Metro Homecare 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 Good. This meant people were safe and protected from avoidable harm.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Safety was a priority for those working at the service.

Staff understood their responsibility to report incidents and concerns. Staff documented accidents and incidents involving people and escalated concerns to the management team. Incidents and concerns were reviewed appropriately to identify any learning.

Risks were not overlooked, and care plans and risk assessments addressed any concerns over people’s mobility and health. Relevant referrals had been made to address any additional support people needed to stay safe.

Staff had recognised when incidents had put people at potential risk of abuse and made the appropriate referrals and notifications.

There were systems in place to facilitate safe pathways and transfers for people. Assessments of need and risk assessments were completed during the initial assessment of care to ensure safe, effective support.

Assessments of need and risk assessments were completed during the initial assessment of care to ensure safe, effective support. Care plans captured people's health conditions and medical needs. These provided the staff with the guidance they needed to seek additional professional health support and when to make appropriate referrals to partners.

People were protected from the risk of abuse.

The registered manager was aware of their safeguarding responsibilities and to notify the CQC of any abuse or suspected abuse. Staff had the training and knowledge to ensure they could recognise when people may be unsafe and to identify potential signs of abuse. Staff understood processes for reporting these concerns and the wider responsibilities including prevention, protection and support.

Risks to people’s care and support, and the impact of any health conditions, had been largely assessed. The provider had understood, recorded and mitigated these risks. However, feedback from one person highlighted the potential risk of some staff not adhering to this.

For example, one person lived with a heart condition that left them breathless with symptoms of dizziness. Although this condition, and its risks had been identified and recorded, the person informed us that staff sometimes hurried them and rushed their support. The person said, “I do need to be given time at my own pace. Im trying to mitigate that risk.” Another person told us, “They (staff) seem like they’re in a hurry.” We fed back to the provider the concerns about staff rushing support.

Environmental risks to people had been identified and assessed. These ensured that care plans had the information staff needed to manage these risks safely. People told us that equipment was used safely, whether in use to help people mobilise or support them with bed care. One person said, “They use a slide sheet. Oh yes, they are always very careful and do it every time they see me. It gets me back up the bed.”

Environmental risk assessments were completed to ensure that staff could undertake care and support safely in people’s homes.

Assessments of the environments of people’s homes highlighted any risks or factors that could impact carers access and their ability to undertake safe and effective care. Assessments identified where hazardous materials were stored or impacted support, while appliances that might be used to provide domestic tasks were assessed.

There were enough trained staff in place to ensure people care calls were completed and to meet their needs. We reviewed the providers scheduling system and staff were provided with time to travel between calls. However, while some people were happy with their scheduled calls, other people told us they experienced late calls and an inconsistent approach from some staff that supported them.

One person said, “Its excellent, can’t knock it, they’re brilliant lads.” While one person said, “Some are lazy and some are automatic, it’s frustrating.” Another person said, “Some are not good. Sometimes it feels like training, like giving commands. Maybe it’s their own approach. Some are interested in the job. Some appear interested in the money and want to get away.”

Some people were happy with their call timings, although other people commented that calls occurred later than they expected. One person said, “Biggest issue with their timings until midday. Carers just show up and don’t call if they’re going to be late. Timings are the main issue.” Some people commented that many of their carers accessed public transport to move between care calls and this impacted timings of care. One person commented, “They don’t drive and send them miles away. Today they were late, two buses to get here and a 10 min walk. All of them catch the bus.” We fed back to the provider the issues raised by some people.

Staff were consistently recruited through an effective recruitment process that ensured they were safe to work with people. Appropriate checks had been completed prior to staff starting work which included checks through the Disclosure and Barring Service (DBS). DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

New staff completed an induction and probationary period. Staff completed shadowing shifts with established staff members prior to lone working. Training had been identified and provided to staff according to the needs of the people the service supported.

Although systems and processes were in place to prevent and control the risk of infection, and people’s experiences were generally positive, we received feedback that personal protective equipment was not always being utilised safely.

For example, one person told us that a care worker had emptied their commode before brushing the person’s teeth with the same gloves, before moving to the person kitchen. Changing of gloves between tasks is crucial to prevent the spread of germs and reduce the risk of infection for both the caregiver and the individual receiving care. We informed the provider of the feedback we received regarding unsafe practices and risk of cross contamination.

Staff had received infection prevention control and health and safety training as part of the completion of their care certificate while there was an IPC policy and procedure in place which staff could access.

Systems and processes were in place to ensure that people’s medicines were administered safely.

Staff had received training in administration of medicines. Detailed medicine care plans and risk assessments were completed to support this. These contained information on medicines management, safe storage and administration. Each peoples care plan contained details of the persons GP and pharmacy

Many people we spoke to were self-medicating or had support from family members, but those that did receive direct support from carers stated they did so safely and effectively. Some people required support to administer topical creams. These were recorded and people told us they were effectively applied and administered. At each person’s initial assessment consent forms regarding the administration of medicines were obtained from people.