Hales Group Limited - Sheffield

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 provider had an accident and incident tracker in place to record safety events. Any learning was shared with staff who were involved in the learning process and understood what actions were taken to mitigate future risks. Lessons were also learnt following CQC notifications, whistleblowing and safeguarding concerns. The provider looked for opportunities to learn and evaluate the service and ways to improve 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 worked effectively with other professionals to ensure people received a seamless service. The registered manager made use of hospital discharge information and social worker assessments to ensure they understood people's needs and how they preferred their care to be delivered. One professional said, “If another organisation is involved in the care, they [Hales Group Sheffield] will contact these to discuss what they are doing for the person, discuss what Hales are doing and find the best solution. Moving forward to work together so they can both improve things for the service user on a daily basis or if Hales are taking over from someone they do their best to make sure things go smoothly.”

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. The provider had a safeguarding policy and procedure in place which was clear and informative. The service took part in a safeguarding week to promote staff awareness.

The principles of the Mental Capacity Act 2005 (MCA) were understood by the registered manager and there were processes in place to review people’s capacity in line with the MCA.The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act (MCA). We found the service was working within the principles of the MCA. One staff member said, “I have had training on the MCA, which is a legal framework designed to protect and empower individuals who may lack the mental capacity to make their own decisions.”

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. Risks associated with people’s care were identified and managed to keep people safe. For example, some people were at risk of slips and falls particularly in bathroom area where the floor could be wet. One person’s risk assessment included safety measures such as checking for obstructions, plan accessing the shower and using equipment safely, supervise with mobility and follow safe moving and handling techniques. One staff member said, “To ensure service user safety, we balance independence with protection through a proactive three-step approach: identifying potential hazards, finding ways to make desired activities safer, and maintaining a secure environment. Our primary goal is to minimize risk while empowering service users to remain as independent as they choose. There are clear, established pathways for service users to voice concerns if they feel unsafe.” However, some staff told us risk assessments were not updated frequently and often did not reflect people’s current needs. Staff knew people well and so the risk was mitigated, however we spoke with the registered manager who looked into these concerns and told us all risk assessments reflect people’s current needs.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Environmental risk assessments were in place to ensure hazards in the care environment were managed safely. This included access, pathways, steps, handrails, and lighting, floor coverings, surfaces, cleaning products, gas and electrical appliances. Fire risk assessments were also in place to identify any potential concerns regarding fire safety. These included paraffin based emollient creams, oxygen cylinders, portable heaters, and unsafe cooking appliances.

The provider made sure there were enough qualified, skilled and experienced staff. However, some staff told us they did not always make sure staff received effective support, supervision and development. We received mixed comments from staff regarding training and support they received. We reviewed the training records for staff and found it included mandatory training. Some staff commented that training was good and gave them the skills to carry out their role. One staff member said, “Training is comprehensive and ongoing, ensuring staff have the skills and confidence to perform their roles.” Historically, some staff had not found training to be effective. We found the provider had listened to staff feedback and training had improved. Some people and relatives raised concerns around the timing of their care calls and staff not staying their allotted time, whilst others had no concerns. We raised these issues with the registered manager who told us they would take action to address these issues. The provider had a recruitment procedure to ensure staff recruited were suitable to work with vulnerable people. We reviewed a selection of staff files and found pre-employment checks had been completed prior to staff commencing in post. New staff completed an induction booklet which commenced with a 5-day classroom based training package followed by shadowing experienced staff.

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. The provider had an infection control policy in place to ensure infection prevention and control were managed safely. Staff had access to PPE and care plans indicated when PPE should be used. People and relatives told us staff wore their PPE appropriately and washed their hands between tasks. One relative said, “[Staff] always wear their PPE and dispose of it properly in the yellow bags before they leave.” Another relative said, “[Staff are] spot on with hygiene. They [staff] respect that it’s the main bathroom in a family home and everything is left clean and tidy.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. People received their medicines as prescribed from staff who were trained and competent in administering medicines. Staff were knowledgeable about any known allergies, and these were documented in care plans and risk assessments. One staff member said, “I have received training in medicine management. My competencies are checked by my coordinator through observations.” One relative said, “Administered [medicines] every visit and logged in file. Carers will pick up prescription from pharmacy for me.” Another relative said, “Medicine kept in a locked safe, always given and carer stays and watches [family member] until it is swallowed.”