Carers Break Community Interest Company

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 69 (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. Staff listened to concerns about safety and reported them. However, these were not consistently investigated. Lessons were not always learnt to continually identify and embed good practice.

Records showed that accidents and incidents were documented, and staff understood the importance of reporting concerns. However, investigations did not always include sufficient analysis or follow-up to understand underlying causes. As a result, opportunities to embed learning and strengthen safe practice were sometimes missed.

Despite these shortfalls, staff told us they felt comfortable raising concerns and were confident these would be acknowledged by management.

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.

External professionals told us the service worked effectively with them and was responsive when concerns or changes in people’s needs were identified. Comments included, “Our engagement with them has been consistently positive” and “The team co-ordinator has demonstrated consistent responsiveness to all calls and emails and has attended all meetings where issues or concerns have been discussed. Their level of engagement has met expected standards”.

Summary information about people’s specific needs, risks and preferences was available to be shared with health professionals to support safe transitions of care, for example, if hospital admission became necessary.

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.

People consistently reported and demonstrated through their actions that they felt safe with their support staff. We observed people were comfortable requesting support and reassurance from staff. People told us, “They are excellent” and “Definitely felt safe."

Involved health care professionals were confident the service provided safe care. They told us, “When we do work together, communication has been clear and timely, and staff demonstrate a good understanding of people’s needs and the importance of reliability and flexibility.”

Staff had a good understanding of local safeguarding procedures and were confident any safety issues they raised would be investigated and resolved. Staff said, “Haven’t had to raise a safeguarding concern but have raised health concerns. I was happy with the actions that followed and felt listened to and supported.”

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. We checked whether the service was working within the principles of the MCA. We found that staff supported people in the least restrictive way to ensure people and their families felt in control of their care.

There were processes to ensure people were protected from financial abuse. Where the service provide support with shopping tasks, records and receipts were maintained for all purchases made.

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.

Staff were confident people were safe; risks had been assessed and were mitigated effectively. Care plans included guidance on how to support people if they became upset or anxious. Care staff said the office made sure they were aware of any updates to risk. A relative told us, “[Relative’s] situation is constantly changing …. they worked together when new equipment was needed, no one wants to have anything happen to [relative] on their watch, they always did their best.”

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 plans included environmental checklists, highlighting potential hazards such as gas, electric and water and where these could be located should they need to be shut down. This supported staff to respond appropriately and safely when working in people’s homes.

We saw examples where environmental risks had been identified and acted upon. For example, one care plan recorded risks associated with accessing the water stopcock, noting that the washing machine would need to be moved first. The provider had taken steps to reduce this risk by requesting the housing association explore extending the stopcock to a more accessible location.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The provider had enough suitably qualified skilled and experienced staff to meet people’s needs safely. Staffing levels were planned to ensure people received continuity of care and visits were delivered as scheduled. People told us staff arrived on time and stayed for the full duration of visits. Comments included, “Yes, always on time and a variety of carers. Some have moved on however I have always been really impressed by the quality of the care team,” and “They stay the full time, can’t leave [relative]. There are enough staff around at the moment, [and there’s] always a handover. It seems to work from what I have observed.”

The provider had excellent induction training, ensuring they employed the right care staff at the right time. Professionals constantly told us how well the staff team were trained, “Carers Break management place a huge importance on staff training, they [Carers Break] want their staff to be as knowledgeable, skilled and confident as possible, to ensure their staff can work alongside people and give them the best experience they possibly can” and “As a service owner, I have seen [provider] invest heavily in high quality training for the staff and spearheading an initiative focused on fast-tracking job seekers into care roles.” Care staff told us, “It was nice to be able to see how the company worked and every shadow that I did the staff member said how much they loved working for Carers Break”, and “My experience in care support training was working through the care certificate and shadow shifts, always waiting for hiccup or speedbump in the road but there’s not been one yet.”

We saw records of training provided during induction which included on-line training and face to face sessions with outsourced, bespoke trainers. The provider had training delivered by ‘lived experts’, individuals with direct personal experience of specific challenges. including epilepsy, dementia and neuro diversity. This training helped care staff develop empathetic and supportive approaches.

Staff were recruited safely and necessary pre-employment checks had been completed. Staff files contained photographic identification and full employment histories. The provider had recently implemented new software, and staff start dates had not always been clearly recorded; however, leaders assured us no staff worked unsupervised until all required checks were completed.

Supervisions and appraisals were carried out regularly. Staff told us they felt supported and able to raise concerns or seek advice when needed.

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 good stocks of Personal Protective Equipment (PPE), including gloves, aprons, and hand sanitiser. Staff told us PPE was readily available and could be replenished when needed. One staff member told us, “All provided, gloves, hand sanitiser, aprons and always able to get more when needed.” Another said, “At induction they gave us everything we needed and clear guidance on how to use it.” We noted during home visits that PPE was used and people told us, “Yes they use PPE and even have foot protectors.”

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.

Staff understood how to manage people’s medications safely and had access to clear guidance on when specific medications should be used. People told us, “They seem to know what they are doing” and “Yes, very competent.” Care staff had received training on medication; however, the provider had not carried out regular medicines observations to assess staff competence in practice. At the time of the assessment the provider produced a new observation record to carry out medication observations.

MARs were accurately completed and demonstrated people had received their medicines as prescribed. The electronic care system did not allow care workers to log out if medication had been prescribed and not administered, which reduced the risk of missed medicines.

Staff told us medication was discussed during supervisions. Staff told us “[I have] done medicine administration training and for Parkinson's medicines. I know about MAR charts and checks that need to take place.”