Arca Healthcare Limited

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 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 safe care and treatment and safeguarding service users from abuse and improper treatment.

This service scored 56 (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 did not always have a proactive and positive culture of safety based on openness. Lessons were not always learnt to continually identify and embed good practice.

The oversight and management of safety events was not always effective. Where accidents and incidents had been documented, the guidance provided to staff was not always appropriate, and they had not always been adequately reviewed and analysed by the provider for understanding and learning. This meant people were at risk of accidents and incidents not being appropriately managed.

There was a lack of an effective learning culture in other areas, as there was no information to show safety events were reviewed within staff meetings. This meant staff did not have the opportunity to share learning to improve the safety of the service.

The provider did not always ensure safe systems of care. They did not always manage or monitor people’s safety.

The provider did not have effective systems of monitoring and managing safety in the service. For example, concerns regarding the management of safety events, safeguarding and awareness of the principles of the Mental Capacity Act 2005 (MCA), had not been identified or acted upon to ensure people were consistently safe. This meant people were exposed to avoidable harm.

People and relatives told us the transition process for people before they received care from the service had been positive and effective. The provider explained what the transition process was for people, and how the information obtained during this process was used to develop people’s care records.

The provider did not work well with people and healthcare partners to understand what being safe meant to them and how to achieve that. They did not concentrate on protecting their right to live in safety, free from avoidable harm and neglect. The provider did not share concerns quickly and appropriately.

The provider failed to always adequately manage and report safety incidents that had occurred and had affected people’s health, safety and welfare. Where accident and incident records showed people had been exposed to risk of harm, these incidents had not always been adequately reviewed and analysed by leaders, nor reported to external partners, such as the Care Quality Commission (CQC) and the local authority. Failure to ensure safeguarding incidents were reported demonstrated ineffective safeguarding processes which increased the risk of a recurrence of incidents. We also found staff did not always recognise safeguarding concerns. For example, records we reviewed demonstrated staff practice caused a person to experience pain, which staff confirmed as being the case. This practice was not in line with any guidance, and the provider's failure to recognise this as a safeguarding concern exposed the person to unnecessary pain.

We checked whether the service was working within the principles of the Mental Capacity Act 2005 (MCA). Where people had been judged as lacking mental capacity to be able to consent to their care arrangements, decision-specific mental capacity assessments and best interest decisions regarding key aspects of people’s care had not been carried out to demonstrate decisions taken on people’s behalf were being taken in their best interests.

The provider did not always work well with people to understand and manage risks.

People’s care plans and risk assessments did not always provide information which accurately reflected people’s needs and risks. For example, care records did not always provide information which adequately detailed people’s communication, mental health, physical health, mobility and safety needs. Where people had mobility needs, adequate guidance was not available to staff, meaning staff unfamiliar with people’s needs might not be able to support them effectively. This exposed people and staff to the risk of harm.

Staff demonstrated an awareness of the risks associated with people and how they should be supported.

The provider detected and controlled potential risks in the care environment. They made sure equipment and facilities supported the delivery of safe care.

Staff received health and safety training and demonstrated a good awareness of how to ensure people’s home environments and mobility equipment were maintained to mitigate potential associated risks.

The provider completed observational checks of people’s home environments as part of the quality assurance checks they completed of staff.

The provider did not make sure there were enough skilled staff.

Staff had not received training which was relevant to support some people’s needs. For example, not all staff had received pressure care and buccal midazolam training, which staff confirmed as being the case. This meant people were at risk of their needs not always being met by competent staff.

Safe recruitment processes were followed, and staff received inductions and regular supervisions with leaders. People and relatives were satisfied staff demonstrated the skills they needed to provide safe care.

The provider assessed and managed the risk of infection.

The service had an Infection Prevention and Control (IPC) policy which set out the provider’s IPC expectations. Staff received IPC training. Supplies of personal protective equipment (PPE) were observed in the office, which staff told us they had access to when they needed it.

People and relatives said staff used PPE when providing care, with 1 person saying, “They always wear gloves and aprons.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

A medicines policy was in place and staff received training in safe medicines management. Staff we spoke with demonstrated a good awareness of medicines processes and people’s individual medicine needs. People and relatives told us they were happy with the medicines support they received from staff.