Craven Home Care

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.

Staff knew how to respond to an incident, felt confident to raise concerns and confirmed lessons were learnt. A staff member told us, “I record notes in the daily notes straight away and contact the office so they are aware and can investigate further. I feel very comfortable raising concerns and feel the management respond quickly and appropriately. We also debrief following incidents to discuss outcomes and any learning.”

The manager explained how trends were reviewed and actions taken following repeat incidents, including working closely with relatives and healthcare partners to address safety concerns. For example, organising referrals for people who suffered repeat falls or working with healthcare partners to have faulty equipment replaced. Information was shared with the local authority and CQC 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.

The provider had developed a service user guide which was given to people new to the service. It clearly outlined what people should expect from the service, including what staff could and could not support them with. A person using the service had helped create the guide and included details of the positive experiences they had had, to help ease people’s worries about the transition process.

People and their relatives gave positive feedback about the referral process, and confirmed staff were always introduced to people so there were, “No strangers turning up.” Information about new referrals was shared with staff during these introductions to ensure they were fully aware of people’s needs.

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.

Staff had access to safeguarding training and the provider’s safeguarding procedure provided guidance about listening to and recording concerns. The procedure signposted people, relatives and staff to the local authority and CQC.

Systems and processes were in place to protect people from financial abuse. Procedures clearly outlined what was expected from staff. Transactions were recorded and regularly checked.

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 supported people to manage risk in a person-centred way. A relative told us, “[Person] had a walking stick but wouldn’t use it. The staff were brilliant with that, and [manager] was on the phone quite a lot to work out what we could do better.”

Protocols were in place to guide staff on how to respond to behaviours that communicated a need, emotion or distress, so this was done safely in an agreed and consistent way.

Managers had transferred information to a new electronic care planning system, but we found that some risks were not comprehensively recorded, with robust strategies in place to guide staff. For example, around choking risks, catheter care or risks relating to people’s medical conditions. The manager explained additional information was sometimes kept in people’s homes for ease of access, or given to staff verbally during introductory visits.

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

Managers completed a risk assessment of people’s homes when people first started using the service and reviewed this annually. The risk assessment covered different aspects of a person’s home and any necessary safety considerations. For example, access, lighting, fire and specialist equipment.

Staff completed training in fire safety, health and safety and manual handling, to help support their knowledge and understanding of environmental risks. Staff carried out visual health and safety checks at people’s homes, and concerns about the environment or equipment was shared with relatives and the appropriate health or social care partner.
 

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 a robust employment procedure in place, and the necessary pre-employment checks were carried out.

New staff received a thorough induction which outlined their duties and the expected standards of conduct. A staff member told us, “I really liked that there wasn’t a set timeframe (for the induction), it was very much down to how I felt before I did anything on my own.” Staff without previous experience working in the care sector completed the Care Certificate to ensure they had the knowledge and skills needed to deliver safe, good quality care.

Whilst we did identify some gaps to the training matrix, managers explained most of these were due to having recently moved training providers. We were assured records would be reviewed and any missing training organised.

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 had a stock of personal protective equipment (PPE) in their homes for staff to use when required. Contingency arrangements were in place for those with compromised immune systems, to ensure support was not provided by a staff member who was unwell.

Staff supported people with cleaning and other household tasks when commissioned to do so. Time from cancelled visits was sometimes utilised to provide extra support elsewhere, to help people declutter or deep clean their homes. This was evidenced in recent feedback to the service, “Just been to [person’s] flat. [Staff] did a fabulous job on the cleaning. The flat is now completely sorted. Thanks so much for everything you’re all doing.”

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 provider had robust medication procedures, and medicines competency checks were completed with staff. People and relatives confirmed medicines were managed safely. A relative told us, “[Staff] were very conscientious about ensuring [person] had the correct medication at the correct time.”

Protocols were in place for those people who used ‘as required’ medications. Information included the medication, dose, intervals, maximum dose per day and reason for prescribing.

Managers carried out spot checks, and logged medication errors and near misses, with action taken to minimise the impact and prevent reoccurrence.