Daley 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 62 (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 did not always have a proactive and positive culture of safety based on openness. Staff did not always investigate safety events. Lessons were not always learnt to continually identify and embed good practice.

The provider maintained a compliments and complaints log, which evidenced action taken to address concerns and to drive improvement within the service. Staff reported concerns appropriately around accidents and incidents. There was not always evidence that these had been fully investigated by the registered manager with action taken. For example, when medicines administration charts had not been signed. There was no formal lessons learned process to prevent safety concerns from happening again. However, we saw no evidence that people had been harmed, and staff knew people well which mitigated the risk.

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.

Pre-assessments were completed prior to people receiving a service and a guide was in place to provide additional support for the transition. Hospital passports were in place. These documents support people when they move between services such as admission to hospital. They contain important information such as people's individual communication needs.

The provider did not always work well with people and healthcare partners to understand what being safe meant to them and how to achieve that. They did not always concentrate on improving people’s lives or protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider did not always share concerns quickly and appropriately.

The training matrix showed that out of 11 staff, 1 staff member’s safeguarding training was out of date and that 1 staff member had not completed safeguarding training. The provider had a safeguarding policy in place, however the registered manager failed to identify and report safeguarding incidents we found during our inspection. This meant the provider did not receive appropriate external challenge and scrutiny to help support and drive learning within the service. Following feedback from the inspectors, the service reported 4 safeguarding incidents retrospectively to the local authority during our assessment.

The provider did not always work well with people to understand and manage risks.

Risk assessments relating to the health, safety and welfare of people using the service were not always completed. Risk assessments that were completed were not always robust and we found inconsistencies across documents. For example, there was no risk assessments in place for people who were prescribed flammable creams and emollients and people who had catheters in place. Where people were at risk of falls, there was inconsistencies across different risk assessments. This meant plans were not always in place to support people to manage risks. During the assessment the provider completed and updated risk assessments. However, there was still some work required to ensure that risk assessments were robust. People told us they felt safe at home with the support of Daley Home Care.

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 provider had assessed people’s home environment for potential risks. Staff told us that when people’s needs changed, the provider contacted professionals, such as Occupational Therapists, to request an assessment. The provider also had policies in place around safeguarding, accidents and incidents and complaints. Staff knew who to report any concerns to.

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.

Staff supervision, spot checks and competency assessments took place. However, staff training did not include all training required to meet peoples’ needs safely and effectively. For example, dementia awareness, infection prevention control, falls safety awareness, dysphagia and stroke awareness. Even though training had not been completed, we did not see incidents of harm. People had regular carers who knew people well and people told us that they were receiving appropriate support. Recruitment records showed staff were recruited safely. This included an enhanced Disclosure and Barring Service (DBS) checks for adults. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

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.

The provider had an infection control policy. The training matrix showed that out of the 11 staff members, 2 staff members infection prevention control training was out of date and 1 staff member had not completed infection prevention control training. Staff practice was observed during spot checks completed by the registered manager. People and their relatives told us that their homes were left clean by the carers.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

We found body maps were in place to provide direction for cream application. Medication risk assessments were not in place for all people receiving support with medication. Following our feedback these were put in place. PRN (as and when required) protocols were not in place during our on- site inspection. However, a template for these were implemented during the assessment. Medication administration records (MAR) did not contain sufficient detail, for example, allergies, how the medicine is takenand name of GP practice. Following our feedback some improvements were made to MAR, however there is still some work required. This placed people at risk of their medication not being administered as prescribed. Although we found concerns around medicines, we found no evidence of harm. People and relatives told us people received their medicines with the support of staff.