Dolphin Healthcare Services

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

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good.

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key requires improvement. At this assessment the rating has changed to 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. Lessons were learnt to continually identify and embed good practice.

When accidents and incidents occurred, staff took appropriate action, including seeking medical attention. Systems were in place to review incidents in an appropriate and timely manner, these identified areas for improvement and lessons learnt were shared with staff to reduce risk to people.

Where complaints had been raised, managers reviewed outcomes and actions and discussed these openly with people and where appropriate acknowledgment by apology letter was completed.

Staff understood the importance of reporting any safety concerns and told us the office was responsive and supportive in dealing with matters raised. Relatives knew who to contact if they had any concerns about people’s care.

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.

Staff told us they had access to care plans and assessments and staff reviewed care plans before they went to visit people. Records showed people had their needs assessed and plans put in place to meet them, and these were reviewed monthly during a service review process or when things changed. The registered manager collaborated with other professionals to develop care plans when needed. People and their relatives had support from a staff team who understood their needs.

A relative told us,“Recently my loved one has been hospitalised when they were due for discharge the hospital and Dolphin Care worked well together it was a seamless discharge.”

Staff had received appropriate training and demonstrated an awareness and understanding of types of abuse people may experience. Staff told us they would report any concerns to the office and were aware of the registered managers role of being the safeguarding lead. The manager understood their responsibilities in reporting safeguarding concerns to the relevant agencies, including the local authority. However, during the inspection safeguarding concerns that had been raised had not been shared with the care quality commission (CQC) as required.

The service responded and notifications were submitted retrospectively with assurances of all actions had been completed to ensure that people were safe.

People felt safe with staff supporting them. A relative said, “So very happy with all the carers who are like family to us.”

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 who used the service had a range of risk assessments in place relating to the support they received. These covered areas such as, medical conditions, eating, drinking and mobility. Where any risks were identified, there were control measures in place to keep people safe.

Staff we spoke with were aware of people's individual risks and shared with us how they used techniques to reduce the likelihood of people being harmed when using medical equipment.

The manager reviewed incidents and information about risks regularly. Care plans were frequently updated to ensure staff had up to date information about people's current needs.

A relative told us, “We had an occasion where there was a medical error. I contacted the office, and they responded quickly and corrected the mistake and changed practices. Communication is very good.”

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

Environmental risk assessments were completed during initial assessments in people’s homes to ensure staff could deliver care safely. Where risks were identified, appropriate risk assessments were put in place and documented in care plans.

The provider had systems in place to monitor environmental safety on an ongoing basis. Spot checks and audits were carried out to ensure compliance with safety standards, and any issues identified were addressed promptly. Relatives told us they felt reassured, and a relative said, “The carers always check everything is safe before they start, and they’re very careful with the equipment."

Overall, people did not appear to experience missed or late care visits, as staff rotas were managed to ensure their needs were consistently met. However, during the inspection, we reviewed electronic call monitoring records and identified data anomalies. As these anomalies were only discovered during the inspection, we could not be assured that the existing governance arrangements were effective in monitoring these records.

People and their relatives told us staff had the right skills to do their job. They told us staff were respectful and caring in their approach.

Staff were provided with relevant training and supervision, so they had the skills they needed to undertake their role. Staff told us they were supported to undertake additional training when this was needed. Staff completed competency tests alongside their training to reinforce learning and development.

People said that overall staff were on time and only late by a few minutes if they had issues with public transport.

A relative said, “All the team know what they are doing. If a new carer starts, they job shadow the more experienced staff. The carers are very familiar with my loved one’s medical condition, and I am confident with their ability to care and support my loved one.”

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.Staff protected people from the risk of cross infection through using correct infection control practices. Staff had completed training in how to reduce the risk of infection, and they followed good practice guidance. Staff told us they used personal protective equipment (PPE), such as disposable gloves and understood how to help prevent the spread of infection. A relative said, “The staff always wear PPE we have the same team of carers that rotate without their support my loved one would not be able to live at home.” During the inspection, staff were observed collecting PPE from the office, and they confirmed that PPE was readily available and restocked regularly.

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 registered manager carried out checks on people’s medicines administration records and acted if there were any gaps in people’s medicines records. The medicines administration records were accurately completed and there was guidance for staff on how to administer medicines safely. Staff had received training and had their competency checked before they administered medicines and there was a policy in place to guide staff on how to administer medicines safely. A medicines support assessment was completed which identified the need for any topical application and body maps were used where required. There was also information about time specific medicines for staff and protocols for when people had been prescribed medicines ‘as required.’ There was a clinical lead who completed medication audits and maintained clinical oversight of nursing tasks.

A relative said, “The carers administer the medication via the [equipment] they make sure they take their time and there are no blockages.” Another said, “We had an occasion where there was a medical error I contacted the office, and they responded quickly and corrected the mistake and changed practices communication is very good.”