Newday Healthcare Professionals 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 changed to 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 regulations in relation to fit and proper persons employed and safe care and treatment. The registered manager had not completed the appropriate checks to ensure that staff were recruited safely into the service. Staff did not always assess risks to people's health and safety or mitigate them where identified. Risk assessments were incomplete and did not include risks we identified during our assessment. People did not always have detailed, accurate and up to date care plans to guide safe practice.

This service scored 47 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service did not always have a proactive and positive culture of safety based on openness and honesty. Staff did not always listen to concerns about safety and did not always investigate and report safety events.

The registered manager reviewed accidents and incidents to identify where actions where needed but care plans and risk assessments were not always updated accordingly. The registered manager told us there had only been 1 accident and incident report, and this was the only example available for review on the day of the inspection. The registered manager told us they had identified lessons learned as part of the incident review. However, there was no formal record of the lessons learned.

The registered manager did not complete an audit for accidents and incidents. This meant the service lacked ongoing monitoring and oversight of themes or trends.

The registered manager shared information with staff through staff meetings and WhatsApp. A member of staff told us, “The manager keeps us up to date with any changes and we regularly check messages on the WhatsApp group.”

The provider did not always work well with people and healthcare partners to establish and maintain safe systems of care. They did not always manage or monitor people’s safety. They did not always make sure there was continuity of care, including when people moved between different services.

The systems in place for when people move between services were not always robust.

The registered manager told us, “When we get a care package, we don’t get an opportunity to complete a formal assessment because the care packages are often required to start immediately. The care coordinator visits the person we are supporting, and we discuss the needs over the phone. I then put together the care plan based on the information the care coordinator has shared with me.” Although the registered manager shared information with staff through a WhatsApp group, there was no formal written initial assessment in place for anyone using the service. This meant staff did not have clear, documented information about people’s needs, risks or preferences, which limited their ability to deliver safe, person‑centred care from the outset.

The service 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 service shared concerns quickly and appropriately.

The registered manager had raised safeguarding concerns appropriately and had worked with the local authority to investigate these to ensure people were being safeguarded.  Staff understood how to recognise the signs of abuse and could describe the actions they would take to safeguard people including informing other agencies if they were concerned about action being taken. A staff member told us, “I would report to my manager, and I would escalate to local authority if I needed to.”

Risks to people's safety and wellbeing were not fully assessed and recorded. Management plans did not provide enough detail as to how identified risks should be managed and mitigated. For example, a person who had dementia did not have a care plan in place to guide staff on how to support them with this condition. Dementia affects memory, communication and understanding, people require clear, personalised guidance to ensure safe and consistent care. Without this, staff did not have the information needed to meet the person’s needs effectively

People's care plans and risk assessments were not personalised, with the information staff needed to provide support safely.A person who had recently had a catheter fitted following a hospital discharge did not have their care plan or risk assessment updated. This meant staff did not have information about catheter care and associated risks, increasing the potential for unsafe or inconsistent practice.

People received personal care and support in their own homes. Although environmental risk assessments had been completed, people and relatives told us they had not seen these in place to guide staff on how to keep people safe and minimise risks within their home environment.

The registered manager told us, ''We involve families and health professionals when formulating and reviewing the care plans and work closely with them on a regular basis.'' However, we found risks to people's safety and wellbeing were not fully assessed, recorded, or provided enough detail as to how identified risks should be managed and mitigated.

The registered manager had not always ensured staff were safely recruited. We saw gaps in the recruitment files we looked at, such as no full employment history. The registered manager audited the staff files and had signed to confirm that employment gaps had been checked, however, this had not been completed. This meant there was insufficient assurance that all necessary recruitment checks had been carried out to ensure staff were suitable for their roles.

Although everyone had a DBS in place at the time of our assessment, the Disclosure and Barring Service (DBS) checks seen on some staff files from when they first started working had been issued by previous employers. The registered manager told us they did not carry out their own DBS check if the existing certificate was within six months of the employee starting work. DBS checks provide information including details about convictions and cautions held on the Police National Computer and help employers make safer recruitment decisions. This meant the provider could not demonstrate they had completed a full and robust recruitment process for all staff when they first started working.

Staff told us they were supported with an induction and were given the opportunity to shadow more experienced staff when they first started working. However, the completed induction records on staff files had only been signed off by the registered manager and did not include any information about shadow shifts, limiting assurance that staff were adequately supported when starting their roles.

There was enough staff available to provide safe and consistent care to people safely.

The service 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 undertaken infection prevention and control training and were provided with personal protective equipment (PPE) which could be collected from the office. A member of staff told us, “I wear PPE when required, such as gloves and aprons during personal care and masks if needed.” A person told us, “All staff wear PPE, and I feel very safe when they are here.”

The service did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. For example, staff were administering medicines from a blister pack and daily notes recorded that medicines had been given. The care plan stated that staff were required to support the person with their medicines; however, there was no medication administration record (MAR) chart or medicines care plan in place for this person. Staff were also applying prescribed creams, but there was no documentation in place to guide staff or evidence this support. This meant there was no clear, accurate or accountable record of the medicines being administered, increasing the risk of errors and reducing assurance that people received their medicines safely.

The registered manager completed a medication audit however, this was not completed regularly which meant opportunities to identify errors, learning or improvements in medicines support were missed, limiting assurance that medicines were being managed safely.

However, staff had received training in managing medicines and had their competency checked. A member of staff told us, “I had my medicines training, and my manager carried out observations and checked my competency.” Staff we spoke to were knowledgeable about the people in the service and their medicines needs.