Acacia 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.

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 75 (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. In addition to quarterly staff meetings, the registered manager had introduced monthly staff forums. These forums were for staff to discuss any issues that had been raised, discuss any challenges, how they felt working for the agency and what could be improved.

The registered manager understood their role under the Duty of Candour. They explained, “It is about being honest and open and own up to mistakes or incidents that happen.” They described an incident that occurred and what was done to ensure this would not happen again.

The registered manager had procedures for dealing with incidents, accidents and complaints. They investigated these and developed plans for improvements. These were shared with the staff. The staff confirmed the registered manager discussed adverse events with them so they could learn together. Relatives we spoke with told us they were well informed when things went wrong, and they were confident improvements were made as a result.

The provider had a learning culture which was adopted by all staff. When things happened, there were discussions and meetings to explore any shortfalls and systems were put in place to make improvements.

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.

The provider carried out thorough assessments of people’s needs, consulting with them, their representatives and other professionals involved in their care. The registered manager told us, “The local authority refers customers to us. We have links with the local community, the district nurses, to improve communication. We have a good relationship with the occupational therapists. They are respectful and help us with equipment for people when they need something.”

The provider supported people when they needed to transfer to another service, for example a care home or hospital. The registered manager told us, “Two clients went to different care providers. The service shared information with the local authority to ensure a smooth transfer. Some have moved to care homes.”

The service had up to date policies and procedures in place. Staff were required to read, understand and follow these.

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 told us they felt safe from harm and abuse. Their comments included, “They are very good; they come on time and I feel safe with them” and “They are very reliable; they go above and beyond. One of them helps me water my garden.” A relative agreed and said, “I trust them completely with [family member’s] care. They are observant and will make a note to the office if there are any problems.”

Staff were aware of their responsibility to safeguard people and who to contact in the event of any safeguarding concerns. One staff member told us, “I received safeguarding training on my induction. If I had any concerns regarding safeguarding I would report it to my manager by email, call or in-person” and another said, “I have completed my safeguarding training, and I also have regular refresher training. If I had a concern, I would make sure that the service user was safe, report immediately to the manager or safeguarding lead, record the facts accurately and follow our organisation’s safeguarding procedures. If I believed that someone was at immediate risk and appropriate action wasn’t taken, I would escalate the concern.”

There was a safeguarding policy in place which the staff were aware of. Staff received safeguarding training and knew how to report any concerns.

The provider was proactive in raising safeguarding concerns with the local authority and CQC. They worked with the relevant professionals to investigate concerns when incidents occurred. We saw evidence of this in the documents we viewed during our visit. The registered manager told us, “We have raised safeguarding concerns with the local authority when some people were not managing their own medicines anymore. Another person was self-neglecting.”

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. People said staff knew their needs and met these safely.

The management and staff worked well with people and professionals to manage risks. The registered manager told us, “The care workers are good at reporting any concerns to us. For example, people refusing medication, or showing distress.”

There were processes to help ensure risks to people were assessed and mitigated effectively. The registered manager reviewed each incident or accident to establish the cause and what actions were needed to reduce the risk of re-occurrence. Documents we viewed confirmed this.

There were effective systems to review care plans and ensure they were sufficiently detailed and contained key information and guidance for staff.

People were protected from the risk of avoidable harm. Where risks were identified, we saw risk assessments were in place, and these were regularly reviewed and updated.

The provider had introduced the ‘Able Assess Falls Risk Screening’ platform. This is a digital, 5-minute health evaluation tool designed to measure a person’s likelihood of falling. It integrates grip strength, lower limb strength, gait speed, and balance into a single sensor-based workflow. It provides a comprehensive approach to falls risk assessment. The registered manager told us, “Not only is this a fantastic additional tool in the mission to prevent as many falls as possible, but it has also been developed as a low-cost solution that can reach as many people as possible.”

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

The management team ensured they carried out a full assessment of people’s living environment to help ensure this was safe. Where risks were identified, the registered manager took appropriate action, which include liaising with the relevant professionals and relatives.

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.

People and relatives said they were happy with the care workers who provided care. They said they usually had regular staff who knew them well and who they could trust. They told us staff were usually on time for their visits. Their comments included, “I’m very satisfied with what Acacia do, they are always prompt and they will let me know if there is a delay”, “What I like is that they are reliable and if they are going to be late, they will let [family member] know” and “They are very good and they come on time.”

The provider carried out checks on the suitability of staff before they started working at the service. Systems in place included checks on employees’ identity, eligibility to work in the United Kingdom and Disclosure and Barring Service (DBS) checks. DBS checks provide information including details about convictions and cautions held on the Police National Computer. This information helps employers make safer recruitment decisions.

People were supported by staff who were well trained and supervised. Staff received a thorough induction before they were able to deliver care and support to people who used the service. This included an introduction to the service, policies and procedures, and training. This was followed by a period of shadowing more experienced care workers before being assessed as competent to provide care and support to people.

We viewed the provider’s training matrix which indicated all staff were receiving regular training. In addition to training the provider identified as mandatory, staff received training specific to the needs of the people who used the service, such as equality and diversity and dementia care. Staff also received training in catheter care and stoma care. This included practical learning opportunities using catheters, convenes and stoma bags. There was a training room with equipment such as a hospital bed, hoist and first aid dummy as well as a variety of slide sheets and walking aids. All training was carried out face to face.

Senior staff had achieved ‘Train the trainer certification. Train the trainer is a methodology intended to equip individuals with the ability and information required to effectively develop and deliver training programmes. A staff member told us, “I’m now doing the online course for train the trainer. I also do induction in the office for the carers. We can offer more help where carers need it.” This meant care staff received regular and prompt training and refreshers in a timely manner and as needed.

The staff were subject to regular spot checks, supervision and had their competencies assessed to help ensure they were providing good effective care to people who used the service.

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 told us they felt safe from the risk of infection and cross contamination. They told us the staff followed safe infection control practices and wore their personal protective equipment (PPE) appropriately. The staff received training in infection control and followed safe guidelines.

Staff were provided with PPE as needed. The registered manager told us, “Each new customer receives a bag with all the necessary PPE equipment. This is then the care worker’s responsibility to ensure this is always stocked. The equipment is kept at the office location.”

The provider has introduced a hand glow ultra-violet lamp as part of infection training. This is an educational and infection control tool used to assess and train people on their hand-washing technique, to ensure staff wash their hands properly. This had made staff more aware of the importance of hand hygiene.

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.

People confirmed they received their medicines correctly and as needed. The provider had processes in place to support this. Medicines administration records (MARs) were all completed in accordance with the provider’s medicines administration procedure.

Staff received training in the administration of medicines and had their competencies assessed every 6 months or more often if this was required. The administration team undertook checks to ensure when staff were due training, spot checks or competency checks, these were carried out.

The registered manager undertook monthly medicines audits. This included all the MAR charts for every person. They also ran a report of this, to identify any errors or trends. Records showed there had not been any medicines errors recently. However, they had identified that staff often failed to record when ‘As required’ (PRN) medicines had been administered. As a result, they had addressed this with all staff, and further training had been offered to help ensure this would not happen again.

Some people were able to self-administer their medicines. Some had family members filling in Dosette boxes for them. We saw appropriate risk assessments were completed appropriately and regularly reviewed and updated.