Roster Home Care Ltd Derby Office

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 newly registered 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.

Staff told us they were confident to report accidents and incidents, describing an open culture where concerns could be raised. The registered manager demonstrated an open and transparent approach to incidents, accidents and complaints promoting a culture of openness, learning and improvements to practice as required.

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.

People experienced coordinated care and support, which promoted their safety and well-being. The registered manager explained they worked closely with a family member and GP practice when they took on a person’s care. A relative said, “The manager rang me to say they couldn’t give medication as they needed the packaging to ensure the correct dosage. The manager contacted the GP and got the medication ordered so they had it in the packaging.” This demonstrated a collaborative approach to ensuring safety.

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. However, safeguarding concerns had not always been reported appropriately.

Relatives told us they felt their family members were safe with the care and support they received. A relative said, “Staff have been trained to use the hoist, and I believe that recently they’ve had refresher training.”

Staff understood their responsibility to protect people from abuse and neglect. Staff had received safeguarding training and were confident in raising concerns and knew how to report concerns promptly and appropriately. This helped ensure people were protected from the risk of harm.

At this inspection the provider had identified that one safeguarding incident had not been referred to the local authority safeguarding team. This meant safeguarding concerns had not always been escalated to the relevant agencies in a timely manner. The registered manager shared this incident retrospectively with the local authority safeguarding team and provided assurance that checks would be in place to ensure incidents were reported to relevant agencies in a timely manner.

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

Systems were in place to identify and plan for risks to people’s safety and wellbeing. Staff told us they followed people’s care plans and risk assessments to support people safely and consistently. Staff were also aware of their responsibilities to report concerns and described a culture where issues could be escalated appropriately.

We identified some shortfalls in risk management and record keeping. A risk assessment viewed during the inspection did not always provide sufficient guidance for staff, and records relating to fluid intake and weight monitoring were inconsistent and did not provide assurance that risks were being effectively monitored. Although no impact on the person was identified, these issues increased the risk of ineffective oversight. Following our feedback, the registered manager acted promptly to review and update risk assessments, reinforce expectations around accurate record keeping, and strengthen oversight arrangements.

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 had been completed to identify risks associated with people receiving support in their own homes before care was provided. This ensured appropriate measures were in place to promote the safety of both the person receiving care and staff providing the support. When supporting people a staff member told us, “I check the equipment to ensure there are no issues.”

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.

There were sufficient staff deployed to meet the needs of the people currently being supported by the service. Relatives spoke positively of the staff team that cared for their family members. A relative stated, “The staff do arrive in time and if they are going to be even just 10 minutes late [person] is always informed.”

Staff training was kept up to date, covering a wide range of areas relevant to people’s care needs. Staff were given opportunities of development and support through meetings and supervision with management and received feedback on how they performed and cared for people. A staff member told us, “I have completed training as part of my employment requirements including both face-to-face and online training. I find the training useful because it helps me understand my responsibilities and how to provide safe and appropriate care. Where I need clarification, I know I can ask the supervisor or manager.”

The provider completed checks when they recruited new staff, to ensure they were employing staff who were suitable for the role. These included checking previous employment history, obtaining references and Disclosure and Barring Service (DBS) checks. However, some gaps were identified in employment histories. We raised this with the registered manager who took immediate action and obtained full employment histories following the inspection site visit.

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.

People were protected from the risk of infection. The provider had systems and processes to assess and manage the risk of infection. Spot checks were completed, to ensure staff were following effective infection prevention measures.

Staff training records confirmed they had completed infection prevention and control training.

Staff explained that they had access to personal protective equipment (PPE) and disposed of this safely. A staff member told us, “I have been provided with the appropriate work requirements, including PPE, and I understand the importance of using PPE correctly when providing care.”

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.

The registered manager explained that they had recently started to provide support with medication. Where staff supported people with the administration of their medicines, relatives told us they were satisfied with the way this support was provided. One relative said, “They [management] have liaised with the GP over the medication.”

Staf had undergone competency checks and training to ensure medicines were administered safely. Processes to make sure people received their medication as prescribed were in place, including audits and daily checks. The provider had systems in place to identify any errors or omissions at the earliest opportunity, and ensure timely action was taken to mitigate risks and reduce the likelihood of recurrence. However, we found for 1 person their care plan did not always contain clear guidance for staff regarding the level of support the person required to take their medicines. This was discussed with the registered manager who took immediate action to address this and confirmed that they will ensure where medication support is provided this will consistently be reflected within the care plan.