Onecare-uk Ltd

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 69 (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.

A system was in place to report, record and monitor incidents and to help support people safely. Accident and incident records detailed the action taken following an accident or incident but there was a lack of detail around lessons learnt. We raised this with the registered manager who said that they would amend the form to include this and in future this would be documented.

Management discussed accidents and incidents with staff during meetings to help ensure staff were familiar with their responsibilities and the action to take in such an event. The provider had recently introduced and implemented PATCH meetings (Person-centred care, Accountability, Teamwork, Compassion and High Standards). These meetings were designed to help people stay safe, clean, respected, independent and listened to. Learning outcomes were shared with all staff to help ensure everyone benefited from this and the risk of it reoccurring was minimised.

Staff were able to raise concerns outside of the management team to help prevent the development of a closed culture.

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.

People’s needs were assessed before they started using the service to help ensure the service was able to meet them. People and their relatives were involved in the assessment process so that their views and wishes were considered when planning their care and support. A person told us, “I am involved in my care plans and they reflect my needs.” A relative told us, “I absolutely feel involved in my [family member’s] care.”

Staff at the service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. People had individual communication and needs passports which were reviewed when there was a change in need.

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.

Procedures were in place to help safeguard people from abuse and improper treatment. Staff were able to recognise signs and symptoms of abuse and received training to help ensure they were up to date with best practice guidance. Staff said they would not hesitate to report concerns.

People told us they were confident they were safe in the presence of care staff and were well looked after. They told us they trusted the staff that supported them. When asked if they felt safe, a person said, “I trust the carers. I feel safe with them.” Another person said, “I feel safe with the carers, they provide the help I need.” Relatives said their family members received care and support in a safe way. A relative said, “One hundred per cent, [my family member] feels safe with the carers.” Another relative told us, “[My family member]does feel safe with carers.”

The provider mostly 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.

Most risks to people were identified and managed to help keep people safe. Risk assessments covered various areas such as the environment, diabetes and moving and handling. They included detail about the level of risk but there was a lack of information about control measures in place. For example, a person had a history of a stroke but did not have a personalised risk assessment in place for this. Another person was at risk of falls and the risk assessment in place did not include detail about how to reduce the risk of falls. We raised this with the registered manager who was receptive to our feedback and took immediate action which included reviewing and updating risk assessments accordingly to ensure they had relevant information to help keep people safe.

staff completed training in areas of potential risk such as first aid, moving and handling and health and safety.

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 service was a domiciliary care agency that supported people who lived in their own homes. The provider did not have responsibility for the safe maintenance of the property or the equipment used. However, the provider had carried out environmental risk assessments of people’s homes to help ensure support was provided in a safe way.

The provider had alone‑working policy and an out‑of‑hours procedure in place, which staff could use to seek support or advice when needed.

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.

Feedback from people and relatives around timekeeping and their care calls was positive. They told us staff arrived on time and no concerns were raised in respect of this.

The provider used an electronic scheduling system to plan and monitor care visits. This enabled real time oversight of when staff arrived and left people’s homes and supported effective rota management. Regular and familiar staff attended calls wherever possible and mapping tools were utilised to ensure realistic travel times, helping ensure calls were not rushed and care was delivered safely.

Pre-employment checks were completed to ensure staff were safe to work with the people they were supporting. Staff had an interview, and their Disclosure and Barring Service (DBS) was checked and previous employment references sought. DBS checks provide information including details about convictions and cautions held on the police national computer. Newly recruited staff received an induction into the service, and opportunities for shadowing of care calls were available.

Records showed that staff had received training in areas relevant to their roles. Staff received consistent supervision sessions. This enabled management to monitor and discuss care staff’s role, performance and development.

The provider assessed and managed the risk of infection. Staff detected and controlled the risk of it spreading and were aware of the procedures to follow if any concerns had to be shared.

Staff followed infection control processes, including washing their hands, keeping people’s home’s clean and wearing personal protective equipment (PPE) where appropriate. This was confirmed by people and relatives we spoke with. A person told us, "Staff understand that I don’t like bacteria so they will always tell me that they are washing their hands as well as wearing gloves.”

Staff had completed training about infection prevention and control. Staff said they had enough PPE.

The provider mostly 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.

Medicines administration records (MARs) were completed by staff. We looked at a sample of Medicines Administration Records (MARs) and found these were mostly completed fully indicating medicines were administered as prescribed.

Where people were prescribed medicines on a when required basis (PRN), protocols were not always in place. Therefore, there was a lack of detailed instructions for staff on when to administer these medicines. We raised this with the registered manager who advised that they would review this and ensure detailed protocols were in place as appropriate. Following the site visit, the registered manager confirmed that they had implemented appropriate protocols and would ensure staff completed refresher training to help them administer PRN medicines safely.

People's medicine support needs were documented in their care plans. People and relatives told us that medicines were administered safely. A person told us, “Carers remind me to take my medication and record it.” A relative said, “Carers support with medication safely.” Another relative told us, “[My family member]has their medication in a dosette box and staff dispense it to[family member]in the morning and evening, staff do everything safely.”

Staff were trained in the safe administration of medicines.