Andrusida Care - Hampshire

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 requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The service was in breach of legal regulations in relation to people’s safe care and treatment and the ways people’s medicines and risks were managed. Recruitment was not always safe and put people at risk of harm.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. The provider had processes in place for staff to report incidents and near misses. This included reviewing and learning from incidents and adjusting people’s care accordingly to keep them safe. Staff confirmed they would report any concerns to the office straight away.

The service 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 supported people to transition into the service including from hospital. Management told us they liaised with healthcare professionals to make sure people’s needs were met.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They 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 service shared concerns quickly and appropriately. Staff and the registered manager knew how to recognise the signs and knew what to do if they suspected someone was at risk of abuse or neglect. They could describe how they had supported a person through the safeguarding process to remain safe. One staff member told us, “Protecting clients is always a priority.” The registered manager told us how regular monitoring had improved one person’s wellbeing as they were now being kept safe.

The provider did not always work well with all people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Assessments were undertaken to identify risks to people and to the care staff who supported them. Areas covered by these assessments included risks associated with the environment, falls and moving and handling. However, these were not always comprehensive, and we found some people were at risk of harm that had not been identified or planned for by the provider. This included fire risks, risk of skin damage, safe use of compression stockings and ensuring people living with diabetes remained safe when their blood sugar levels became unstable. Staff therefore did not have all the information needed to support people to remain safe.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care. Although health and safety home assessments had been completed these had not always been sufficient comprehensive. Two people were at high risk of harm due to the increased risk of fire. For 1 person this involved the use of oxygen, limited information was in place to support staff to keep them safe. For another person their cream put them at risk of fire and the service had not explored this. We asked the provider to make a referral to the fire service due to our concerns to ensure people’s safety. We spoke with the registered manager who informed us no one used any moving and handling equipment. The registered manager understood who to contact should they feel people may benefit from additional aids or equipment and told us they would ensure staff were trained in how to use it safely.

Recruitment processes were not always followed to ensure staff were fully checked for suitability before being employed by the provider. We reviewed recruitment files for the 4 staff members. The provider had failed to always undertake the required pre-employment checks to assure themselves of staff’s satisfactory conduct in previous related employment by obtaining a full employment history. This was the case for all the staff files we looked at. The Disclosure and Barring Service (DBS) helps employers make safer recruitment decisions and helps prevent unsuitable people from working with people who use care and support services. However, the provider did not undertake these checks for staff and used staff’s previous DBS checks from their previous employer for 3 staff members. This meant they could not be fully assured that staff were suitable to work for the service. The provider’s policy did not reference the use of updated DBS checks and record how they will evidence a DBS had been check to be current. There was no risk assessment in place for staff who were using a previous DBS to ensure safe recruitment whilst an updated or new DBS was sought. Staff records included an application form, two written references and a character reference. However, for one staff member we could see no records to support their application. The provider did not keep any records of their shortlisting and interview process to show how staff had been assessed as suitable for the job role. This meant we were not assured that staff were recruited safely.

Staff received training relevant to their role and systems were in place to promote their ongoing learning and development, including regular supervision and shared learning through team meetings. Some staff told us they had also received annual appraisals to support them and felt valued by these.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. People raised no concerns in relation to infection control. Staff told us they wore appropriate personal protective equipment (PPE) whilst they were providing care. The provider had effective infection control policies and procedures in place.

The provider did not make sure that medicines were safe and met people’s needs, capacities and preferences. The provider had policies and procedures developed in line with national guidance, to help ensure staff were following best practice. However, these were not being followed. Care workers should make a record each time they provided medicines support; this must be for each individual medicine on every occasion. Medicine administration records (MARs) were requested for people’s medicines and prescribed creams. We were only shown 1 MAR chart for 1 person’s medicines which was not completed in line with national guidelines, The record did not show whether the person had received their medicines as prescribed and by whom. We did not receive any other MARs or records relating to people’s cream applications and could therefore not be assured appropriate medicine records were kept.

People’s care plans were confusing and did not detail the support people needed to manage their medicines. For example, some records stated people managed their own medicines and staff were to prompt them to take their medicines, However, people’s daily records and feedback from families and professionals showed that staff supported people to take their medicines. For 1 person using oxygen there was no medicine care plan in place to support staff how to support them safely and no records kept on how this was being administered and managed. Incomplete medicine related records increased the risk of medicine errors occurring.

We were not assured medicine competencies were in place for all staff when speaking to staff there was some confusion if these took place in accordance with national guidelines. We were then shown some competency records, but these were related to medicine support in a residential setting and not relating to care in people’s own homes. The registered manager informed us following the inspection and our feedback that they would look at their training provider and ensure staff were all re-trained in medicine management. They also planned to review everyone’s medicines and liaise with their families to ensure they were providing safe support with medicines going forward.