feedback to the service, to ensure detail on people’s needs and preferences around medicines was recorded clearly.